Clear and effective communication makes work and life so much simpler when it’s present. When there’s more or less total transparency and everyone’s on the same page, it’s far easier to do whatever it is you aim to do. In some areas, however, communication is far more important than in others. Sometimes, a white lie, a misspoken ‘fact,’ or an inability to mention a single detail can be the difference between life and death, health and illness.
For instance, medical professionals need a lot of information about their patients and their medical histories in order to treat them appropriately. Whether a patient is seriously ill, has been injured, or has come for a run-of-the-mill health checkup, failing to mention something that seems unimportant can have dire consequences.
The doctors of Reddit shared their stories about their very worst ‘I don’t think this is important, but-’ patients. Scroll down and have a read about how failing to disclose something a patient thought was meaningless actually turned out to be very meaningful. If we have any Doctor Pandas in the house today, you can share your own tales about miscommunicating patients in the comments, as a warning.
Bored Panda got in touch with Dr. Andrew Carroll, the CEO/Medical Director of Atembis LLC and Family Physician, for some insights about trust between doctors and their patients, what patients should prioritize communicating to medical professionals, and how experiencing pain differs between individuals.
"When you have a long-term relationship with a physician, it’s easier for there to be a two-way trust relationship. Our patients trust us to be knowledgeable, thorough, non-judgmental, and wise. We trust our patients to be honest, forthright, and open to a conversation. That’s more difficult when you’re seeing someone at an urgent care or emergency room because these are people you don’t typically know. That’s the value of having a Family Physician/Generalist," he explained to us.
"Also, just know that sometimes there’s a detail you may think of that you believe may not be important, but might be crucial to making a diagnosis. Just be honest and tell us."
#1
Me "do you have any medical history? Including things like heart attacks, strokes, high blood pressure?"Patient "no, nothing ever"
Me "so why do you take [list of heart meds]"
Patient "oh I've had multiple cardiac arrests"
Image credits: saltieeee
According to Dr. Carroll, the CEO of Atembis LLC, the information that a patient should prioritize telling their doctor depends on the specific situation.
"What are you concerned about? What is it that got you into the doctor in an urgency? Does your chest pain remind you of when your father had his heart attack? Are you losing weight, but you don’t know why because you haven’t changed anything? Is your period late when you are always on time, no matter what? What has changed, what is different? Then tell us the story," the doctor shared what patients should consider.
#2
Everyone at my company knows the story of the patient who came in for genetic counseling, went through their whole family history with the counselor, and then concluded with "Oh yeah, I was adopted as a baby and don't know who my birth parents are, does that matter?"Image credits: ThadisJones
#3
Me: "do you have any chronic diseases like Diabetes or high blood pressure?"Patients: "no :)))))"
Me: "but you do inject Insulin daily?'
Patients: "yeah :)))"
"What's that for then?"
"oh, for my sugar, ya know"
Image credits: sadworldscaredgirl
"It is easier for us as physicians to not ask a ton of questions, but to just let you tell us the story of what happened. Make it descriptive and rich. Start from the beginning or even before the beginning, and don’t stop until the end when you arrived at the doctor’s office. We can fill in any needed details after you’re done telling your story."
Dr. Carroll noted that the pain experience of an individual is very different between people. "There are many factors that go into it: genetics, upbringing, previous pain experience chronic illness (diabetes, heart disease), neurologic injury, substance abuse and addiction, ethnicity, history of mental, physical, and sexual abuse, current medications," he said that this list isn't exhaustive.
#4
5 year old girl, at a pediatrician visit her mother said she was “acting loopy.” A day later a scan confirmed a massive brain tumor in inoperable real estate. Three weeks later I did her autopsy.Image credits: jaded_trollop
#5
Had a male in his 50s WALKS into trauma to have his left thigh stitched up. Not an uncommon wound in an agricultural area. Speaking to him while stitching him up he tells me he fell off a ladder while cutting a branch and the machete sliced him on the way down. Told him I was going to write him up for an xray of the entire leg just in case. He kept on saying he was fine, his knee hurt a bit but logically that was from the fall, I agreed, but asked him to go to the xray department just in case.He reluctantly walk there and back. X-rays showed a helical fracture almost the entire length of his femur! Besides being a dangerous fracture the femur is supposed to be the most painful bone to break and he was walking around.
