Archive for November, 2008

Dick Tations case files…

Posted on November 26, 2008. Filed under: Benign, Did I say that? |

This week something in a patients notes was drawn to my attention.

I had sent a lady in her late 30’s for a chest X-ray, the report that returned read…

“Chest Xray clear, no evidence of infection or abnormality, as far as I can tell this lady has a very nice chest”

“Blimey” I thought.  Did he actually mean to put all of that information into his report? Had he either forgot to switch his Dictaphone off or assumed his secretary was actually paying attention to what she was typing and would just laugh and leave that bit out.

This reminded me of some of the classics entries in medical notes. These are doing the rounds and I can not vouch for how genuine they are, but in this job you soon learn the dafter something is, the more likely it is to be true.  So for those of you that haven’t seen them…

1: No previous history of suicides.

2. Patient has left white blood cells at another hospital.

3. Patient’s medical history has been remarkably insignificant with only a 40lb weight gain in the past three days.

4. She has no rigors or shaking chills, but her husband states she was very hot in bed last night.

5. Patient has chest pain if she lies on her left side for over a year.

6. On the second day the knee was better and on the third day it disappeared.

7. The patient is tearful and crying constantly. She also appears to be depressed.

8. The patient has been depressed since she began seeing me in 1993.

9. Discharge status: Alive, but without my permission.

10. Healthy appearing decrepit 69-year old male, mentally alert, but forgetful.

11. Patient had waffles for breakfast and anorexia for lunch.

12. She is numb from her toes down.

13. While in A & E , she was examined, x-rated and sent home.

14. The skin was moist and dry.

15. Occasional, constant infrequent headaches.

16. Patient was alert and unresponsive.

17. Rectal examination revealed a normal size thyroid.

18. She stated that she had been constipated for most of her life until she got a divorce.

(Perhaps she got rid of the little sh*t)

19. Both breasts are equal and reactive to light and accommodation.

20. Examination of genitalia reveals that he is circus sized.

21. The lab test indicated abnormal lover function.

22. Skin: somewhat pale, but present.

23. The pelvic exam will be done later on the floor.

24. Large brown stool ambulating in the hall.

25. Patient has two teenage children, but no other abnormalities.

26. When she fainted, her eyes rolled around the room.

27. The patient was in his usual state of good health until his airplane ran out of fuel and crashed.

28. Between you and me, we ought to be able to get this lady pregnant.

29. She slipped on the ice and apparently her legs went in separate directions in early December.

30. Patient was seen in consultation by Dr Smith, who felt we should sit on the abdomen and I agree.

31. The patient was to have a bowel resection. However, he took a job as a stock broker instead.

 

There was also a segment in one of the GP magazines, where people write in funny occurrences, and one GP was saying how (like me), his typing goes out the window when he is running late and subsequently realised he had written a patient was to have his “arse syringed”.  A simple case of right letters, wrong order, but could have led to a particularly unpleasant colonic irrigation.

Let me know what you find…

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How to irritate your patient

Posted on November 19, 2008. Filed under: Benign |

In a recent post I identified ways in which patients can (and often do) irritate their clinicians….as such it seems only fair to reverse these roles…

The following list comes from experience of sitting in with mentors and colleagues who have irritating habits that they are probably not aware of, plus a few things I also do on occasion…not on purpose though!

So here is my list of ways to irritate patients (incidentally I don’t recommend doing any of these if you want to be liked)…this is not definitive so please feel free to add you own in the comments box, I’m sure most of you have come across at least one irritating clinician…

1: Try to maintain a conversation with your tongue rammed firmly in one side of your mouth in an attempt to supress laughing in the patients face…I was doing this only last week when my patient advised me that his piles were “much better since his autopsy…”  I assume he meant biopsy, if not he was looking extremely well for someone who had a recent autopsy.  Although I have reason to believe that autopsies do stop the pain of piles and all other discomforts!

2: Don’t put your tongue firmly in your cheek and thus laugh blatantly in the patients face, then as the dribble rolls down your chin, shout out.  “Don’t be stupid, how can an open window cause you to have arthritis in your knee!”  or some such drivel.

Looking forward to his retardment..

3: Diagnose the patient as they walk to the consulting room, as soon as you enter the room start tapping on the computer and issue a prescription and tell them to come back in a week if it hasn’t improved and at no point allow the patient to tell you why they’ve attended.

4: Lecturers in communication will tell you it is good to make positive noises when listening to a people, however you can use this to irritate your patient, by says “Hmmm” and nodding after every third word they say.  It makes this consultation go quicker.

5: Allow the patient only to see one side of your face, as you stare directly at the computer monitor, thus not notice the patients eye is actually hanging out of their face and then hand them a prescription for chloramphenicol.

6: Whilst the patient is talking, fiddle, look at your nails and rock like a loony in your chair.

7: Use fabulous terminology with no attempt to explain what it means or it’s implication and then issue a blood test form and make a follow up appointment for a months time.

8a: Ask if the patients nasty sexually transmitted infection has cleared up, in front of their new partner.

8b: Ask how your teenage patients are getting on with the pill in front of their parents who didn’t know they were on it.

8c: Ask if an elderly relative is dead yet.

9: Spend the whole consultation chatting about someone else in the family, and then give no time for the reason the patient presented.

10 : Mutter those immortal words rich in sarcastic tone: “Oh you’ll live!”.

That’s a starter…come on give us some more dearest reader…

…as always I appeal to you for any humorous goings on and if anyone wants to write an entry for this blog just email it to me, guest writers are welcome, or if you are lacking in confidence about your writing ability, but have a funny tale, tell me all about it in an email and I’ll polish it up and write it in my own daft style.

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