WhiteCoat Challenge #6 – Odd Chief Complaints


I was going to just make a post about a weird chief complaint that a patient had recently, but then thought that we haven’t had a good WhiteCoat Challenge in a while.

A middle aged female patient presented at the registration window demanding to be tested for “aluminum toxicity.”
When she got back to the room, she stated that her genitals were inflamed and believed that it was caused by aluminum in the whisk that she uses in her kitchen. She called the manufacturer of the whisk and confirmed that the metal portion of it was indeed made from aluminum.

The nurse didn’t really understand why the patient thought aluminum toxicity might be inflaming her genitals. So, to make small talk, the nurse asked the patient what she had been baking. The patient cast her a strange look. She wasn’t using the whisk for baking. She was using it for … um … how should I say … um … autoeroticism.

So here’s the challenge …

List the strangest/funniest chief complaint that you’ve had.

Top three as judged by EP Monthly editors get a choice of any one product from EP Monthly’s online catalog. We’ll also try to publish as many of the top entries in an upcoming issue of EP Monthly’s print version – which is distributed to more than 25,000 emergency physicians around the country.

Contest goes through midnight Monday, June 7, 2010.

Make us laugh.


  1. I won your last contest and tried to claim my prize. I sent numerous email (as instructed) and never got a response. Is there a real prize or is this another contest with a pseudoprize?

  2. I’m an EMT, not an MD, but thought I’d share this one…in a similar vein to yours:

    50 year old male complaining of a “personal massager” stuck inside his rectum. Upon further assessment, he reports he tried using a spoon to get it out. No, the spoon didn’t get stuck in there too.

  3. Yikes. Mine…sad to say that it was also sexual. The man asks, “How could I have gotten VD(aka Gonnhorhea), we used a rubber on my tongue!”

    My response,”What did you wear on your penis?”
    Needless to say…he turned several shades of red.

  4. c/o “My feet are cold and sweaty and I can’t sleep.”
    Ummmm, any drugs on board, sir?
    “Yeah, cocaine.”

  5. I was called for a petite young lady with an open lock (bilateral TM dislocation that would not self reduce. Seems she had a new, extremely well endowed boyfriend…

  6. Nursing triage note read (and I quote) “Sat on Darth Vader”

    He had one of these: http://www.amazon.com/Action-Collection-Electronic-Figure-Kenner/dp/B000BBBX40/ref=sr_1_5?ie=UTF8&s=toys-and-games&qid=1275454109&sr=8-5 well, how shall I put it… in the dark side.

    One of my favorite professors once said “You are not in medicine until someone looks at you with a straight face and tries to explain how ‘that’ got stuck ‘there'”. He honestly tried to explain that he accidentally sat on it. Surgeon said that the arms of the doll were duct taped to it’s sides… How exactly he explained this to his wife (out of town at the time) is beyond me.

  7. Male teenager requesting testing to prove to new girfriend he has not had sex for over 4 months with anyone else.

    Find me an ICD9 for that one.

  8. Chielf Complaint: dysuria
    We had this 16 year old guy with frequent UTIs. He had several extensive workups (VCUG, ultrasounds, MRI), but no one could find anything wrong with his plumbing. He ends up in my ED yet again complaining of frequency and dysuria. Surprise! Another UTI. So I kick his parents out and point blank ask him: dude, I won’t tell your parents, but what are you sticking up there??

    It turns out that his girlfriend’s mother works for a urologist. The girlfriend found a urinary catheter and wanted to experiement with it. She’s been cathing her boyfriend, then pouring red wine up the catheter to fill up his bladder. She then wants him to ‘release’ the wine into her mouth. They’ve been using the same catheter (though he swore they cleaned it in between).

    The only thing I could think of to say was ‘why RED wine??’

    You seriously can’t make this stuff up!

  9. 40y/o male BIBEMS “because my friend’s house is near the hospital and i didn’t have a ride. i told them i have chest pain but i don’t really have chest pain. can i sign out now?”

  10. Also, how could I forget this classic?

    Woman in no apparent distress walks up to triage:

    “I had an ultrasound yesterday at my OB/GYN and the doctor said my baby was a boy. I want a second opinion.”

