Thursday, August 5, 2010

What does she know? She's just the patient

From another neurologist's note:

"Impression: Patient referred here for carpal tunnel syndrome. She clearly has significant headaches, though denies having headaches at all. She also obviously has trouble sleeping, though tells me she sleeps fine. She keeps asking me to address her carpal tunnel syndrome, but that's not the main issue here."



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20 comments:

Cthulhu Sashimi said...

"Given her lack of understanding of her situation, I felt it best not to tell her that I ordered gender reassignment surgery. She thinks she's going to the hospital for a blood test. There will be time to explain afterward."

Jeff said...

Reminds me of....

Doctor: I'm just gonna need you to drop your pants and bend over.

Patient: But I just have an earache.

Doctor: Shut up. I'm a doctor, I know what I'm doing.

Kat's Kats said...

::head:wall:repeat:: "I will give you this 'headache/sleeping' medication that will help you with your carpel tunnel syndrome." ::stares innocently at the ceiling::

lacessed - patient who likes what they think the problem is so much that they ignore what they are having so many problems with that they can't think...

Jackie said...

Uhhhh *blink* doctors like that scare me!

Amanda said...

Wondering if the apparent headache and weariness was caused by having to deal with this particular doctor...

Captain Foulenough said...

At least there is one accurate finding in this note: The patient's CTS is certainly not the main issue here.

Gloria P said...

Oooh, I know him--that's Dr. Butthead!

SheilaShine said...

Could she have sleeping issues because the pain from the CTS is keeping her awake? Just a thought....

Moose said...

I've seen at least a dozen doctors like this. With most of them, it goes like this:

Dr Obsession: "You need to go on a diet."
Me: "Yes, fine. I have a really bad infection here..."
Dr Obsession: "Have you considered weight loss surgery?"
Me: "Let's talk about it later. I'm really concerned about this infection."
Dr Obession: "I cannot treat you unless you deal with your obesity problem."

(& when I wind up in the hospital weeks later, that's my fault. If only I'd gotten surgery!)

Or the psychiatrist who prescribed Prozac because "nobody could be as fat as you and not be depressed. Besides it will help you lose weight."

Or, and maybe it was the same jerk, the neurologist who told me to start taking an aspirin a day because "fat people are more likely to have strokes" (despite having low blood pressure, no cardiac issues and I was there for, yep, what turned out to be carpal tunnel).

Oh, yeah. Welcome to my life.

Chris@Knucklehead! said...

Well, as with the hammer/nail analogy, when you're a doctor specializing in headaches and sleep disorders, nothing looks like carpal tunnel syndrome.

Or something like that.

arzt4empfaenger said...

I agree that the main issue here is something totally different...

Kat's Kats said...

ER doc - "How many times have you been to the ER for your migraines?"

Me - "Huh? I haven't."

Smart ER nurse - "Ahem, I think they are concerned about the possibility of congestive heart failure." [points to the extremely swollen legs which I mentioned when coming in as the reason I'd called the triage nurse rather than just taking my imitrex duh]

ER doc - "I'm going to give you some benedryl, cantremember, and magnesium. Magnesium is very good for migraines."

Me - "Yes, I know. That's why I take 500mg daily for my migraines."

Husband - "What about her extremely swollen legs??"

ER doc - "I'll be back later to see how your migraine feels. Oh and we'll give you some fluids as well."

Smart ER nurse - [alarmed at this point] "Ahem, should we do this given the amount of fluid in her legs??" (trying desperately to point them out again)

ER doc - "Oh! Hmm. Okay, let's just use a flatpac."

Oooh look!! The feedback form from the hospital just got here. muahahahahahahahahahahaha! Nurse = 10! ER doc... -10 and I've really really got to tattoo "Go Straight to Vandy ER" on my hand. This is the THIRD time this ER has totally ignored the reason my doctor or a triage nurse has sent me to the ER. ::head:desk::

a.generic doc said...

When I was a med student, a former family practice doc who went back to do a radiology residency told me, "Never believe anything a patient tells you. They all lie."

Maybe that guy left radiology and did a neuro residency after that.

The Mother said...

Shades of Victorian hysteria?

Guessing the neurologist in question was male...

terri c said...

Oh for the love of God!!!!!!!! I think the doc might have been at risk for sudden onset, severe, one-sided headache with swelling and discoloration around the eye on the affected side. Actually he probably is at risk for that a lot.

ShelliB said...

This could be my neuro! I went for a consult for migraines...ended up having a test for carpal tunnel...

Anonymous said...

I used to go to that quack.

Michelle Dailey said...

This "neurologist" should order himself an MRI, I would be surprised if it actually showed a brain!!

Anonymous said...

So, um, you have an established diagnosis for epilepsy? For five years? From a neurologist who has been practicing for 20 years? Well, without doing any tests, I don't think it is that at all. I've been out of my neurology residency for 4 years you see, and I think you have dissociative identity disorder.

:: face palm ::

Anonymous said...

Army neurology resident: You can't have migraines. Your headache is bilateral and migraines are unilateral. It's a sinus headache.

Me: Um, something like 20% of migraines are bilateral. And sinus headache is technically only possible with a sinus infection, not 2-3 times per week.

CPT Stupid: Let's give you some compazine for that sinus headache.

Me: Isn't compazine an anti-emetic? And my chart says in 2 inch high letters I have bad extrapyramidal reactions to it.

CPT Stupid: Okay, since you're being difficult, I'll give you some IV DHE.

Me: Um, I just told you I took Relpax 1 hour ago. DHE is contraindicated.

CPT Stupid: You're just a sergeant. What do you know about neurology? I'm the officer. Shut up and do what I say.

Me: Actually, I finished two years of PhD neuroscience research before I enlisted. Take your DHE and shove it.

CPT Stupid: Do push-ups.

 
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