Get ready for this one. Woman comes into clinic with a urinary tract infection. Talking through the translator phone--
"Yes, it has been painful when I urinate."
"Okay, have you noticed any other symptoms?"
"When I tasted the urine, it was sweet, not salty."
"Excuse me? Translator-- did she say she tested the urine?"
"No, she said tasted."
"Can you ask her to repeat what she said?"
"When I tasted the urine, it was sweet-- usually it is salty."
"Wait, why are you tasting your urine?"
"I wanted to see if it was different."
"Why had you tasted your urine in the past? You should never be tasting your urine. Do you understand what I'm saying? You should not put your urine in your mouth."
"Doctor, this is the translator. She's asking me to clarify."
"Please tell her not to drink her urine. Ever. Not something she should do."
"She's asking how she is supposed to know when something is wrong if she does not taste it."
"Tasting it is not the answer to anything. She needs to see the doctor if she thinks something is wrong, and we can test-- test, not taste-- test her urine for any abnormalities, but she should not drink her urine. Can you make sure she understands this?"
"Yes, she says she understands."
"Okay, great."
So we hang up, and I go talk to the attending-- we do this for each patient, we run our plan by the attending and then go back and finish up with the patient. So I go back in, and use the translator phone again, and this time we happen to get a different translator. We go over the plan--
"And please remind her that she should not taste her urine."
"I'm sorry, this is the translator speaking-- I'm not sure I heard you correctly."
"I think you probably did. I'm trying to tell her that she should not taste her urine."
"Test her urine?"
"No, no. Drink her urine. Put it in her mouth. She should not do that. Can you make sure she knows that she should not do that?"
"This is the translator speaking again-- why would she be drinking her urine?"
"There was a different translator earlier in the visit, and this was part of the conversation. I just need you to make sure she knows never to taste her urine."
"Okay, she says she understands. But she also wanted me to make sure you knew that it was sweet, not salty."
"Yes, tell her I know what she is saying, and we are testing her urine."
"She wants to know why it is okay for you to taste her urine, even though she is not supposed to."
"No, no, testing. We are testing her urine, not tasting. Please make sure she understands."
"Okay."
"We're good? Everything's clear."
"Not to me, the translator. But the patient says everything is good."
"Okay, great."
"I don't know what just went on, doctor."
"Me neither, translator. Have a good rest of the day."
Thursday, January 27, 2011
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Who's on first, doctor?
ReplyDeleteI thought urine was sterile, so it shouldn't really matter?
ReplyDeletehow did the translator know you were a doctor? when i have used the translator phones, the interpreter never asks if it is a doctor, nurse, chaplain, social worker, etc.
ReplyDeleteDoctor, I certainly hope that you are aware that diabetes was first diagnosed in Ancient Egypt by urine tasters...who tasted the urine of people who were symptomatic (polyuria, polydipsia, rapid weight loss, etc...).
ReplyDeleteSweet urine = diagnosis....
Oh and the etymolgy of Diabetes Mellitus is:
Diabetes from the Greek: Dia (through or completely)
Betes: a form of the word "baino" to go
Mellitus from the Latin: from the word mellis meaning honey
So...to translate...Diabetes Mellitus means to "pass through completely and sweetly" - your sweet poluyuria!
So, I don't know which culture your patient came from...but it seems completely plausible that if the patient came from a 3rd world country without glucometers and access to clinics...tasting urine might be the obvious means of tasting for diabetes and/or high glucose (which spills into urine generally at about a BG of 180).