How to Lose $4.00

A 21 year old woman came into the ER complaining of intermittent crampy abdominal pain for the past two months. She decided to come to the ED today because she felt like her stomach was getting bigger and she just couldn’t take it anymore.

“Tell you what,” I said to the nurse who had just given me the chart. “I’ll bet you a buck that when it’s all said and done she’s pregnant.” She agreed to the wager and I went into the room to see the patient.

It turned out that she had delivered a child three months ago, but still hadn’t had a resumption of her menstrual periods. Nor did she know when her last one was before she got pregnant. She had been vomiting daily, and had been having unprotected sex. But hse maintained that there was "no way" she could be pregnant. As one of the Cardinal Rules of the ED is that anyone who says they can’t be pregnant is until proven otherwise, I told the nurse I’d double or nothing the bet to a $2.00 total .

The nurse then went in to talk with the patient she learned that the patient had been having unprotected sex, but only with a woman partner. She said she had never had sex with a man, and when the nurse indicated that she must have had some sort of momentary relations in order to account for the three month old child in her arms, she said, “the stork brought him, just like Jesus.”

I try to be respectful of others religious beliefs, but as far as I could tell, this did not appear to be a potentially Messianic scenario. I understand that Jesus came from humble beginnings, but one would think that if three kings had dropped into the middle of Daytona Beach on a warm September night, someone might have noticed.

(To be honest, though, I suspect we all think we’re the products of an Immaculate Conception. The thought of our parents actually engaging in carnal actions is really far too much to bear.)

Armed with this bit of knowledge, my level of certainty grew by leaps and bounds. I proposed another double or nothing bet, which was quickly accepted. And when the labs came back, the pregnancy test was negative, and what was really going on was an intermittent bowel obstruction related to intestinal scarring from a childhood abdominal surgery.

So I now owe the nurse $4.00, which will actually be six or seven once my debt is redeemed for some sort of fruity alcohol-based drink with an umbrella sticking through a slice of tangy citrus. I’m sure there’s some sort of lesson here about trusting the patient, not underestimating their veracity, the need to do a complete workup to exclude emergency conditions, or even about the untapped potential inherent within every child, Messianic or not. But I will tell you that I’d make that wager again any day. And next time I bet I’ll be right.