1. Short of Money
During my round, I asked one of my patients if he was short of breath. He replied “No, I am short of money.”
2. Oriented…Only for a Moment
A patient of mine with cognitive impairment was only oriented to person, but would never knew the place or date. One morning she was admitted with pneumonia and I was checking on her. As part of my exam, I asked her about the date. To my big surprise, she answered correctly the year, the month, and even the day. However, my surprise faded away when I found her starring on a script on her room board. On that script, her nurse had already written the date of that day.
3. The Translator
When I started my residency of internal medicine at a hospital in North East of New York, I did not have any knowledge of Spanish language. In the clinic, translators, some of who were volunteers, used to assist doctors to take history and explain recommendations for only-Spanish speaking patients. The clinic was divided into three modules. It was my first day in the clinic where I was assigned to the first module. Not fully oriented to the place yet, I went to the third module instead. When I called my first patient, of course, no body was responding as that patient was waiting in the first module. Finally, an old lady in her 70’s, as if waking up from a nap, raised her face up and asked “do you need me?” Thinking that she was the patient, I answered “Yes, I have been calling you. Your name is Maria, right?” She said “Yes”. So, I introduced myself and led her to the examination room. There, I preceded into the routine medical interview questions. “What brought you here?” I asked. She said, “I am working here.” For courtesy, I continued, “How many years so far?” “For 10 years” she answered. “Now, tell me why you are here today.” I said again. She looked at me “I just told you, I am working here and you called me.” I was a little frustrated but kept asking her “So, did you have any pain or any thing that made you come here today?” I could see now frustration on her face too. “I have been having pain in this toe for a week now.” She finally answered. “You see it is easy.” I said. As I was preparing my self to examine her foot, I asked her if she had any trauma onto her foot. She denied. As in any history taking, I then remembered to ask her about the type of work she does exactly in the hospital. That might give a clue to her toe’s pain etiology. She answered back “I am working here as a translator, and I thought you had a patient whom you need help in translation…But, I do not see any one in your office.” I was in silence for seconds as I realized that she was not the patient, but did have the same first name, and besides, I was in the wrong module. After, I explained to her about the confusion, both of us laughed. Anyway, I told her that she might have some osteoarthritis in her big toe and advised some pain medications. She left my office, and I went to call for my assigned patient in the correct module this time. I saw Maria in the clinic for months after this incident and she was very helpful in translating for many of my patients until I mastered some basic medical Spanish terms. Unfortunately, later that year, she retired.
4. Am I still Alive?
Today, I interviewed a 102 year old woman. She was admitted because of confusion after a fall. I asked her how is she doing? She looked towrds me with her almost totally blind eyes and said " Am I still alive?"
5. What are the bowels saying?
While I was examining a patient's abdomen and listening to her bowels with my stethoscope, she looked at me and asked "What are they talking to you about?"
6. A hollow head
A patient came for a routine check up. His wife sat on his left side in the exam room. I prceeded to do physical examination but as soon as I put the otoscope in his right ear, his wife sarcastically said " Can you see me through his ear?"
7. Tip of the Iceberg
A patient came to my office complaining of an ear fullness and ache for several days. Using the otoscope and a tweezers, I pulled a beefy tissue from his ear. I inspected it carefully. Puzzled of what it was, I told him “I found a piece of cabbage in your ear.” He replied in a very tranquil way, “Doc, I hope it is not the tip of the iceberg.”
8. The Code Drills
During orientation in a hospital, medical students were told about different emergency situations such as codes for cardiac or respiratory arrest, fire drills, etc. In her first week on the medical floor, a student was called for a code on a patient. Mistakenly, she rushed to another room and immediately started compressions on the patient’s chest. Fearful and startled, the patient tried to get up from his bed. The student then recognized her blunder, but told the patient “Sorry, I thought it was just a code drills.”