I have chest pain...

" open sesame " or is it " open says a me "  who knows.  If you do know please clue me in.  In any event the point is no matter how you say it... in the Emergency Room it's spelled " I - h-a-v-e  c-h-e-s-t p-a-i-n. "  Flat affect, crying, while laughing, with scorn or contempt it just doesn't matter how you say it as long as you can get out.  

Today I had an otherwise healthy young man, 21 years old, who according to nursing notes complained of chest pain.  When I spoke to him he complained of a sore throat.  Vague, nothing particularly concerning.  Nothing taken for discomfort and no real difficulties with eating or drinking.  When I asked him about his chest he said " oh yeah...my chest hurts 'right here' " and gestured somewhere around the middle of his chest and sort of moved his finger around.   I guess I was to assume that everything from nipple to nipple below his shoulders to his abdomen hurt.

Not one to be put off by vagaries I launched into my " where were you on the night of..." spiel.   I adroitly went from one feature to another asking for far more details than he could conjure.  Picture Bobby Fischer with a stethoscope- check and mate.   

So, realizing that he was: a. NOT SICK  b.  NOT SICK  and  c. gonna be fine no matter what I did.  I briefly explained that he was " fine " and was gonna be " fine " and could expect some improvement eventually.  I smiled, thanked him for coming and wheeled around to leave the room.  Case closed!  Now on to help other patients with varies maladies including but not limited to butt pain, toe pain, sinus congestion, insomnia, and bloated waist lines.  I long since opted for the cape free uniform...less risk of it getting caught in the door as I made my exit.  

Well, not so much.  I had a two step lead and was within a breath of being out of the door when I heard " hey doc"  It was like I was a 6 # chihuahua who had just come to the end of his leash...jerked back to reality immediately.  Forced to let go of the thought that my coffee could still be warm and I should find out.  

In any event I turned around to be courteous and asked ...Yes..??!!  That's when I was confronted with the nasty truth of the whole situation.   " Well...uh, my girlfriend..well she said the health department told her I needed to get checked for Trick.. stutter stutter "  Well as I am sure all of you know Trick = Trich or Trichomonas.  Latin for GROSSIOUS or GROSSUS.  Websters unabridged version defines it as a nasty protozoan sexually transmitted disease.  

The point is not that he had it or that he got it from his girlfriend or that he gave to his girlfriend and she didn't kill him.  The point is that this whole situation is indicative of why the cost of healthcare consumes almost 18% of the GDP.  A 4$ prescription that costs $275.00 because he feigned chest pain in order to be seen for exposure for an STD.  It's not that I mind seeing him or that he or his condition doesn't count.  It's just that not only do I need to do the right thing I have to do it after sorting through a host of bogus complaints (see chest pain).   

So, remember friends...It's chest pain.  Always chest pain and  something else.