  11. “My mother becomes unconscious every night after going to bed…”
    “Umm.. What happens in the morning?”
    “Well… She wakes up just fine…”

    The head CT was normal.

  12. Well, I had a whole blog about this stuff, but here are a few of my favorites…

    “I went to the hair salon and the dye they used in my hair made some of it fall out.”

    Gay couple: “I brought my boyfriend in because he insists on pissing in a diaper.”

    From just a couple of days ago: “My [14 day old baby] cries during the night and keeps me awake! I think I need some sleeping pills.”

    “It’s senior prom later this week, and I can’t get rid of these zits!”

    Hypochondriac: “I think I accidentally peed on my hand, can you do some tests to find out?”

  13. Fifty-something woman complaining of “movements inside me” and wanting to be checked for pregnancy. It was her pulsing aorta shaking her fat abdomen.

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  15. Mercifully not one of my patients. E-mail from a friend who linked this “ask the doctor” website.


    My name is Carmen, about 5 Years ago I had a fairly long hair wrap around my whole eye ball, I could see it around the whole thing, I tried getting it, I got about a 1/4″ of it to stick out as the rest disappeared, I thought I had it but my eye kept moving and I lost it, it disappeared too the whole thing was gone in behind my eye, well I had totally forgoten about it. Well all these years since I have been to the Dr. I thought I had Throught Cancer because it only hurts on one side of my throat. And I have Serious Stomach and Bowel problems so I take 9 pills now for all my problems and I hate pills, Well I was watching a show on TV just a few days ago, and they showed a Diagram of the Optic Nerve. And It hit me The Hair is Wrapped aroud my optic nerve. So I went to the Dr and he Laughed at me and said “That is not possible”. I started crying I watched it go back there I told him, Then he Contradicted himself and said “It pobably worked it’s way out” I said “I have never pulled a hair out of my eye that looked like the one that whent in!” He smugly said “It probably came out while you were sleeping” Please I am in so much pain and can’t take anything but tylenol. Nobody believes me! I know it’s back there, What do I do? and it’s been 5 years of Hell, and My Quality of Life *****!

    I hope I never see that as a chief complaint

  16. My favorites from the ER has an intern.

    1. “Something crawled up my husband’s butthole and died inside!”

    (After a thorough exam wife was admitted to the psych ward.)

    2. Patient: “I think I have a tampon stuck.”
    Me: “Why do you think that?”
    Patient: “I think my boyfriend had sex with me
    last night while I was sleeping.”
    Me: “Nurse…speculum…..

  17. Chief complaint: None

    Triage note: Pt brought in by EMS from nursing home states “Why can’t I say that I’m not hungry without being brought to the ER”

  18. 16 y.o male comes into the ED. Chief complaint is ‘dysuria x 2 days’.

    He had taken the inside of a ballpoint pen and inserted it into his urethra (ballpoint part at the tip). He had tried for 2 days to get it out (including efforts with various-sized tweezers) which only caused the glans to swell more, eventually over the entire ball point (insert obvious jokes here).

    He mistakenly assumed that to go to an ED in Canada you needed a parents permission if under 18 which is why it took him TWO WHOLE DAYS to present.

    That’s what you get for trying to write with your pee pee.

    • Oh whoops. I just realised that a chief complaint of ‘dysuria’ isn’t funny at all, just the etiology of it was…ok well then my funniest chief complaint was

      “stabbed self due to mother in law”

      True story. My first Thanksgiving shift in the ED a 6 foot-blah-blah military dude comes into the ED with the above CC. He had been sharpening his carving knife beside the fridge, mother in law came around the corner, opened the fridge door and knocked his knife hand in ‘mid-sharpen’ into his left pectoral muscle.

      He was mostly concerned about how he was going to live the story down at work. Apparently his M.I.L was about 5 feet tall and 90lbs soaking wet.

      We got a good chuckle out of that reg form though, a statement probably many of us have come close to.

  19. 21 y/o female approaches triage with her hands bandaged in wet quaze. She meekly reports “I burned my fingers”. Assuming the worst, my tech kindly fills out her info for her (so she doesn’t have to write) and escorts her in.

