https://paulnystrom.com/tags/middle/Recent content in Middle on Paul NystromHugoen-usSat, 23 Aug 2025 00:00:00 +0000https://paulnystrom.com/posts/exaggeration/Sat, 23 Aug 2025 00:00:00 +0000https://paulnystrom.com/posts/exaggeration/<p>If you bring your teenager or young adult child to the ER and that person helps “sell” your symptoms to me, I feel sorry for both of you.</p> <p>Today, I saw a 42-year-old with chest pain and shortness of breath. Her daughter described how Mom “couldn’t breathe” when she woke up, and Mom reported her breathing got worse all day. You probably picture someone struggling to breathe based on that description—i.e., could not breathe in the morning, and now at 3 p.m., it’s worse.</p>https://paulnystrom.com/posts/return-to-work-notes/Sat, 23 Aug 2025 00:00:00 +0000https://paulnystrom.com/posts/return-to-work-notes/<p>Patients come to the ER for work notes, and I wish they would just be honest upfront about it rather than concoct complaints and then slip in a comment about a work note. It’s frustrating to do all the song and dance about some potential problem they have that they often have difficulty describing. Their answers to my line of questioning about symptoms sometimes don’t make sense, and I’m left scratching my head, sometimes worried there is really something sinister going on. In reality, they are only halfway paying attention because the goal is the work note, nothing more.</p>