"This leg is hot, doc," the ambulance medicwhistled. "Scratched the bottom of her foot three days ago. A nick.Nothing." He threw up a perplexed hand. Mrs. Anders, a 35-year-old blackwoman, brooded in her wheelchair. Vexed at the absurd injury that had landedher in the emergency room, she just wanted her leg to get better so she couldgo home to her three kids.
"Go to it," I told Kevin, my physician’s assistantstudent.
Kevin was a star, the kind of PA student who sometimes makesmedical school seem overrated.
"Get the history, examine her, then tell me your plan,"I told him, unnecessarily.
Ten minutes later he crisply read out of his little spiralnotebook, "The patient scratched the bottom of her left foot three daysago. Can’t remember what on. Yesterday it began to hurt and swell. Last nightshe felt feverish. Except for a history of depression, she has no other medicalproblems. No diabetes, no prior leg surgeries, no nothing, really. Her temp is104.6."