Today, this blog wrote itself.
I saw fifteen cardiology patients today. Here are eight of them:
Patient #1: Denial
Me: "Do you have trouble sleeping at night?"
Patient: "No. I've taken Xanax at night to sleep for years. I'm not addicted, just used to it."
Patient #2: The Generous Risk-taker
Doctor: "Your stress test and angiogram showed that four of your bypass grafts are blocked and your heart is severely damaged. You need to be very careful or you will need a heart transplant."
Patient (reeks of smoke): "Well, can I go up in a hot air balloon to 4000 feet?"
Doctor: "You really want to go up there and do a self-induced stress test in a basket 4000 feet up with no medical personnel to help you?"
Patient (thinking): "That's a good point. Would you like to come?"
Patient #3: The Medicaid Fraudster
Patient (with $400 purse, BMW keys, and 3 pack-per-day cigarette habit): "Doctor, I know my cholesterol is worse than before since I stopped taking my meds. I can't afford my medication and Medicaid doesn't cover it for me. I need a generic."
Patient: "Yeah. That reminds me, my boyfriend and I are buying a hot air balloon. Would you like to come for a ride sometime?"
*note: I do not know what is up with hot air balloons today. Apparently they are the thing to do for cardiac patients in Arizona.
Patient #4: The Undersharer
Patient: "I have chest pain."
Doctor: Asks all manner of questions related to chest pain symptoms
Patient (20 minutes later): "I work for a company that transports museum exhibits. A few weeks ago, I was at work and was pinned between a wall and a 1200 lb crate that rolled into my chest."
Me: "Is that when the chest pain started?"
Patient: "I think so."
Later X-Ray showed 4 broken ribs
Patient #5: Another Undersharer
Me (taking history): "Have you ever had any heart problems?"
Me: "Any murmurs, stents, valve replacements, high cholesterol, high blood pressure, or chest pain?"
Me: "Have you had any surgeries?"
Me: "Any problems with your lungs or breathing?"
Patient: "Well, I had pneumonia after my quadruple bypass three years ago."
Patient #6: The Neurotic Oversharer
*contrast this to patients #s 4 and 5.
Patient: "Doctor, I know you told me to to worry about my myocardial bridge, but I am concerned."
Doctor: "The myocardial bridge is nothing to worry about. Your angiogram showed that it is not significantly occluding your coronary artery, and since it is a congenital condition, it will not get worse."
Patient: "Well, I've been looking into research to get it fixed. There are all kinds of new experimental procedures."
Doctor: "You don't need it fixed."
Patient: Produces 6 page, typed, single-spaced paper detailing his research on the subject, complete with references in parentheses and a works cited page.
Doctor: "This research is for bridges that cause artery blockages. You don't need any intervention. And, this experimental procedure is only done in New Zealand."
Patient: And while I'm here, I want to talk about my blood pressure."
Patient: "It's just out of control. I take my medications, but every time I put my cuff on, I get so anxious and just watch the numbers creep up and up."
Doctor: "How often are you taking your blood pressure?"
Patient: "Roughly, um, (thinks)....maybe 25 times a day?"
Doctor: "I think you should do it just a few times a week, when you are relaxed and not stressed."
Patient: "I also think my blood pressure is causing me to have erectile dysfunction."
*note: by now I am zoning out and am as bored by the patient as you probably are at this point.
Doctor (later, to me): "That guy is really annoying. I think I'm going to fire him from my practice."
I don't blame him.
Patient #7: The Surgical Clearance Patient
Patient: "I need cardiac clearance for a surgery that I'm supposed to have on Thursday."
Doctor: "That's in two days! I'm not sure we can clear you that quickly, especially if you've had any heart problems in the past."
Patient: "Please, doc. I really need this surgery ASAP."
Doctor: "Well, what is it for?"
Patient: "It's with an ENT doctor."
Doctor: "For what?"
Patient's wife: "Well, I bought him a nose hair trimmer for an early Valentine's gift. But he had so much darn hair that I guess it wrapped around the attachment and...."
Patient: "It's stuck up there."
Doctor: "What's stuck up where?"
Patient: "You know. The nose trimmer attachment. It's stuck way up there and I need the surgery to remove it."
Doctor: "We'll do your cardiac clearance as soon as possible."
Patient #8: The Med Student Abuser
Me: "Can I listen to your heart and lungs?"
Patient: "Sure. I'm all for helping students learn."
Me: "Sounds good." (Listens and then puts stethescope down on the exam table next to patient).
Patient: "So you're learning how to use this thing, huh?" Picks up stethescpe and whirls it around, just as I lean into check his pulses.
Stethescope bell hits me in the temple.
Me: "I'll just go get the doctor for you."