James Jones is a forty year old African American male who presented to the emergency department with left sided weakness and a slight facial droop that began 10 minutes prior. He is an otherwise healthy young person who is slightly overweight but exercises three times a week. His family history includes only hypertension. He is a non-smoker and endorses only two alcoholic drinks a week. He has no previous surgical or medical history and says he has not seen a doctor since he was a child. He admits to bearing down and straining while trying to have a bowel movement prior to his symptoms appearing. His blood pressure is 140/95 and he states that he is feeling anxious. His CT scan shows no evidence of a stroke or brain bleed. James’ lab tests result with a normal hemoglobin and pt/INR. His triglycerides are within normal range. His 12 lead electrocardiogram shows normal sinus rhythm with a rate of 85. After 45 minutes of waiting James symptoms resolve and he begins to feel better. He asks if he is allowed to go home. James is surprised to learn that the doctor would like to admit him for monitoring and testing.