* * Anonymous Doc

Tuesday, April 19, 2011

"I see in your chart you never followed up from your last exam. The doctor found blood in your stool, and sent you for some additional tests."

"There's no blood in my stool."

"The doctor last time didn't tell you the tests showed blood in your stool?"

"No, he did. But there's no blood in my stool."

"The tests showed there was."

"No, no, I don't see any blood. I told the doctor. He said it was microscopic."

"Yeah, you wouldn't see it."

"Yeah, that's what I'm saying."

"No, it still means it's there, even if you can't see it."

"No, he said it was microscopic. So I figured I didn't have to worry about it."

"No, you do. That's why he sent you for more tests."

"But it's barely even there."

"But it shouldn't be there at all. We need to see if it's gotten worse, and get some other tests."

"Oh, it's definitely gotten worse."

"How do you know?"

"I can see it now. That's why I came back. I wanted to get it checked out."

"Okay, well, I'm glad you came back, and I'm glad now you want to get it checked out. In the future, you should know-- if the doctor wants to get something checked, you should, even if you can't see it. Problems can still be problems even if you can't see them."

"No, I like to wait until I can see them."

"That's not always a smart thing to do."

"It's what I believe."

"That's not necessarily the best thing to believe. I don't want to dwell on what you should have done, let's just get the tests done now and see what the problem is and hope we're catching early whatever it is."

"Definitely early."

"How do you know?"

"Because I still have a lot of blood left."

"That is not how we would measure whether we're catching something early, but I'm glad you still have a lot of blood left and have not lost all of it in your stool."

"Yes, that is right."

"Okay, I'm glad we're on the same page now."


  1. Something is wrong with your patients. I know patients can be defensive, stubborn, even weird at times but yours take the cake. How do you avoid beating your head senseless against a wall?

  2. ha.. ha ..ha.. cme to india n u cn b sure f one thing...u will never b on same page with ur pts..

  3. Well, I'm glad he realized that complete exsanguination was probably a bad end point.

  4. *facepalm*.... or *facewall* may be more appropriate

  5. Head, meet desk. I have a patient or two like that in my practice... fortunately not many. All you can do with them is document, document, document.