A woman came into work today. She had skin like alabaster, lips gone gray, and eyes so empty that you could get lost in them. She had a presence that screamed out for a hug, but made perfectly clear that she didn’t want anyone to dare try.

I wrote down:
INITIAL ASSESSMENT: Pt. pale and diaphoretic, pupils dilated. Withdrawn.

“Ma’am,” I said, “I’m a paramedic student. I would like to ask you some questions. Is that alright?”


“What day is it?”

“July second, 2004.”

“Where are we?”

“At a hospital.”

“And why are you here?”

“I don’t believe in the Fourth of July.”

I dutifully wrote it down, followed by:
NOTE: possible altered mental status.

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