That was one helluva strange night. It was like the ED axis was spinning just slightly off kilter. Whatever the chief complaint was, it had nothing to do with what was actually bothering them.
Chief complaint: shoulder pain
Actual problem: Baker cyst x 3 months causing leg stiffness which resulted in a fall which resulted in the shoulder pain which resulted in exasperation over Baker cyst, which resulted in ED visit despite impending surgical consult for removal of cyst very soon.
Chief complaint: shoulder dislocation (2 weeks ago)
Actual problem: scabies (and alcohol abuse)
Chief complaint: dizziness
Actual problem: desire for expedited nursing home placement
And it went on like that.
I had the husband of an IV ABX dental abscess refuse to look at me and just kept repeating over and over again, "I want to speak to the doctor". He wasn't quite getting the concept that there was NO doctor in the department at the time and at 0100h NO doctor is going to come in from a warm bed or give orders on a patient unless the NURSE makes it happen.
Then there was the completely obtunded teen that drank himself into a bedwetting stupor. He awoke from the depths of a Silent Sam induced coma to drag himself to the ED patient washroom. He then pissed all over the floor, wall, sink and escaped out the other entrance to the bathroom. When mom arrived to pick him up a few minutes later I went to get him out of the bathroom only to find a trail of urine footprints out the other side. I did some frantic searching through the few unlocked doors on the main floor and into the basement, worried that I might find him head first down a stairwell or something. Then saw that the pissy-prints went out the front door. I offered to call the police to help find him but mom was fairly certain that he'd just wander to a friends house and pass out there for the night.
Needless to say I was more than relieved when she called to say that he'd stumbled home. Heart attack by me averted.
There was more, but I think I'll give those ones some time and space. It is a small town after all.