"Well, this really doesn't look good"

Saturday I worked at my school's student run free clinic. It's located in the very poor inner-city Bronx. Thus, most of the patients have no health insurance and in fact, very limited access to any kind of routine health care. This is my third time working there. The first two times I did important, but not the most exciting jobs. I took vitals and processed specialist referrals. Yesterday I was a clinical shadow, so the day was a little more exciting. When you shadow, you basically tag along with one of the 3rd or 4th year students who are acting as physicians at the clinic. They see patients, take the history, do any physical exams, make a diagnosis and plan treatment. They then run all the information through a "real" MD who is the attending doctor for the day. The attending then makes sure the plan is sound or adjusts it as needed.

My day was pretty uneventful. The patients we saw had problems like strep throat, or needed a gynecological exam or a refill of some prescription. During one of the waits for our turn with the attending, a 4th yr student asked me if I wanted to do an EKG. An EKG is one of those electrical traces of your heart:

I said sure, I'd like to learn how to run one. So we went in and popped the little stickers onto the guy's chest and started up the machine and got the trace. The 4th yr looked at the results and I could tell that something was wrong. Her eyes got just a little bit wider when she first looked at them. So she said that she had to go talk to the attending to confirm what she thinks this is showing. When we left the room she said that she thought the guy needed to go to the ER because she thought the EKG indicated a heart attack. I asked how long ago she thought he had the heart attack. She said "No, he's having the heart attack right now."

So we showed the attending the EKG and she said "Well, this really doesn't look good." The 4th year went outside, hailed a cab and took the guy to the ER. I have no idea if he's OK nor not.