A 47-year-old male with hypertension, type II diabetes, and obesity presented to the ED with complaints of difficulty swallowing and dizziness, symptoms that began early and worsened throughout the day. Notably, he had knee replacement surgery the day before and was discharged with a scopolamine patch for postoperative nausea prevention. The primary concern was anticholinergic toxicity, likely due to the scopolamine patch, a medication known to cause autonomic nervous system symptoms. Nausea and vomiting are protective reflexes coordinated by the vomiting center and the chemoreceptor trigger zone in the brainstem. Anti-nausea medications act on these pathways; serotonin antagonists (e.g., ondansetron) and neurokinin-1 antagonists (e.g., aprepitant) are commonly used in the operating room. Anticholinergic toxicity, often due to scopolamine, is managed with supportive care and benzodiazepines. This case is designed to review the basic science and clinical science of the autonomic nervous system.