Ok today's pt beat the last one.
This morning, we were about ready to see a pt who had been having paranoid delusions and hallucinations. Some of these things may have been side effects of the anti-HIV meds this pt was on. I was kind of excited because this pt was a woman.. and you almost never see women at the veterans hospital. "Kind of a nice change," I thought. Boy did I not realize what a change this pt was... Just before we entered her room, we looked at the white board on the wall with all the pt's names on it. Next to hers was the little symbol that means female (you know what I am talking about, that little circle with a plus sign). Well, this one was kind of weird, because it had the plus sign as well as an arrow on it (like the symbol for a male). Basically, it looked like it was both the female and the male symbols put together.
No one in my group thought anything of it, except for my resident (the same guy I wrote about last time), who got very excited. He assured us that this was a purposeful combination, but we were not impressed. So, he grabbed one of the nurses (he is very buddy-buddy with all the nurses) and asked her what it meant. She explained that this military vet was formerly a man who had undergone a complete sex change operation. Dude, this guy fathered KIDS. And now... viola... he's a she. I'll call her "Francine." We went into her room, and there was this woman with well done up blond hair, thin features, but her hands looked like big man hands. The creepiest part was her face. She was only in her 50's, but her face was as wrinkled as a 95 year old. It was so wrinkly that it didn't even look like skin. She also had, unfortunately, the very skinny face that people get when they are on HIV meds (called lipodystrophy). She had a soft, womanly voice, but it was clear she was not your typical woman. As part of the mental status examination, we asked her what her name was, and she replied "the name I was born with or the one I have now?"
Anyway, that was really creepy to me. My team got in an argument over what sort of 'partner' she would prefer (bisexual man, homosexual man, do bisexual men really exist... according to my other resident, "of course they do! he has a friend who will have sex with just about anything..." I wondered if it's really his friend, or if this is one of those veiled ways that people talk about themselves when they're too embarrassed to admit something. SO GROSS!) Luckily I got out of there because I had an exam to take.
Moral for today: Some things are worse than exams.
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