Tuesday, October 27, 2009

We Have Medication For People Like You

I saw a new patient today, who brought his briefcase. I don't care. Maybe he hates leaving it in his car. Maybe he's a courier. Maybe he's a part time nuclear "bag-man" for the President. Whatever.

I asked him if he'd had any headaches recently.

He opened the briefcase, pulled out a HUGE notebook, flipped through it for a minute, then said:

"Yes, mid-afternoon on October 10, 2003. I took 1/2 of one of my wife's Percocets for it, and it resolved in 45 minutes".

The notebook and briefcase can't come back here anymore.

25 comments:

Dr. Phil said...

I discourage lists, notebooks, multiple family memebers to cooroborate the story, etc. If you can't remember to tell me, then it must not be important! I know that there are exceptions to this rule...For example, on Januray 16, 2001 (according to my notebook)...... :)

Doris said...

Makes one wonder what else this person is making notes about...

Are there different colors for different subjects?

Scratch'n sniff?

Photos?

Sound captured and saved to CD?

MOVIES?

SAMPLES?!?!?!

He's a don't ask if you don't want to know kind of guy, I guess.

>:)

Anonymous said...

I have funny episodes sometimes. They last about 30 seconds, and I can't really remember what goes on during that time. For all I know, I could be doing a chicken dance, or posting in a blog.
So when a dipshit doctor asks me what happens during these things, I can't tell him. And if my wife isn't there, then what's the point in wasting $300?
Sorry, Dr. Grumpy- (and Dr. Dick from above)- you lost me. As a patient, I would like to be treated with a little respect. (I also don't feel bad when my insurance only pays 25% of what you charged).

Anonymous said...

All over the internet, you see sites where people are told to keep track of their headaches, write them down, preferably in a spreadsheet, and bring it with them to the doctor with them. I'm surprised you don't see this more often. It actually makes sense to me as well.

The question I hate most is when was the first day of my last menstrual cycle? I'm just not that interested in remembering when it was or how many days it lasts or if it came early or late. If I wrote them down, I could give an answer to that! Instead I just answer either yesterday or 2 weeks ago.

Jen said...

Anon, you missed the point of someone complaining of migraines they haven't experienced for 6 yrs. Lighten up.

Grumpy, M.D. said...

I encourage patients to keep diaries or headaches, seizures, etc. I have nothing against that.

At some point, however, to be tracking daily activities, symptoms, and bodily functions for years at a stretch becomes obsessive-compulsive.

The Good Cook said...

Wow. I'd like to see that notebook.

Outrider said...

I think I've seen the other notebook in that briefcase. The one about the goat.

(I maintain that some of your patients own some of mine.)

f8hasit said...

My brother travels with his Franklin-Covey everywhere. I tried to buy the electronic one for him, but he prefers the big one.

I'll have to ask him if he came to see you! (I'm sure he wrote it down...)

:-)

ERRN4U said...

Dr. Grumpy asked "have you had any RECENT headaches?

Patient had to look through his notebook and came up with
a date SIX YEARS ago. NOT recent anon so chill out and have a "funny spell" no need to record what happens.

Anonymous said...

At least they didn't bring in their internet enabled phone and pull up a bodily function blog that they have been keeping since 1999.

Anonymous said...

Anyone who keeps records like that, much less carts them around, has way too much time on his hands. I don't call a 6 years ago headache as being too recent!

Drew said...

I am not a doctor (or a clinical practitioner of any variety) but I work for a small rural Critical Access hospital in the Pacific Northwest. First, love the Blog (and a number of medical blogs) because I enjoy working with physicians, nurses, and others as the head of our emergency preparedness program. Sorry for the rambling bio, but I love stories like this one for many reasons not the least of which is that the question you asked could have been a lot more personal. "So, patient x, have you had episodes of IBS of late?" One shudders to think of how detailed his entries related to defecation might have been (and here I'm wondering if he might have told other stories with photos) in response to such a benign question. Again, great Blog!

