A patient comes to the clinic complaining of a fatigue and headache. The person with him says, "he's just not a perky as he usually is."
So, I begin to interview him with the standard questions.
When did you start feeling bad?
This morning.
Where do you hurt?
Back of my neck.
Do you hurt anywhere else?
No
Has this happened before?
No.
Do you have high blood pressure?
Yes.
Any other health problems or conditions?
No.
When did you last take your medicine?
This morning.
What do you take?
2 pills.
Do you know the names?
No. I can't remember right now.
And so on, and so on......
I take his BP and its 188/111. I do an assessment and find nothing else unusual. So I get him to lay down, give him something for his headache, arrange for him to be taken home and called his doctor.
After I do all this, I go back to check on him and take his BP again. It's gone down a good bit.
You feeling any better?
A little.
Any chest pain?
No. You know I had one of those things done to my heart a few months ago (as he points to his groin.)
A heart cath?
One of those things where they go in your leg......
Did they put anything in your heart, a stent?
I don't know.
Did they give you a card to keep in your wallet? (for those who don't know, you usually get a card to carry saying what kind of stent was placed)
(digging around in his wallet) Yeah, this.
Have you been able to remember what medicines you take?
No.
But you did take them this morning?
Yes, but that is the first time in about 2 weeks. I just got it refilled yesterday.
Why didn't you get them filled when you ran out? Are you having trouble paying for them? You know, some pharmacies have some medicines for $4......I can help you.....
No, I don't pay for them, I get them from the health department.
How's your head feeling now? (because mine is about to spin around.)
Well its not as bad as when I have migraines.
*Sigh*
Why in the hell didn't you tell me about the cath, the history of migraines, and not taking your medicine for 2 weeks when I first talked to you? And, how in the hell do you not know what someone did to your freaking heart and what the names are of the freaking pills you take?
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4 comments:
"And, how in the hell do you not know what someone did to your freaking heart and what the names are of the freaking pills you take?"
Because he's an idiot.
And thank God for that, because if it weren't for people like him, I might have to get a real job. ;)
No kidding!
I don't know how many patients would do that to me.
They'd be complaining of miscellaneous ailments and deny chest pain. I'd roll into the ED and give the doc my report only to have the doc say "Are you having any chest pain?" and the patient would answer yes.
WTF? Did you suddenly develop chest pain in the last 60 seconds? I asked you repeatedly on the hour drive in?
That always throws you for a loop--and the doctor just looks at you like you're an idiot for not having asked.
Ah, yes. Looks like this fine specimen is on his way to being a Darwin Award winner someday.
What was the teeth to tattoo ratio of this dude? My nurse friend Cindy (who is a nurse) says if the dude has more tattoos than teeth he will survive catastrophic accidents.
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