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Sometimes you end up working a holiday because you are too lazy to check the calendar. Believe it or not that’s just how I ended up working on my last birthday. Thank goodness it wasn’t my wife’s birthday. But when I entered the ER last night and saw all the hearts hanging on the walls, I realized I’d blown it again.

“Hey, honey,” I said to my wife with my most sugary sweet voice as I juggled my cell phone and swapped my overcoat for a lab coat. “Happy Valentines Day.”


“I wondered if you were going to remember it,” she deadpanned. I could see her eye roll through the phone.

“I was wondering if we could plan on going out tomorrow night, just the two of us?” I said, trying to sound romantic.

“Did you check the calendar? You work tomorrow night too.”


“I’ll make it up to you, I promise.”

“Get to work,” she said with a sigh. “I can hear the monitors beeping from here.”

What a wife, I thought in my husbandly ignorance.

My first patient was a little pre-pubescent girl of twelve. She was petite for her age and unlike so many other tweens I have seen, this youngster carried herself like a little lady. Her freckled face was scrubbed clean and her thick, auburn hair was pulled back in a neat pony tail. She sat upright with perfect posture. “Sore throat” was the chief complaint.


Accompanying the patient was her mother and a boy sitting in the corner that I presumed to be her brother, playing a hand held video game. Scanning the chart I noticed that the triage nurse had already gotten a strep screen, CBC, and a mono spot test. Sweet! I thought to myself. This is a one stop.

Even though everything was laid out for me I waited to give the results to the patient and family until after I examined the girl.

“The triage nurse noticed that in addition to your sore throat you had large swollen lymph nodes,” I said pointing to the child’s neck. “It turns out that you have a positive strep test, but you also have mononucleosis. We’ll have to adjust your antibiotic regimen a little to accommodate this, but most important you have to realize that this second problem will take longer to recover from and you’ll have to watch for some potential complications. Your home-going instructions will cover everything.”

“How did she get the mono?” the mother asked.

“It’s a virus passed in body fluids,” I explained clinically. “They used to call this ‘the kissing disease’.”

At this last phrase, the girl’s face burst into a broad smile that revealed her braces.  The mother scowled and shot a look at the boy in the corner who had been outed. The look of terror revealed that he was obviously NOT her brother, but rather her first ‘boyfriend’.

“Maybe you should tell his mother to test him, too,” I said over my shoulder while making for the door.

The next case was not so classic Americana. Or maybe it was. “I’m sorry to tell you that these sores in your vaginal area look like you have a bad case of herpes,” I told the young woman in the stirrups. “I’m sorry to have to do a pelvic exam, because it is likely to be painful. But I’ll need to check you for the possibility of other sexually transmitted diseases. You also need to inform your sexual partner so he can be tested.”

“I barely know him,” she murmured. “He’s a new boyfriend. I don’t know if I can tell him about this.”

“Well, uh,” I said somewhat baffled. “He’s likely the one who gave this to you. And if he is having sex with other people, they need to know as well.”

“Other people?” I could see tears welling up in her eyes. “He said ‘I was the one.’”

“You may be,” I tried to console her. “But the hard truth is that this disease is usually passed by sexual contact. He had to get the disease somewhere, from someone. Medicine will help mitigate the symptoms. And, if this is a long term relationship,” I said emphasizing the word IF, “you’ll need to protect yourself by using condoms religiously.”

“Religiously?” she said.

“Sorry, bad choice of words,” I said. “You know what I mean.” I completed the exam and left without much further discussion, her sense of betrayal hanging over the room like an unspoken foul odor.

“You’ve got to see this,” the charge nurse said as I came glumly out of the gyn room. She pointed with her head to a man being wheeled into a room on an ambulance gurney. He was in a bathrobe and retching violently into a large yellow bucket.

“Vomiting?” I asked. “That’s a must see?”

“No,” she said. “Get a load of his girlfriend’s outfit” She, too, was in a bath robe. But she had cat whiskers painted on her face. And the tip of something was hanging out from under the back of her robe.

“Don’t tell me,” I shook my head. “It’s a tiger tail.” The nurse just giggled.

“Looks like a Cialis commercial gone wrong. I can’t take any more ‘love’ tonight.”

“The paramedics think she tried to poison him.”


“Yeah. They arrived to find her in her little skimpy leopard nighty and he’s puking his guts up like he’s dying. They could barely get his head out of the toilet.”

“If I gave my wife one of those outfits, she’d probably poison me too,” I said. “I just hope this isn’t one of those stupid Sex Brought Me to the ER things.”

“I’m OK, I’m OK,” I heard the man repeat to his partner in between retching as they wheeled him into the room. Then I noticed they were both wearing shiny rings. Oh no, I thought. They’re married. This was hitting a little too close to home.

“How did this happen?” I asked as the nurses got IVs and antiemetics started.

“I gave her some lingerie for Valentines and she made me a cake. That’s all,” the man explained.

“I did it,” the young wife wailed. “I killed him!”

“No honey,” the man gulped, fighting back his internal revolt. “It’s just a little stomach bug. The cake was good. It really was.”

The paramedic signaled for me to step out of earshot of the patients. “Whatever made him sick is in the cake,” he said and handed me a bag with the fragmented remains.

“What did you put in this?” I asked the young woman who was now sobbing.

“Nothing,” she wailed. “I can’t cook, but I decided to try to make one of those cakes that you only have to add an egg and a half cup of sugar for the icing.”

“You can cook,” the young husband reassured his wife. “I ate several pieces and it was good.”

Impulsively I reached into the bag and swished off a piece of icing and tasted it. Pure salt. She had made the icing with a half cup of salt.

“Did you taste this?” I asked the young woman. The man shot a look at me as if I’d called her an obscenity.

“Well, it’s actually quite good,” I said with a sly wink at the husband. I saw him relax as he realized I was playing along with his loving charade. “But sweets like this can be a little rich for some people.”


“I made some of your favorite waffles for breakfast, sweetheart,” my wife called out as I entered the house the next morning. “Happy Valentines.”

I paused just to look at her. “Can I take you out to dinner tomorrow night at La Normandie?”

She looked at me quizzically. “Just the two of us, no friends, no family? No lingerie?” she said with an impish grin. I had that one coming. In 39 years of marriage to the same woman I had given my wife every goofy and inappropriate thing a husband could think of.

“Nope,” I said, “just flowers. And by the way, I think I’ve given up salt.”



FOUNDER/EXECUTIVE EDITOR Dr. Plaster has been an emergency physician for more than 30 years, working exclusively night shifts for the past 20 years in emergency departments across the country. During that period, he joined the U.S. Navy and served two tours in Iraq. Dr. Plaster is the founder and executive editor of Emergency Physicians Monthly and the founder of Plaster Publishing.

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