    I begin unwrapping her fingers and ask, “How did you burn your fingers”?

    She replies, “I was cutting jalapenos. They just won’t stop stinging”.

    Cost of a Jalapeno at local market? About thirty cents.

    Getting to write “Spicy Fingers” as the Level II Trauma center cheif complaint? Priceless.

    If only the treatment was sterilization…

    • The skin of some people is really sensitive to pepper juice (capsaicin). So this is a real thing. Don’t get that juice in your eyes though!

  20. (A) – “My burps smell like farts”. From a 16 year old girl, accompanied by her “I’m a lawyer” father. Symptoms since birth. Came to ER for diagnosis since “none of the other quacks know what is going on.” Neither did I, but they thought I was the bee’s knees when I referred them to a GI doc (who probably hates me now).

    (B) – 5 year old boy with CC of “swallowed FB”. He swallowed a small christmas tree light bulb because he “I was hungry and couldn’t wait for breakfast”. Mom was making oatmeal.

    (C) – 13 year old girl brought in by mom for a “hymen check”. Girl had just told mother that her uncle had raped her the previous month. Mother didn’t believe her and wanted us to prove that her hymen was intact to show daughter was lying. When told that I couldn’t prove virginity that way, mom said I didn’t know what I was talking about because a doctor had checked HER hymen before she got married to prove she was a virgin. Yes, CPS was called.

    (D) – 36 hour old infant brought in by parents and grandmother at 7am. Had been discharged at 24hrs of life at 7pm the previous evening. CC was “up all night” crying (afebrile, eating well, etc, normal pee/poo). When told by the incredibly competent triage nurse that newborns must be fed every 2-3 hours, grandma loudly stated, “Well, all MY children slept through the night from day ONE!”. Wonder what she was drugging them with?

    (E) – 2 year old girl with a bead up her right nostril. Removed with many tears and much screaming. Two days later, same girl: different bead but same nostril. Mother was red faced, but laughing. Same nurses, same doc (me). Advised removing all beads from house.

  21. Chief complaint as seen on ED board: “Can’t get girlfriend pregnant”. However, he was not admitted to Medicine, so I did not have the fortune to evaluate him.

  22. I had a 21 year old girl show up at 2 am on a busy Saturday night. She was a week post-op from the repair of some kind of vaginal trauma resulting from the recent delivery of child number 4. Her complaint was she couldn’t find her clitoris and was worried her sex drive, obviously healthy until now, would suffer.

    Perhaps I was a bit cranky, because I told her “honey, I’ve been a doctor for almost 30 years and I still still can’t find the damn thing most of the time”.

  23. I am a Paramedic for a busy Metropolitan service.

    I have responded with lights and sirens to:

    1) “My farts smell worse than normal”

    2) “My poop is not big enough”

  24. Man comes in with GSW to foot. Cause? His wife refused to turn off the TV when he was trying to go to sleep so he grabbed his handgun from the dresser drawer to put one through the screen.

    We suspect she was watching gunsmoke.

  25. “I was asleep when I suddenly realised I had passed out”

    and another more recent one:

    “The hairs on my asshole are growing too long”.

  26. 50 year old farmer presents to triage with superficial bite to his hand from a sheep.

    A simple enough presenting complaint.

    What was entertaining was that he brought the sheep with him for it’s teeth to be checked.

  27. Thirty something fellow presents to me at the triage desk with complaints of ‘my balls hurt’.
    I ask ‘so, when did this start?’
    ’12 years ago’.
    ‘So what brings you here tonight? Is it worse?’
    ‘No, it feels like it always does, but I just couldn’t take it ANY LONGER!’

    Just as a ‘by the way’, his MBA was in the 200’s and his tox screen was NOT negative. Slept it off for a while and discharged with ‘Tylenol. Number; 3’

  28. OK, telling story on my partner here. She was making dinner and backed into the open dishwasher. She managed not to land IN the dishwasher, but she did get a knife blade in the buttock. (She puts them point up so they ‘get cleaner’. Still does it that way, too!)

