I had three different patients infer that I was a bad doctor in one day. I’m starting to get a complex.
Oh well, at least none of them spoke in Baby Talk.
First was a patient who was 16 years old who had an aphthous ulcer (“canker sore”) in her mouth. Looks painful. Try Anbesol. Oh, the Anbesol didn’t work? Use Tincture of Benzoin to cover the ulcers and they aren’t as painful. What’s that? You need a note for missing school for the past 4 days?
“OK, what should I write as the medical reason that you weren’t able to make it to school?”
[With the eye roll] “Because I’ve been crying my eyes out in pain for 4 straight days, duh.”
“Unfortunately, I can’t write ‘crying your eyes out’ as an excuse for missing school.”
Mom and painstricken teen glanced at each other.
Then mom gathered up their things and said “Come on, honey, we’ll go to Metro Satellite Hospital and get a note. The doctors are better over there, anyway.”
Then was the mom who brought her child in after being bitten by a dog. The child had a small cut of about 1 cm on the side of his face that needed closing. The mom made it clear on several occasions that she “was studying to be a nurse.”
Before I even said “hello,” the mom said “I want him put out for this and I want a plastic surgeon to close this wound.”
“I don’t think you’ll find anyone willing to take the risk of putting your son under general anesthesia to repair a half-inch cut on his cheek. I’ll go call the plastic surgeon to see if he is available to fix it, though.”
Grandmother was in the room when I came back. I told her that the plastic surgeon was unable to come to the hospital that evening, but that he would see her son in his office in the morning and would close the wound then.
“How is he going to put him to sleep in a doctor’s office?” the mom asked.
“He isn’t,” I told her.
Grandmother chimes in “they’re just not doing these things here because they aren’t qualified.”
They left the ED and called administration to complain about me later in the day.
Finally was the man in his 70′s who had been falling … for 3 years. He had seen multiple neurologists and had been evaluated multiple times for the same symptoms. Because all doctors are dimwits who earn their money by testing and not by diagnosing, there was no official reason why the patient continued to fall. His latest round of radiation (CT scans) and laboratory testing were performed two weeks prior and showed nothing. Several doctors had recommended that he use a walker … which he refused to do. He also refused to go to a nursing home.
The patient fell again that evening, so his wife brought him in to be evaluated by me for the 27th “second opinion” of the cause of the patient’s falls.
I didn’t find anything different from the exams documented on him previously, and I didn’t see the need to engage in insanity by ordering another round of radiation and blood tests, so I told the patient and his wife that I planned to send him home.
“I want him admitted for a couple of days,” she stated matter-of-factly.
“OK, what is it that we’re going to do for him while he’s in the hospital?” I asked.
“Just watch him so he doesn’t fall.”
“You said he fell because he wasn’t using his walker. You want him admitted so the nurses can make sure he uses his walker?”
“I want him admitted anyway.”
“What’s going to happen after a ‘couple of days’ in the hospital?”
“I want him admitted.”
“If he wants to go to a nursing home, we can try to admit him to satisfy Medicare’s rules. However, you’ll have to sign a form stating you’re aware that Medicare might not pay for the hospitalization and that you will agree to pay for the stay yourself if Medicare does not do so. Or, he can stay on our extended care facility at a reduced rate if you’d like.”
She scowled at me and said “You’re not a very good doctor.”
The specter of a monetary outlay for one’s medical care had an effect on her desires, though. She took her husband back home, warning me that “he better not fall again” as the nurse wheeled the patient out to the car.
Maybe you can form a support group with Canker Sore Girl and Gramma Dog Bite.