When taking a history from a patient, sometimes your questions get very unexpected answers.   This can happen even with what you think is a straight forward yes or no question.

I was called to the pediatric Emergency Room to evaluate a pleasant 14 year old girl with a hot swollen knee.  It was most likely an infection.  The treatment would be to tap the knee to get some fluid for cultures and tests.  If the fluid was infected it would also need to be washed out surgically.  It was always helpful to let the lab know what we were looking for so the cultures and gram stains are done appropriately.

In orthopedics, it is pretty rare to be treating venereal diseases, but at Charity, disseminated gonorrhea was a real problem.  This was caused by untreated gonorrhea getting into the blood stream and potentially causing infections anywhere, even in a joint.  It was important to know if the potential for a venereal disease was a possibility.   So, I asked her “Are you sexually active?”  She thought for a minute and answered, “No sir, I mostly just lay there.”


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