The black toe mystery

"So, med student, you're getting more comfortable with the physical exam?"

MED STUDENT: "Yep, definitely."

"Great. You want to take me back in to see the patient and walk me through what's going on?"

MED STUDENT: "Sure."

[And he talks me through the highlights, from head to... lower leg.]

"You know, with a diabetic patient, it's especially important to check the feet."

MED STUDENT: "Oh, his wife said he's fine."

WIFE: "Yes, he's fine. I check his feet every night."

"Okay, that's great, but I'm just going to take a quick look."

WIFE: "It's so hard for him to get his socks off."

MED STUDENT: "I didn't want to create a whole problem with the socks."

WIFE: "Yeah, it's really hard to get them back on."

"Well, let's just take a quick look, and we can get a nurse's aide to help with the socks if it's a problem."

...And we remove one sock, and his big toe is... black. Like, gangrenous, dead, completely black. The wife gasps. Audibly gasps.

WIFE: "I have never seen that. I swear, doctor, it was not like that yesterday."

"I think it probably was."

WIFE: "Well, it certainly wasn't like that a year ago."

"Okay... somewhere between a year and yesterday seems plausible..."

WIFE: "I don't understand. It was never like that. This is a sudden change. I think it's something in the hospital."

"He's been here for three hours."

WIFE: "And I think something must be going on that made his toe like that."

"I'm sorry. That's not a sudden kind of development. That's not something that happened in the past three hours. I promise you."

WIFE: "Well, it looks terrible. Are you going to have to get him a new toe?"

"Excuse me?"

WIFE: "Will he need a new toe?"

"Um... I think we're going to have to get a specialist to take a look. Why don't you put the sock back on, and we'll be back in a bit."

And as we exit the room:

MED STUDENT: "I don't mean to ask a stupid question, but... should we also look at his other foot."

Yes, uh, indeed. Yes, we should. Thanks, med student.