A 48-year-old man presents to the emergency department with chest pain and hematemesis. History is significant for hiatal hernia, acid reflux, and a single esophageal dilatation 15 years ago for an impacted food bolus.
A 35-year-old woman, in the ED for the second time in the same day, is described by ambulance medics as "bizarre." ECG and labs are normal except for elevated urinary and peripheral WBC counts. More, here.