The following doctors answered what some of the most painfully obvious things are that patients tend to forget. Although you may assume that many of these things are common knowledge- that is not always the case. Also, a friendly reminder to never 'google' your symptoms and leave the diagnosing and treatment plan up to your physician.
Source list available at the end.
My Medication List
“In the small town where I used to work, we saw a lot of ‘grey nomads.’ They were older people who were touring the country in their motorhomes, and some of them were unbelievably unprepared.
A wonderful example of this was a woman from a large interstate city who came in on a Saturday morning and asked for some blood pressure tablets. I took her blood pressure and said, ‘No problem. What tablets do you take?’ She looked aghast and said, ‘You’re the doctor. I take ordinary blood pressure tablets, and I just want a script.’
She didn’t bring in a list of her medications, neither did she or her husband know the name or the address of their primary clinic, and she just said that she would see any doctor in the clinic anyway, therefore, I couldn’t even google the doctor’s name. She said that the clinic was on the corner a large intersection and that the pharmacy was near the clinic and that she didn’t know why I was being so difficult because the doctors in her clinic just opened her file and printed a script.
I explained to her that there were many different types of blood pressure medication, and I needed to make sure I gave her the right tablets and the right dose. She thought I was wasting her time and being difficult. Eventually, I managed to track down the name of her pharmacist, and he gave me the name of her clinic and her medication(s).
I wrote a letter ‘to whom it may concern’ with her medication list along with the name of her pharmacist and her clinic all down and then gave it to her. I advised her to take the letter with her every single time that she saw a doctor moving forward. She thanked me but said that her usual doctors weren’t as unintelligent as me because they would just give her the right script the first time around.
I don’t think she or her husband had dementia. I just think they thought that all little white blood pressure tablets were the same, and they always just attended a great big anonymous super clinic where they would see a different doctor every time.”
CT Scan Safety
“At 11 pm, I got a call from the ER about a 2-year-old child who had fallen from their bed and was having multiple episodes of vomiting. So, I arrived at the ER and examined the child. A crying, irritable child with swelling all over his left forehead, vitals stable, no signs of raised ICT, or internal injury. The child had no history of seizures or loss of consciousness. I informed the parents that an NCCT head needed to be done to rule out an internal hemorrhage. The father frowned.
Father: ‘CT scan? IS that not going to expose him to radiation and cancer risk?’
Me: ‘The risk of radiation is minimal when compared to benefits this investigation provides.Thousands of kids undergo this every day.’
Father: ‘He seems to be normal now. What makes you think he has a bleed?’
Me: ‘I just want to rule it out before discharging him. We wouldn’t want to wait till he gets seizures or goes into shock. Even though he looks fine now, people practice very defensive medicine when kids are concerned.’
F: ‘Actually we show him to XYZ doctor every time. We would like to consult him in morning and then do what he says.’
Me (Getting impatient): ‘Fine, you can sign a LAMA consent and then take him away. Although, I would strongly advise you not to.’
Father (Getting on backfoot): ‘Okay, do the CT scan.’
Me: ‘Alright, then I am going to give him Pedicloryl now. Let’s hope he goes to sleep, otherwise, we will have to give him IV sedation.’
Father: ‘IV? Isn’t that going to hurt him? Can it not be done without it? He’s already irritated.’
Me: ‘No, it cant. Kids often require sedation for such purposes.’
Father: ‘Are there any risks involved?’
Me: ‘There are minimal risks like apnea and hypotension. However, rest assured, we are fully prepared if such things were to occur.’
Father: ‘Why is he crying so much? Have you ruled out any other injuries? What if he has a fracture?’
Me: ‘I don’t think there is any fracture. There is no tenderness or crepitus on palpation of bones. In any case, I’m more worried about ruling out any bleed right now.’
Father: ‘Children don’t break their bones do they? They usually bend, no? How are you going to rule it out?’
At this point, I had lost my patience and had raised my voice. I told him something that I thought every patient knew. As a doctor, don’t you think that I would know a lot more about what needs to be done then when some patient comes in with his taught-by-google ideas? Why can’t you let your doctor do his duty without questioning him each and every step? Ever take a cab? Do you also question the driver on his driving and tell him when to brake or change gears? Why then is such condescending treatment reserved for professionals like doctors alone?”
