Tuesday, March 6, 2012

AND THE PATIENT SAID------

   These are some of the statements made by the patients or their  relatives that have taught me or left me with deep impressions. Some of them are funny , some of them are serious and some of them are just statements to remember.
    1. I saw this 80 year old male for the first time . He had chronic cough. When  I asked him , how long he has the cough, he said , " Now let me see, I had in 2000 , may be even before that. I think it got worst after I got divorced. " I was not sure if it was his way of remembering the time or he was just saying things just for the sake of it.  Since he was 80 , and got 'divorsed' I was little surprised. So I asked him , how long he was married , thinking that it may have been second marriage and may lasted for the short time . His answer was surprising. He was married for almost 45 or 47 years . I was more surprised , so I asked him , " What do you mean , it took you 45 years to know that 'this' one is not for you?". His answer was shocking or funny or eye opening. He said , " you know how it is , I knew it at the time of the honeymoon, that she was not 'right ' one for me. " . " So why did you wait so long ? " I asked . "Well it is like a stock, you know it is not good stock and you should sell, but  you think it may go up one day and so you continue to hold it .Same thing happened to our marriage."
    2.I saw this young lady age27 years. She was from out of town ,and had flown to this area for the visit . She started with some chest pain and came to hospital . i was consulted to rule out blood clot in the lung . She had no previous history of any medical problem or any lung issues. She was on 'birth control 'pills . As you know these can increase incidence of the pulmonary embolism ---clots in the lung . Air travel or long distance car ride can cause phlebitis-and the they can travel to lungs. After listening to her story and examining her lung I wanted to check  for the phlebitis in the legs . So I asked her if I could check her legs . She made very serious face and said , "Oh no, you should have told me earlier .," I was not too sure as to what she meant by this . So I asked, 'what do you mean ? ' She said " If I would have known , then  I would have shaved them ."
   3. She was 18 years old and came to me shortness of the breath and the cough . She came with her mother . Her chest X-ray showed diffuse infiltrates. ---congestion. Not sure I decided to do bronchoscopy and biopsy . On asking other history, I came to know that her mother owned a pet shop. She had sold it and then got home some birds as the were not the part of the inventory  of the store  that she had sold. I thought of something . Could it be an allergic reaction to the bird dropping. I ordered the blood test to confirm it or to rule it out. I did her bronchoscopy and  all the things came back OK . Instead of doing "open lung biopsy ", which would have meant major surgery, I decided to start her on steroids and told them to get rid of all the birds at once. After extensive discussion about the steroid , their side effects , precautions etc, I gave the prescription  and they left.
   At the end of the day as I was clearing the messages I saw the message 'The mother had some more questions '. When I called her her question surprised. (This was 1981)She wanted to know if she could continue giving her daughter the "birth control pills !"

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