"On a scale of 1-10, how would you rate this stomach pain?"
"I don't know."
"You had a bleeding ulcer last month. You had pain then. How does this pain compare?"
"I don't know."
"I'll tell you, I'm trying to figure out whether you're bleeding again, or this is a different kind of pain."
"Yeah, I don't know."
"What color has your stool been?"
"I don't really know."
"Did you look at it?"
"I can't remember."
"How long has the pain been going on?"
"I'm not sure."
"Hours? Days?"
"I don't know."
"You know your body better than I do. I need you to help me figure out if this is a serious problem, or this is indigestion. Because otherwise I have to treat it like it's a serious problem and send you to the emergency room."
"I don't think I want that."
"No one wants that. But I'm trying to figure out if you need that. Your blood pressure is normal. Your last blood work came back OK. I don't think you're actively bleeding, but it might make sense to try and make sure."
"Wait, I'm feeling a little better."
"Great."
"Oh, no, it's worse again."
"If I tell you to go to the ER, are you going to go?"
"No."
"So I don't know what you want me to do for you. You're on all the right medications. There's no evidence you're bleeding. I don't know what more I can do except tell you to eat and drink fluids and rest and try and go to the bathroom, and monitor how you're doing."
"I still don't feel well."
"I don't know if there's anything I can do without sending you to the emergency room, where I do think there's a good chance they will send you home."
"You know, you're totally f***** useless. Can I make an appointment for next week?"
"I don't know what's going to be different next week."
"I'm probably still going to have this stomach pain, obviously. I'll make an appointment for next week. Goodbye."
Monday, October 10, 2011
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