Stride

Each one of us has a system.

A line of questioning that we follow each and every time to get the answers we need.

Following the same method for each patient ensures not only consistency in our history-taking, but also in our treatment of the patients.

Personally, it guarantees that I have asked all the questions, at least the basic ones, to know where to start and which line of treatment is the most likely.

History taking involves everything from past medical problems, to current drug treatments, from the time of the last meal to bowel opening patterns, from sleeping patterns *ahem* to the actual current reason for calling the ambulance.

And then, there's pain related questions. Where is it?

How bad is it?

When did it start?

Does it move?

What were you doing when it started?

Does anything make it worse? Or better?

All in order. Need to keep my stride.

It's especially important towards the end of a night shift, and even more so towards the end of a set of nights.

My favourite pain-related question, probably because the answer is invariably "No", is "Have you taken anything for the pain?"

You know, any analgesia or anti-inflammatory stuff? Anything that might have helped you get the night's sleep that you're complaining you didn't get? I'm always a little bemused by people who go from having a pain that they can cope with straight through to excruciating-ambulance-required-immediately pain without going through the lets-take-some-tablets-and-see pain in the middle.

I digress. Must try to keep my stride.

The following is a true, if slightly shortened, recording of a recent conversation with a patient in pain.

InsomniacMedic: "When did the pain start?"

Patient in Pain: "About 12 hours ago". That would have been at the more tolerant and alert part of my shift.

IM: "And you haven't slept at all?"

PIP: "Not a minute."

IM: "Did you take anything for the pain?"

PIP: "Yes."

IM: "Can I see the tablets that you took?"

PIP: "It wasn't a tablet." Assuming that this patient can't swallow tablets, I presume it must be a liquid. Exasperation is slowly setting in.

IM: "Can I see the bottle then?"

PIP: "It wasn't a bottle." Exasperation is slowly being followed by the loss of will to live.

IM: "So what did you take for the pain then?"

PIP: "Coffee."

IM: "....................................."

All the training, all the working on a system, all the pre-planned questions, all down the toilet.

I mean, with answers like that, how is a guy supposed to keep his stride???

I think I need a drink.

And not necessarily a coffee.

Defeat

After my election manifesto of a little while ago, I received some feedback and suggestions of improvements and additions. I nominated members of the Cabinet in the comments section, and prepared for my move to the seat of power.

It would seem however, that not everyone liked my proposals. I was sent the following copy of the minutes from a secret meeting of medical specialists:

*****

The Allergists voted to scratch it, but the Dermatologists advised not to make any rash moves.

The Gastroenterologists had sort of a gut feeling about it, but the Neurologists thought the Administration had a lot of nerve.

The Obstetricians felt they were all labouring under a misconception.

Ophthalmologists considered the ideas short-sighted.

Pathologists yelled, "Over my dead body!" while the Paediatricians said, "Oh, Grow up!"

The Psychiatrists thought the whole idea was madness, while the Radiologists could see right through it.

Surgeons decided to wash their hands of the whole thing.

The Internists thought it was a bitter pill to swallow, and the Plastic Surgeons said, "This puts a whole new face on the matter...."

The Podiatrists thought it was a step forward, but the Urologists were pissed off at the whole idea.

The Anaesthetists thought the whole idea was a gas, and the Cardiologists didn't have the heart to say no.

In the end, the Proctologists won out, leaving the entire decision up to the arseholes in Government.

*****

In light of the above, I concede defeat.

Thanks to my secret souRCe. You know who you are...