    I drove her to the emergency room, where she had more personnel than necessary come in to get her story. 🙂 Oh, and she had to certify that it wasn’t domestic abuse.

    Fortunately, she healed up without complication, but they sent her to her PP for follow-up. Must have amused the residents.

    • I forgot the kicker!

      We went to a weekend mystery convention a few days later (painful car ride), and she ran out of Band-Aids. We were discussing a trip off site to a store when we spotted a table selling bandages patterned after CRIME SCENE TAPE. She still had one on her butt when she went for the follow-up.

  29. I burned off all eyelashes, eyebrows, and the front of my hair one day as a teen. Never went to the doc for that. (I was playing with model rocket fuel and it ignited in my face.)

    Oddly enough, I didn’t have ANY skin burns, anywhere. Boy, it smelled awful though.

  30. A Canadian Resident on

    When I was a med student on a Gen Surg rotation:

    Patient: “There is something stuck in my sigmoid”
    Me: “Oh. In your sigmoid? Not in your rectum?”
    Patient: “Yeah, don’t worry I checked. It’s in the sigmoid. I’m told it’s 22 inches long. I didn’t know when it was going in though, I was enjoying it.”

    The tube extended to his splenic flexure on the x-ray.

    The senior resident pulled out a double-headed rubber dildo in the OR.

    • hahahah so everyone in the ED has retained foreign body stories, but this struck a chord with me for the unique combination of the confidence behind “Don’t worry, I checked,” and the uncertainty of “I’m told it’s 22 inches long.”

      • A Canadian Resident on

        Haha, thanks, glad you appreciated it 🙂
        I think this was the only funny part of Gen Surg (can you tell I’m not a general surgeon?). The senior also requested a huge bucket to send it to pathology (not sure how necessary that was, but he wanted to give them a laugh).

  31. A patient came into the County Hospital ER carrying his own eye. Story goes that a big man behind him at the liquor store checkout had demanded that my patient buy his beer. When my patient adamantly refused, the big man somehow ripped out my patients left eye using only his big fingers.

    The patient was honored with the ‘Chief Complaint of the Week’ in the ER when he said…”Doc, my vision used to be 20/20, now its just 20.

  32. Dr. Greenbbs on

    I had a seemingly healthy 6 year old kid get dragged into the ER in the middle of the night for the chief complaint of “wet farts for 6 hours”

    Grandma and mom were notorious abusers of the ED who came in during the middle of the night for their non-urgent complaints. Apparently, the kid hadn’t had a BM in about a day or two, and then had ‘wet farts’

    We go to evaluate the kid, and he’s sleeping. No complaints. We sent him for an X-ray and he was constipated. They were pissed when we sent them home with the enema to use there because they said “So, who’s going to clean up the mess later?”

  33. Regarding a number of these entries: As a surgeon with very large hands my nickname during internship became “The Extracter” after removing rectal foreign bodies that only I could reach non-surgically. Frequent comment after viewing x-rays “how did he swallow that?”
    I had one young woman come in with a plant growing out of her right ear. (She had inserted seeds given to her by an herbal healer and gradually noticed a loss of hearing, stuffed sensation, and then increasing pain). When I told the story in the doctors’ dining room I heard colleagues stories about the plants growing from the vagina (forgotten sweet potato pessary)and nostril (child embarassed about putting in a green pea).
    I had one patient with only the handle of a large kitchen knife protruding from his forehead after an argument with his wife. It looked like a party gag except the tip of the blade was visible on x-ray touching the inner occipital skull. He was awake alert and apparently intact, even after it was removed without apparent incident in the neurosurgery OR. Creepy when his wife came to visit him in the ICU later.
    I admitted one woman for colostomy take down who had the stoma surrounded by venereal warts (with many comments made about “getting a little on the side”).
    I also had a woman come in to the ER at about 3am complaining about infirtility explaining “you don’t know how hard it is to get by on welfare with only 3 kids”. It made it more difficult to ignore her ostentatious gold jewelry and designer jeans.

  34. This was a long time ago. I saw a 78 year old spinster lady in the ER for abdominal pain. Little to go on, but performed a vaginal exam. Solid object encountered and removed. Once we cleaned it up, turned out to be a wooden spool, like thread would be wound on. When confronted with the object, she said “I wondered where that went.” She lost it two decades previously.

