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Early in my professional life it became apparent that I would have the wonderful opportunity and honor to care for patients with a wide variety of illness and injuries. I started to collect medical images with the express intent of utilizing them to educate medical students, residents and fellow colleagues. The patient cases presented in this book pose unique diagnostic and therapeutic clinical challenges.

The practice of Emergency Medicine has changed dramatically over the course of my career. Medications, medical imaging, procedural equipment, and medical knowledge have significantly transformed the specialty of Emergency Medicine. The clinical management of the cases presented in this textbook represent what was the standard of care at the time the case occurred. The reader should realize that a given case might very well be managed considerably differently at the current time.

The cases presented in this book span a period over 36 years. I would like to sincerely thank the patients for allowing images related to their illness or injury to be obtained. Great care has been taken to present cases confidentially, and some specific case details have been excluded to prevent patient identification. Cases are not presented in chronologic order, so the given patient age does not correspond to any particular time period. The images have been screened for individual patient identification content, and the metadata associated with each digital image was removed.

There is a wide variation in the clinical, intellectual, and emotional aspects of the presented cases. All are presented with the express intent of education.

In caring for my patients, I adopted a personal philosophy early in my career summed up by the axiom “There but for the grace of God go I.” I present these cases with that understanding and mindset.

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