Dolor aqui?

Because I know you're on the edge of your seat from last time, I thought I'd enlighten you today about my #2 chief complaint: hurts all over.

Me: So, in one sentence, tell me what brings you to a rheumatologist?.
Patient: Well, I had the back injury 25 years. And then there was the car wreck with really bad whiplash 17 years ago; can you believe they didn't take away his license, after hurting me like that? I mean, I could have died. And then they did that surgery 9 years ago...*
Me: I'm sorry. But why are you here today?
Patient: I was telling you,..
[I'll spare you the painful details. Ten minutes later...]
Me: So you have chronic pain?
Patient: Yes.
Me: Where does it hurt the worst?
Patient: All over.
Me: But if you had to pick one spot, where does it hurt the worst?
Patient: All over.
Me: No, it would really help me if you could take one finger and point to the spot that hurts the absolute worst.
Patient: Here. [Takes one finger and makes circular gesture from chin to knee and back.]
Me: Well, I've got great news. You don't have lupus.
Patient: What? Well then why do I hurt everywhere?
Me: It isn't lupus. Lupus doesn't do that. Lupus gives you funny rashes and ulcers and makes your hair fall out. It doesn't make you hurt all over.
Patient: But I read all about lupus on the internet!
Me: Well, the good news is that none of those things are happening to you.
Patient: Well, I don't know. I may get a second opinion.

Thank you for this interesting consultation. The patient has been seen and discussed with Dr. A, who agrees with the above assessment and plan.

Sincerely,
Beth Scholz, MD
Rheumatology fellow, PGY-4
*You have just failed my "follows simple commands" test. One sentence, people, one sentence.