Night Sweats Are *Not* Normal
It always just amazes me that there’s so much variety in the human experience. That you and I can be so genetically similar, and yet have such different backgrounds and understandings of the world. I saw a professional today in clinic for high blood pressure, and as I was going through my laundry list of questions, I found a pertinent positive:
Me: Any recent illnesses?
Him: No.
Me: Weight loss?
Him: No.
Me: Fevers?
Him: No.
Me: Chills?
Him: No.
Me: Night sweats?
Him: Yes, every couple nights.
Me: Any cough?
Him: No.
Me: And you said no weight loss, right?
Him: Right.
Me: … Okay.
And he didn’t bat an eye. I followed up skeptically: “Night sweats that soak through your t-shirt?” And again, not batting an eye, “Yeah, soaked every 3-4 days.” Taking his perspective, I guess it doesn’t seem that strange–he’s just sweating a lot at night. Maybe due to a nightmare or something. But I instantly took my own perspective–at the first sign of night sweats like that, I’d get to a doctor! (You’re probably wondering, I’d imagine. Night sweats, coughing up blood, and weight loss are the “classic” findings in a patient with tuberculosis.)
Sometimes you forget not everyone has all this information and experience. You use your medical knowledge so frequently, and the medical associations and logic become so commonplace to your brain that you start to feel like they’re as elementary and commonly-learned as addition, the state capitals, or Shakespeare. “They have temporal arteritis? Well of course they’re having vision changes. Duh! Next you’re going to tell me you didn’t know Dorothy was from Kansas!”
So we’re placing a PPD (TB skin test). Another possible point for my diagnosis pickup. Cha-ching!