Thursday, January 29, 2009

The pan-positive patient

Otherwise known as the "triple P", the pan-positive patient will report that EVERYTHING is wrong with them if you ask. If they've never heard of something before (such as uterine fibroids) they will ask what that is, just to make sure that they haven't been told in the past that they have such a malady, or maybe they just want to go home and google it so they can check themselves for occult symptoms. The PPP ranges from sad to comical to simply annoying. Sad if they really do have so many illnesses that not a single organ system is healthy. Here's an example:
Me: Good Morning Mrs. Peabody, I need to ask you a few questions and review your medical history. I understand from your chart that you have CHF? and you've had a minor stroke? But you're not sure when... um. okay. So you also have hypothyroidism, diabetes, fibromyalgia, manic depression, rheumatoid arthritis, and dandruff? And you're deaf in one ear and you can't taste things that are sour? And you're a morbidly obese cocaine addict with a 3 pack a day cigarette habit for the last 40 years? Anything else?
Mrs. Peabody: I have a lump up under my left armpit halfway down to my hip. and sometimes the pads of three of the fingers on my left hand feel a little fuzzy. And sometimes I get this cramping feeling that moves from my back around to the front.
Me: Ohhhkay... so to review, you're also worried about some tingling in your hand and a back lump and abdominal cramping?
Mrs. Peabody: Yeah... I'm going in for A full body CT scan tomorrow.
Me: Umm... sounds great. I think I have that down. Any surgeries?
Mrs. Peabody: I had to have surgery after I jumped out of a 3-story window and my arm fell apart. And also a dog bit my leg to the bone and I had to get that opened up. And I had my tonsils out when I was 12.
Me: erm... okayy... so why did you come in today?
Mrs. Peabody: well, I'm having some discharge from down there, and I haven't been to the lady-doctor for about 15 years so I figured I should come get checked up on.


Note: this patient is fictional but her story isn't much of a stretch. I combined a few patients to make her but you see some crazy stuff at a county hospital. People come into the ER with a duffel bag full of meds and a complaint of "feeling lousy". Well, ma'am, you haven't gotten out of your bed except to use your bedside commode for 6 months, you drink a pitcher of margaritas several times a week, you weigh 450 lbs, and you smoke like a chimney. You can't do that to your body and expect to feel good. It's like filling a car's engine with horse manure instead of gasoline and being shocked that it won't run. ugh.

1 comment:

blue said...

"My blood hurts"
"Excuse me?"
"My blood hurts."