scope 2009-FINAL.qxd_scope06Final.qxd - SIU School of Medicine

of cigarettes a day over thirty years, and he puts away a six-pack or two of beer on the
weekends.”
“And what have you done so far?” Santini asked.
“I hooked him up to oxygen by nasal cannula at two liters per minute but his lips
remain cyanotic. I gave him a sublingual nitro- glycerin tablet. I didn’t feel there was time
for an EKG the way he looked. I wanted to get this guy to the ER stat but he was too
unstable to transport by wheelchair.”
“Let’s go see him.”
Mr. Gary Boone looked like a different man as he sat on the examining table. Only
a little short of breath, he was pinker and more relaxed. “Doc,” he said to me, “I feel
better since you put this thing in my nose and that pill under my tongue, but wow— what
a headache, just like you said.” He got off the table and started getting dressed.
“Where are you going?” I asked in bewilderment.
“I’ve got to leave.”
“You’re not ready to leave.”
“Oh, I don’t want to bother you people, so if you just get me unhooked I’ll be on my
way. Thanks a lot.”
Santini gave me a puzzled look as he introduced himself to the patient. “Mr. Boone,
do you have a plane to catch?” he said, trying to inject some levity. “Seriously, though, I
must ask you a few questions. I am responsible for your care today.”
Boone sat down again. “Okay, but please hurry.”
Santini questioned him about previous episodes of chest pain. Boone’s answers were
vague. Santini keep hammering at the point. Mr. Boone, now looked down at the floor
sheepishly and then at me. My intuition told me he was about to confess to something
troublesome. Boone returned Santini’s gaze. “Sure, I‘ve had chest pains before, just not
this bad.”
“Why didn’t you mention this?” Santini asked.
“I don’t know. Look, I have to be honest with you. I don’t want to waste any more
of your time. It comes down to this. I’m not a great husband to my wife. I’ve beaten her
when I was drunk and only knew it by the bruises left on her face the next day. I know
the ticker is giving out but I hope to redeem myself in my wife’s eyes with the $750,000
dollar life insurance policy I have. I deserve this pain. Lord knows I’ve caused her years
of heartache. I just came by to pick up my wife from her appointment and got a little lost.
I came into this clinic, thinking no one was here and I would finally die. This nice lady
saw I was hurting and helped me out. But that’s as far as it goes.” He proceeded to take
off the nasal cannula, stood up, and buttoned his shirt. “I’d gotta get going. My wife will
wonder what happened to me. Can you tell me how to get to the kidney clinic? She has
bad kidneys, you know.”
I looked at Santini in disbelief and was about to say something to Mr. Boone when
Santini cut me off. His face was uncharacteristically stern. “Mr. Boone, I strongly advise
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SCOPE 2009