    Final diagnosis obstipation. I don’t know whether the foreign object removal had any…uh…impact.

  35. 24 y.o. woman with complaint-“I think my vagina had a stroke”–except she actually used a common slang term for vagina that starts with a “p”…Her boyfriend apparently was “looking down there” and told her one of her labia was much larger and lopsided compared to the other and told her to come to the ER to have it checked for a stroke.

  36. Ron Rakowski on

    “I tatooed my junk”

    Seems that after a few beers, a 17yo misguided youth felt he needed to show his girlfriend just how dedicated he was… When I asked if her name was “Ann,” he gave me a bewildered look – “heck,” I said, “that was the shortest name that I could think of!” He was too neuron-challenged to understand. And, lo’ and behold, he had taken a tatoo gun and scrawled “Jewl :)” Now, I’m no spelling-bee winner, but I believe that it was mispelled… for eternity!

    In the next room was a young lady who came in ’cause she said that she had a piece of meat stuck in her throat and every time she got her very long, manicured finger nails on it, SLIP, back down her throat it would go. She apologized for the trouble, and I told her at least she hadn’t “tatooed her private parts like a pt earlier;” she giggled. So, on exam, upon opening her mouth, there, in the back of her throat hung a very macerated uvula. I calmly told her that what she was trying to remove was supposed to be there.

    No joke, both in one night and back-to-back; oh, they were not related to one another!

  37. “He keeps oozing onto my side of the bed!”

    Middle-aged woman with h/o paranoid schizophrenia; had called police and complained that her husband had been oozing onto her side of the bed. On entering the home, a foul odor was discovered. She was correct; her husband, who had apparently died recently (but not that recent) had begun to decompose, and despite her best efforts – stuffing full paper-towel rolls under his corpse – his “fluids” had found their way to her side of the bed. Her underlying psych illness had made it difficult for her to grasp the severity and report the situation initially, but something must have made her think “enough is enough!” She mentioned, when I interviewed her (brought in as an Emergency Petition)that she believed that he had stopped breathing the month prior, but then he started again, so she declined to call 911…

  38. Michael Kirk, MD on

    Mom picked up her 7yo daughter from school and brought her right into the ER because her hands were turning blue. I took her over to the sink and washed off the blue paint.

  39. Michael Kirk, MD on

    An adult female with multiple personality disorder came in with a chief complaint of one of her other personalities sticking a pair of scissors up her private parts. Naturally, I had to ask, “Is everybody up to date on their tetanus shots?”

  40. Michael Kirk, MD on

    “I had just taken a shower and was watching TV. The lamp over the TV was out, so I changed the light bulb. Something interesting came on the TV and I sat down on my chair, nude, forgetting that I had placed the lightbulb on the chair earlier. And that’s how the lightbulb got stuck in my rectum.”

  41. Michael Kirk, MD on

    During one of my first pelvic exams in my residency I was having a very tough time getting two fingers into the patient. I commented to the patient, “Boy, are you tight”, and she smiled and replied, “Thank you very much!”

  42. Michael Kirk, MD on

    Worked up a very petite newlywed girl with pleuritic chest pain. Made the diagnosis when I was introduced to her 6 foot 3 inch 250 pound husband. My suggestion, “Stay on top”.

  43. Most interesting/strange.
    Why are you in the Emergency Department today sir?
    Answer (Completely pleasant matter of fact):”My wife thought I should be checked out”
    Why does your wife think you need to be checked out?
    “because I tried to kill her last night” by now we are into the story.
    Why did you try to kill her?
    “I don’t know”
    What did you do?
    “Took a log from the fireplace and hit her in the head”
    Is she OK?
    Yes she is at the hospital and got some stitches but she will be OK.
    Needless to say went to psych ward as wife “didn’t want him home”
    No prior episodes no psych history. Sorry don’t know the end of the story.

  44. I’m a paramedic. Had a drunk native guy complain of having dutch elm disease….’nough said. He got into an argument in the er department with another drunk native guy who thought he was jesus. It was an amusing way to end the night shift.