Jelly On Toast
“This actually happened to a friend of mine. She once had a patient who came in wondering how she got pregnant when she had been using contraceptive jelly every day. My friend explained that that wasn’t the most reliable method, but my friend still asked her anyway how she had been using it. I kid you not the patient’s answer was, ‘Well, I put it on my toast every morning!’ My friend had to explain to her that contraceptive gel was not to be taken orally.”
“My sister is a psychiatrist, and one of the most common things she has to tell people is that a patient may look healthy on the outside, but on the inside, they could really be suffering from a major disease. A lot of her patients deal with depression, self-harm, anxiety, etc. But what their parents and family members don’t understand is that they might look normal and act normal, but they still need a lot of help, therapy, and medicines.
Ignorance on their part can lead to damage, which at times, can last a lifetime. Some of her patients are kids as young as 8 or 9. They go through some serious stress related to studies, family, and friends. But their parents only see them as young healthy kids who don’t need a doctor. Some scolding and beating should suffice. So as these kids grow up, they tend to stay isolated and struggle with everything in life.
If we break a bone, we would immediately go and see a doctor, but mental illness can take anything from days, weeks, months, or even years to be reported. When we see a dentist, we can tell everyone, but seeing a psychiatrist is kept secret and not discussed socially. Mental health is so important!”
I Can See Clearly Now
“I’m an optometrist, and I was stunned when a patient’s mother told me that her 10-year-old daughter’s glasses were completely wrong. The mother stated that she had tried them on, and she personally couldn’t see anything through them. She therefore concluded that her daughter must be seeing things as blurry too. I had to explain to her that she couldn’t see out of her daughter’s glasses since, first and foremost, they were made FOR her daughter’s near-sighted prescription, and secondly, since the mom wasn’t nearsighted, of course, they would be blurry for her. Actually, I was so shocked that at one point I said, ‘Why would you see out of her glasses? They are her prescription’ Of course, they left without paying.”
“As a radiologist, I often get many unique indications to do a mammogram. Recently, one woman put on her form that she had lead in her breasts due to secondary trauma. I assumed it was from a gunshot or some similar injury. After reviewing her mammogram, I saw nothing out of the ordinary. Upon telling her this, she seemed very surprised.
Patient: ‘Are you sure there is nothing in there? I could swear there must be tons of lead in me.’
Me: ‘No, your mammogram is completely normal. Did you get shot or something?’
Patient (Looks at me quizzically before responding): ‘No, I was stabbed with a pencil.’
As it turns out, people often refer to the writing portion of a pencil as lead, but it is actually composed of graphite. This is generally not visible on a mammogram.”
“When I prescribe you a Nitroglycerin patch, you have to take it out of its package and stick it to your chest. This does not mean to put it, still wrapped, in the breast pocket of your shirt.”
Trust Your Doctor
“I’m a pediatrician, and I work at one of the busiest pediatric centers in India. Like any other government hospital, at times, we face a discrepancy in the ratio of patients to available facilities due to a very high patient inflow (mostly referred to us from catchment areas).
Very often, in my emergency duties, a lot of my colleagues and I have had to face difficulties in making people understand the different aspects of the disease their child is suffering from, and how to manage it. Be it counselling regarding the non-availability of beds, or the severity and the prognosis of the condition their child has. People just find it so much easier to believe that the doctor is not functioning to the best of his/her capacity and is trying to get rid of their responsibility rather than empathizing with the actual situation of the patient.
I don’t know of any other profession where you need to take an oath before starting your job and we (speaking on behalf of most of our fraternity) take our Hippocratic oath very seriously. A disease is a process, which at times, can be reversed by medicine. Other times, it can at least be controlled, and then there are times when the condition is just beyond the scope of medicine itself. However, by pressuring or abusing the doctor, you can’t alter the disease process. If I am straining my brain for 30-hours in a row, at times, missing meals and sacrificing my personal life, I don’t think that I have to provide any more proof that I care about my patients.
I live in developing country, and there is a limitation to the kind of facilities a government setup can provide versus affordability of a private setup, but trust me, amidst all this your doctor is doing their best to provide you with the best care. The assault, the abuse, and the disrespect that doctors have to go through (having personally experienced it myself) are very demotivating to our fraternity as a whole, and it creates a divide between the doctor and their patients.
