One day I was trying to get ready to go to the hospital when I got a page. It was one of the orthopedic surgeons asking me to consult on a patient.
"The nurses called me and they're freaking out," said the orthopod. "The guy threw up red stuff and they're afraid he's got a GI bleed. I'm supposed to take him to the OR at nine-thirty."
I hate it when I have to clear a patient for surgery on extra-short notice. I got the hospital and was relieved to see he was a young, otherwise healthy man who'd gotten a bit drunk and fallen off a porch. He had a bimalleolar fracture that needed fixing, but what was the deal with throwing up red stuff?
"What happened?" I asked, after introducing myself.
"I don't know," he said. "They told me I couldn't have anything after midnight, so I went to bed and next thing I woke up and puked."
"Have you ever been told you had liver disease?" I asked him. My eye was on the clock, which said the guy was due in the OR in fifteen minutes.
I had a thought. "What was the last thing you had to eat or drink?"
He thought for a moment. "I had a tuna sandwich for dinner," he said, thinking hard.
He looked right at me with an aha! expression on his face. "And I drank a big thing of Kool Aid before I went to bed."
I found an emesis basin where there was a bit of residue left. It was bright, fruity red, and there was no evidence the contents had coagulated. A faint aroma of artificial sweetner arose from the basin.
I ran a stat CBC. His hematocrit was the same as it was when he was admitted. I cleared him for the OR. In my note, under Assessment, I wrote: "Probable Kool Aid ingestion." I hope we get paid for this consult.