  45. Here’s another random one I just remembered…
    Middle-aged man with BPH comes in with a Foley cath:

    “I had to have a catheter put in…my urologist is a man, and I got a little erection when he did it…I feel really weird about that and want to talk to someone.”

    This guy turned out to be a frequent flyer with weird psycho-sexual issues.

    • I think I’ve encountered this guy. I had a fella who would call once or twice a week, ask if there was a male on, and then go into detail about his troubles with his indwelling cath. Apparently if no male staff were on, he’d just swear a lot, and hang up. He only came in a couple of times though, since he didn’t get a lot of sympathy.

  46. And I hope she NEVER bakes with it!! Just the thought of the possibility ..eww.

    There is a *book* in the making here WC. These are great!

    Do light bulbs actually stay in tact in the rectum? I can’t imagine how they even fit because they’re huge!)..but since they apparently do ..do they break into shards of glass and if they don’t ..why not? They seem so fragile and I would think just the pressure alone… Seriously ..it sounds like a Houdini trick ..not actually Houdini ..but magic.?? If this is too delicate to answer ..I understand.

    In response to #25 – Wryly’s Jalepeno post ..the first time we grew them ..I didn’t know that could happen and after cutting a whole bunch of them and freezing ..I made the mistake of touching both sides of my face and OMGosh … it B-U-R-N-E-D and I had red marks … like streaks on my cheeks. I kept putting ice on and N-E-V-E-R made that mistake again. Thankfully ..I didn’t rub my eyes! I don’t remember my fingers burning ..but the cheeks ..YIKES!

    Michael Kirk #s 46 and 48 are hilarious! 🙂

    WC ..this isn’t for contest because not as funny as others and it was a complaint to my dentist… not ED.

    I was a teenager and after having two root canals done ..I kept getting odd sensations in those teeth ..back and forth ..”almost like signals” I told him. He thought that was hilarious and then said there was no way I could feel anything after a root canal. (But I did) They stopped soon after.

    But then a couple years after that .. when I came in for a check -up, he showed me this article that he had clipped out of a newspaper. We had a good laugh because it was about a woman who claimed to be receiving radio signals in her molars. He laughed about that for a while and would ask me how the signals were. 🙂 Btw – I never said *radio* signals ..I just didn’t know how to describe the sensations because they seemed to interact with each other. Never had it for other root canals as an adult though. 🙂

    • Lots of documented cases of lightbulbs in the literature. Apparently they go in rather easily, assuming a certain amount of ‘looseness’ in the target area, and plenty of vaseline. Getting them out intact is quite another thing.

      • Thank you ER Murse.

        You’d think it would be the other way around.


        I guess no one ever thinks it will happen to them. But GLASS? YIKES!

      • It is my understanding that a broken lightbulb has to be completely reassembled in the OR, to make sure that the parts are all accounted for.

  47. My favorite chief complaint was listed as “Ants in pants.” Walk in the room and the guy is writhing all over the bed yelling different obscenities. Turns out the guy was a schizophrenic who happened to like a little cocaine on the side. For those interested, it turns out he did not have ants in his pants. :o)

  48. Elderly male presents with his demented elderly wife. He reports that he wants his wife checked for her chest pain because her cardiologist told him, the wife has “unstable vagina”…

  49. 19 yo male
    ME: “How can I help you today?”
    PT: “My friend has been sick and I have been hanging out with him and want to make sure I am not sick too.”
    ME: “What symptoms are you having?”
    PT: “I don’t have any symptoms but he is sick!”

  50. Care of Dragon transcription software:

    CC: Overdosed on fortified aliens.

    Supposed to read: Overdosed on 4-5 ambiens.

  51. Triage CC: “States tooth started hurting after her husband’s penis got stuck between her teeth and has not stopped hurting since then”. I would have understood had the husband presented with c/o pain. Drug seeking.

  52. Ok I know I am way past the dealine but I have to share. CC: I want these tested! It was about 1/4 c. worth of scabs she had picked off her arms and saved for me convinced that they were bugs she and wanted them “tested”.

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