"D.F.O.I.C."

D.F.O.I.C. : Translated from medical terminology this means "dun' fell out in church". I first learned this abbreviation working in the E.R. at a N.C. hospital. I remember a doctor explaining to me as a student that this is how patients talked about passing out. I didn't buy it at first, but slowly, with lots of listening, I heard lots of stories of how Sally Sue "dun' fell out". And often it was in church. Picture the crowded room, fans on. Sally Sue has been up since early morning cooking and getting ready for a long church day. Then Sally Sue stands, sings, sits, prays her way through a service. As her blood sugar gets lower, the building gets warmer. Long and short of it, she passes out and ends up in the ER. Doctors get to determine if she had a heart attack, or a stroke, or simply couldn't handle the long sermon that day. Interestingly enough, even the emergency room in Philadelphia used the DFO as a patient descriptor. (I assumed the southern terminology limited its' use.)

We had a DFO in our church today. A real one. A good one; not the stories I often heard where I wasn't sure if they passed out or simply dozed off for a bit. A gentlemen fell over abruptly during Sunday School while seated. He was pale as a sheet with a true green hue. His pulse was thready and slow. After a bit he could answer questions, but just barely. He was sweaty and kept complaining of nausea. Our fellow church people filed out of the room. An ER doctor, myself and a nurse practitioner attended to the man. He was coming around, but really not so quickly. Nausea and sweating in a 50 something year old man is always a good bet for a heart attack. But his wife said that it was actually the announcement about the church blood drive had made him ill. He hates the thought of needles. I knew he was a cyclist, a math professor, very active. We found out he took a baby aspirin that morning. The paramedics arrived and his blood pressure started to creep up a bit towards normal. We were able to obtain a normal heart tracing for him. After about twenty minutes, we were able to walk him out of the building.

And here is the part that shows how I really made it through med school: I had so much fun today. It was so fun to do real medicine with friends and for a friend. It was so good to think through all the options: what it could be, what we could do for him without any medical equipment. Because we knew him and could take our time, check a rhythm strip, we were able to save him a trip to the ER today. Anywhere else, without any doctors around, in this litigious environment, he would have quickly been hauled to the ER without a thought. All in all it was a good DFOIC and a good reminder that I occasionally love to use my medical brain.