Tuesday, September 3, 2013

Psych, MD...not!

So, here's the deal. I went through a LOT of schooling and training to be a doctor. I'm not bragging; I'm stating a fact. I have learned a lot, because, let's face it, there is a lot to learn. And there is plenty more still I haven't learned. One of these things I haven't yet mastered (and I am going out on a limb to say I never will) is how to read minds. I know it may seem like it when I can spot nursemaid's elbow across the room, or guess rashes from the age of the child (a fun game we liked to play in clinic). Some things are just more common than others. But the truth is, if you don't tell me certain things when you bring your kid in to see me, I am not going to be able to provide good care.

The following are true stories (or compilations of multiple similar stories), with very little changed to protect patient privacy.
Me: Any medical problems?
Dad: Nope.
Me: Any medicines she takes on a daily basis?
Dad: Oh, the Synthroid for hypothyroidism.
Me: Any hospitalizations?
Dad: That one time for asthma.

Oh, I guess those don't count.
Me: Does she get headaches?
Mom: No
(An hour and a half later after treating with ibuprofen and fluids)
Mom: What is going on? This is just like what happened before?
Me: Oh, has this happened before?
Mom: Yeah, we went to the doctor. Here's what they said. (Hands me discharge instructions from Neurology Clinic saying the patient has migraines.)
Me: So she has migraines?
Mom: What's that?
Hmmm....
Me: Medical problems that run in the family?
Parent: Nope.
Me: Anybody with asthma?
Parent: Oh yeah, I had that as a kid.
Me: Eczema? Allergies?
Parent: Oh yeah, all the kids have those.
Me: Any of the kids have asthma?
Parent: Her two sisters do.
Maybe I should have just skipped the first question.
Me: Anybody else been sick?
Mom: Nope
(10 minutes later after I finish my exam and diagnose Hand, Foot, and Mouth)
Mom: Oh, about a week ago I had these blisters in my mouth that were awful, and I had these spots on my hands. I thought it was an egg allergy.
I really wish I was making this up.

People get mad when they have to tell the same story over and over again--to the triage nurse, the ED nurse, me, the admitting team, the consultants, etc. But the truth is the story keeps changing. And if someone asks a question in the right way, they get the right answer.

I get it, it's a stressful situation and sometimes people forget. But sometimes people just aren't taking responsibility for their own or their child's health. It's dangerous to assume that we know more than you about you or your child. Knowing the history makes a huge difference and can sometimes be the deciding factor in whether you get an ineffective or even harmful treatment.

So please, know your own medical history, your family's medical history, and especially your children's medical history.

That way I don't have to guess.

Even though I can sometimes be a pretty good guesser.

2 comments:

Michelle said...

Do we have to know Mom's medical history? Cause I think we're screwed. Maybe we can just call it an egg allergy.

Jim Z said...

Good one Michelle.

As for me... I have no medical history that I recall. As a matter of fact...Who's the president again?