It’s not uncommon for me to hear, “Doc, I passed out yesterday.”  As a matter of fact, I just received that very call, only my friend passed out earlier in the week.  When a patient loses consciousness, there are long list of things I want to know:

  • Was the loss of consciousness witnessed?
  • Did he/she hurt him/herself?  What injuries were suffered?
  • Did they go to the ER?
  • Were they confused when they awoke?
  • Have they passed out before?
  • Did they experience any chest pain?
  • Did they soil themselves?
  • How are they now?

These are but a few things I need to know in order to safeguard their wellbeing.  The immediate questions I need to answer are:

  • Is there an immediate risk posed by their injuries?
  • Why did they pass out and what risk does the underlying cause pose?
  • Are they at risk of passing out again?
  • Is there any evidence of a head/brain injury?

Again, these are but a few of the things I need to know.  The possible reasons for passing out are just about anything you can think of and, particularly on the first episode, need to be investigated promptly by a physician.  You would be surprised to know that a huge percentage of men will refuse to go to the ER.  In my experience, women are much more likely to be seen in the ER because their spouses/loved ones rightly call the paramedics.

Why are women less likely to dial 911?  The answer is simple.  Men can be stubborn assholes.  My favorite and most often heard interchange between loved ones is:

Women – I’m calling 911. You need to be checked out.

Man – “I’m telling you, don’t call the paramedics!  I’m fine!  I just passed out.

Women – “I’m calling the paramedics; you don’t look fine!”

Man- “If you call the paramedics, I’ll never speak to you again.”

I want to point out two critical flaws in the above conversation.  First, there is no such thing as “just passed out.”  Passing out needs to be treated seriously until proven otherwise.

Second is that, if you stay home and die from an otherwise treatable illness or injury, you will definitely never speak to your loved ones again.  Also, you will always regret not having dialed 911.

So, if your gut tells you to call the paramedics or take a loved one to the ER, do it!  If they are mad at you for caring, at least they will be alive.  If all else fails, call your doc and ask for his/her advice.

Here’s today’s music and a joke. 

A cucumber, gherkin, and cock are sitting around discussing how fucked their lives are.

“My life sucks,” said the cucumber. “When I get big and fat, they cut me to pieces and chuck me in a salad.”

“That’s nothing,” said the gherkin. “When I get big and fat, they squash me in a jar with the rest of my family and cover me in vinegar.”

“You two are living on easy street,” said the cock. “When I get big and fat, they pull a plastic bag over my head, stick me in a dark, damp room and bang my head against the wall until I throw up and pass out.”

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