Nurse K said...

I hate notebooks. The symptoms kept track of are almost always non-important too. Tingling in rt toe, headache with spasms in rt cheek, loose stool x 1, etc etc

Kate Allison said...

I have had clients bring in detailed records of their cats' stool. Seems to be a cat owner thing. One even recorded weight, allowing for a certain amount of litter (literally factored in). You know these are the types to bring their pets in for a post alien abduction exam.

Science Marches On said...

The Science Marches On Department thinks a nice graph would go well here.


for a price. ;>)

Anonymous said...

Scary! When people pull out notebooks like that I have to wonder if they're keeping track of me.

Occasionally I get OCD about something. Like the time I was bound and determined to lose weight and for five and half months kept track of ALL my exercise and food intake (separated into protein, fiber, saturated fat, fluids) noted in terms of caloric input. It didn't help much for the weight loss, but when I contracted hepatitis, I could tell the endocrinologist that I didn't have HAV associated with certain fast food establishments. (Maybe it was all the work in keeping track energy that wore me out.) Part of the therapy recommended was HAV, and HBV series... which I complied.

After years recovering, I realized I'd better complete any long-term career plans, so finished the didactic portion of a HCW program, and in anticipation to the final experiential assignments, sold the textbooks, tidied up drug studies, get rid of paperwork, etc. to plan for final rotations, and possibly a new job.

Health insurance and a physical were required, along with TB test and immunizations. I impressed my internist with the dates of every vaccine I'd ever had because I had been clearing out documents and paperwork and ran across shot records my mother kept--even dating to Territorial days.

Guess I'd forgotten I'd previously received the HBV series. And, just barely met timing issues prior to first assignment. The school picked up the tab. I would really have been ticked if I'd had to pay for the second series because I'd forgotten I'd had it several years before.

Yes, OCD, except for something important.

GradStudent said...

if he ever comes back you should ask to look at the notebook, make interest-feigning faces while flipping through it and tell him you'd like some time to *really* peruse it. then you lose it somewhere in the trash can or the paper shredder. the end.

ERP said...

Let me guess, he could not remember his med list.

Knucklehead said...

Reminds me of that scene in Rain Man when Ray wrote in his notebook . . .

"Squeezed and pulled and hurt my neck in 1988."

Anonymous said...

Reminds me of a patient who brought in a detailed 10 page, hand-written medical history which began "I was not breast-fed as a baby." I told her to be SURE and show it to the doctor.
-whitecap nurse

student dr. blaze said...

Okay, I'm putting a brief version of my $0.02 here: don't judge a patient by their notebook. Please. I'll grant you that this guy sounded nuts, but not everyone who documents what's happening to/with their bodies is insane. Not even if his/her notes are detailed. Sometimes, if you have chronic illness, the only thing you can do to help your situation is to provide your physician with information in a manner s/he understands, which is often by quantifying it (doctors are considered scientists, after all). No rational patient enjoys keeping such records--they only do so in hope of resolution of pain &/or for survival. So to all the commentators here who care for patients, I implore you: please don't be too hasty to pass judgement. Thanks.

Anonymous said...

I agree with student dr. blaze! I HATE the archives I have compiled for my daughter, but it is learned behavior from the grillings I have received from her specialists.

Ashley said...

its just kinda funny that it was from freaking 2003...and that he was able to track the entry down so quickly.

What part of "recently" did the man not understand??

Old Time CRA said...

I work for a company that manages clinical trials and was monitoring a psych study. This site decided it would be a good idea to give each subject a diary to record taking their dose. One subject took it upon himself to write down every feeling and what he did including his episode of masturbation to completion on Christmas Eve. I was monitoring in a conference room and started laughing out loud. The study coordinator said "are you reading Subject XYZ's diary?".

Doing this job for over 15 years I should write a blog of everything I've seen and heard while in a doc's office.

 
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