Anonymous Doctor

"I have terrible stomach pain," said the patient in the ER-- female, 50s-- as I approached.

"I recognize you! I saw you in clinic a few months ago!"

"Yes, doctor. I remember you. I have very bad stomach pain."

"You had pain in your stomach then."

"Oh, but this is different. This is much worse. Unrelated to before."

I grabbed the chart-- sure enough, I saw her six months ago, noted what seemed like an abdominal mass, referred her for a CT and to see a specialist.

"I don't see any scan results-- did you ever follow up?"

"Oh, no, I did not. But this is different pain."

"Why didn't you follow up? I told you, this could be serious."

"I thought it was just a hernia. I still think so."

"I told you six months ago it wasn't a hernia! I told you that you needed to follow up. You said you would get the CT scan. I made you an appointment, remember?"

"Yes, I did not go to the appointment."

"I had the nurse call to follow up. She said you were going to the appointment."

"Yes, I told her I would go to the appointment, but I did not go to the appointment. But what is the difference? That is a hernia, this pain is something else."

"I think you have a mass in your stomach."

"No, I just ate something funny."

"For six months?"

"No, this pain is not related to my stomach problem. This pain is in my stomach."

"Yes, this pain is in your stomach. This is the problem."

"No, this is a different problem."

"We're going to do some tests, but I'm telling you, you need to be prepared for news that may not be good. I think this is very likely related to what I think is a large mass in your stomach."

"I don't think so. I have had this stomach problem for a long time, and this kind of pain is new. So it is not the same."

"This is how things progress, unfortunately. Problems get worse."

"No, this is not the same."

"I hope it is not, I hope you're right."

"You should have been a better doctor."

"What was I supposed to do?"

"I was never going to go to another appointment. You should have known that."

"I had to send you to a specialist. I thought you were going to go."

"No, I am very busy."

"I don't know what you wanted me to do."

"I wanted you to tell me everything is OK. Then you are a good doctor."

"Okay. For now we will say everything is OK. But we will run some tests and see what is going on."

"Thank you, doctor."