Welcome back. So I was in the hospital this past week and I was seeing a lot of patients and one of

them happened to have a PE, but it really wasn't his biggest issue. It wasn't massive P.E. And the

reason he got the P.E. was really his other issues like functional decline and his kidneys were

starting to fail. An older guy and he was a bit cranky,

but nice guy, nice guy. By no means was he mean. He just was a little bit down on life and it was

understandable. But at one point he mentioned to me something kind of sad and he said,

listen, there's days where if I could just end it, I would take a gun and shoot myself.

So, of course, I called his wife, who seemed totally uninterested in everything I had to say about him.

You know, I'm telling her, he's got a blood clap, but the bigger issues, he's heading towards dialysis,

he's not sure he wants to do dialysis,

and then I mentioned that he said, if he had a gun, there's days he might shoot himself.

And for the first time in the conversations, she speaks up and says, where do I bring it?

In some days, I don't know whether I should be laughing or crying, but what I do know

is this job is always interesting. All right. So in the last lecture, we were talking about

pulmonary embolisms where I mentioned that if you think it's a false positive, like a small

PE that's not in the right place

of where the patient is having pain, you know, I think I gave the example that came in with

right upper quadrant pain, but the PE's in the left upper chest and that sub-segmental,

that you probably have a false positive and you may not want to treat that.

But what happens if you have a sub-segmental PE that you think is real?

You know, let's say it's really close to where they're having pleuritic chest pain.

The question then comes up, do you treat that patient if that's the only finding

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