Phishing, Not Like This

He had a headache. A bad headache, he said, been hurting all morning.

"I have headaches too," I said, not impressed.

"Not like this," he replied.

"Have you had headaches like this in the past?" I asked, half paying attention to his answer.

"Not like this," he replied.

Something about him wasn't right. He was my age, maybe a little younger. His one room apartment was full of computers. The screens were dark, but I could hear them working, clicking and clacking, little blips here and there. The patient noticed my curiosity and started to move toward the door.

"What's up with all the computers?" I asked, visualizing my most recent batch of SPAM as I asked, wondering if this is where the notification that I won the lottery, my cousin was in prison in Bangladesh and needed bail money, my penis could triple in size in one day and I could live happily ever after in a vicodin fueled haze.

"You never mind," he said and started walking toward the door, quickly. We followed him outside, he locked the door and before I knew it we were in the rescue, and he had commandeered the stretcher.

All in a days work, I figured, took some vitals, his blood pressure was high, 170/100, heart rate normal and respirations where they should be. We ran a 12-lead, and that was unremarkable. The usual questions followed, he was on hypertension medication, but was non-compliant, said he couldn't afford to continue taking them.

Bad day phishing, I figured.

We took him to the ER, and I pretty much forgot about him soon thereafter. Monday mornings are relentless, the calls add up, the people making them make an appearance in my life then dissolve nearly as quickly as they appeared.

The phisherman re-appeared a few hours later, being wheeled past me by a private ambulance company as I was busy triaging a different patient. He was unconscious, and intubated.

"I just brought him to the other hospital," I sad to the guys wheeling the stretcher past me.

"He had a massive head bleed, we're taking him to the OR."

I have got to start taking these headaches more seriously.


  • John says:

    My wife had a cerebral bleed at age 27 that started the same way, so I'm always alert to the connection between headaches and cerebral bleeds. But even if you had a CAT scanner in the rig, not much we as paramedics can do for it.

  • JSalow says:

    I had a similar experience last year. Patient was a woman in her early 40s complaining of a headache. Like you I only took it half seriously, we get tons of calls for headaches that aren’t anything close to emergencies. I’m not compromising care but certainly not rushing. Shortly into obtaining her history she screams, seizes, and goes right into full respiratory arrest. Massive bleed.

    As I was securing the airway I knew I would never dismiss a headache offhand again.

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Michael Morse

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