In conclusion, my message would be to please trust your doctor. Let’s work together for the welfare of the patient.”
The Birds And The Bees
“One that often comes up is regarding medications. Many patients have asked me, or they have at least let it be known that they think Tylenol (acetaminophen) and Advil/Motrin (ibuprofen) are the same thing. In fact, I would say that very few patients have any common knowledge on over-the-counter (available without a prescription) medications.
Another one that comes to mind was the teen who refused a pregnancy test after missing her period. When asked, ‘Why?’ She simply replied,’… Because I know my body, and I know I’m not pregnant.’ I think we saw her several months later after she started showing.
One of my clinical instructors told me that she once had to go into in-depth instruction for a couple who was trying to get pregnant as they had not had intercourse despite being married, and they didn’t know how it worked. To think, people still fight against reproductive education.”
9 Days Old
“This happened to me at an internship at a hospital.
I was hanging around the emergency ward, collecting information about why some of the patients were there. I would later try to think of solutions and discuss them with my professors. I WAS NOT allowed to provide diagnostic advice. I was moving around and had collected around 20 different scenarios. I came across this one family. There were around seven people sitting in a close group with three females in the center and four males around them. They were occupying a good amount of the waiting room area and were wasting space by sitting like that. So, I naturally noticed them. I approached them thinking that I could just get a scenario from them and call it a night. It was freezing, and I just wanted to go home, sip on some chocolate milk, and burrow down in my quilt.
As I neared them, I saw that one of the females had a little baby wrapped in a bundle of blankets resting in her lap. It was neonatal really, and upon asking, I found out that ‘he’ was around 9-days-old. Contrary to what I thought, they were actually pretty receptive and open. I thought my job would almost be done, and I could go home soon. They told me where they were from and that the child belonged to the woman holding him and the guy closest to her. I asked them about WHY they were there. They told me that the child was not feeling well and was coughing a lot. Plus, his breath came out in wheezes, and he was shivering violently. Until then, everything was fine. I asked them if it was possible he had caught a cold.
What I heard next made me yell at the top of my lungs, and I immediately got the nearest staff members to get the kid into EMERGENCY. Apparently, they had been keeping him warm with blankets and heat etc. BUT, as the child was cold to the touch, they fed the kid naswar! Naswar is tobacco snuff! And to top it off, they gave the kid high doses of Bhang to drink. Bhang, which is essentially drinkable pot! They were still feeding the kid naswar and Bhang while sitting there. The kid was non-responsive. He was rushed to the NCU (Neonatal Care Unit) and the doctors had him stable within the next 12 hours, with almost no permanent damage. So, the thing I had to tell a patient that I thought was common knowledge was NOT to give a 9-day-old child tobacco and pot.”
“You can get pregnant again after just having a baby. Always use contraception unless you want two babies under the age of one.
Genetics is not destiny. Even if everyone in your family has diabetes, it doesn’t mean that there’s no point in you trying to exercise and/or eat well. Even if this doesn’t prevent diabetes, it will still mitigate the associated risks.
Antibiotics will only work for bacterial infections. If it takes 30 seconds to prescribe you antibiotics for a sore throat and then another 10 minutes to explain why I shouldn’t when I get paid by the number of patients I see. If I take the 10 minutes to explain, it’s because I think it’s not bacterial and not because I like to talk more. (By the way, when someone then looks at me after that and says, ‘So, you’re not going to give me any pills, but I need antibiotics!’ it really makes my day.)
There are a lot of things that medical science cannot fix. We’re not hiding some special cure from you. The perception seems to be that medicine can do a lot more than it can.
There are some things medical science can help with like blood pressure and cholesterol levels. Often, though, lifestyle changes can also help these things better without the side effects.
An MRI is not like a ‘Tricorder’ from Star Trek. It can tell us a lot in the right context, but it’s not going to give you a printout of everything that could possibly be wrong.
Good nutrition from the prenatal period onward is hugely important to your health.
Doctors generally understand very well that people are often on pills because of significant barriers that stop them from being able to exercise more, eat well, sleep better, etc. We’ll still talk to you about changing these things even if we know it’s not easy (and sometimes not even realistic) for you to do so because we feel you should know about these things. We know that medications are often band-aid approaches rather than fixes and that whatever situation you may be in that limits good lifestyle choices may not be your forever-situation.
Doctors are people, too.”