In the end had to show him the break to get him to sit down on a wheelchair and into the hands of orthopedics. That man's pain tolerance still impresses me.
Image credits: F0ssil
#6
Had a patient come into the ER with some sort of spider/bug bite on her hand that had progressed to a red line running up her arm. She stated she put Benadryl cream on and it was very itchy.We continued talking and I asked if she had any allergies…”yes, Benadryl.” I thought good lord wtf and I’m sure it was reflected on my face.
We washed the Benadryl cream off her arm and miraculously it stopped itching.
Image credits: sweetlyserious
Real life might not be like an episode of ‘House,’ but a single detail can change how medical professionals approach your treatment. Patients, especially if they’re ill or hurt, aren’t in the best condition to know what information might be vital for doctors to know and what’s useless, so it’s best to be fully open and honest.
In short, the more information you give your doctor, the more they know about your medical history, the more appropriate and effective the treatment they can give you. What’s more, this can help them diagnose any illnesses you might have, whether hereditary or not.
So it’s best to tell the professionals about your medical history, your family, what surgeries you’ve had, what allergies you have, and what medication you use. And if you’ve had an accident or mysteriously fallen ill, details from the actual incident or preceding days and weeks can help turn the tide in your favor.
“Family medical history is a record of health information about a person’s family, usually including three generations of relatives. Families share genetic makeups, environments, and lifestyle—these factors can provide insight into medical conditions that may run in your family. Noticing concerns in a patient’s health as well as having an understanding patterns of diseases or disorders will make a diagnosis more likely, which is particularly important in catching something harmful early,” writes ‘My GP.’
#7
My (~4F at the time) mom thought that it was weird how I could describe what I see of one part of the environment and not the other especially because according to her I was a happy child and didn’t report any sight issue.She brings me to the doctor, afraid that I may have an intellectual disability.
Turns out one of my eyes is totally blind.
Image credits: Emptydumbass
#8
I had to take out the remainder of this guy's teeth. He was in his 60’s and told us verbally and on his health history that he didn't take any meds. So I took out his last 8 teeth, all easy extractions due to infections and periodontal disease. But I couldn't get him to stop bleeding. I asked him again if he was taking anything. I finally got the clots stabilized, but it took almost an hour and I had to consult our oral surgeon. When he saw the oral surgeon a few months later about placing implants, he told the oral surgeon he was on BP medication and blood thinners. I refused to see him anymore after that.Image credits: DrRam121
#9
Intercepted a young woman who was just hit by a car. Her boyfriend was standing with her freaking out. I do a basic physical exam and get a history, and make her comfortable as we wait for the ambulance to arrive.Once the ambulance arrives they ask for the same information, except this time the boyfriend mentions he was the one who was actually hit by the car and was shielding his girlfriend's body. The entire car's windshield was cracked by the impact of his back. He was just freaking out and worried about her, and was in shock and hadn't begun to feel any pain yet.
Image credits: milksteaknjellybean
Meanwhile, ‘Web MD’ notes that this information gives your doctor important clues about your health. Many diseases run in families, after all.
“The history also tells your doctor what health issues you may be at risk for in the future. If your doctor learns, for example, that both of your parents have heart disease, they may focus on your heart health when you’re much younger than other patients who don’t have a family history of heart disease.”
Trust can lead to more openness and honesty. According to a study published in 2017, researchers found that the actions that help build trust between doctors and patients included providing reassurance, telling them that it’s fine to ask questions, and showing them their lab results and explaining what they mean.
What’s more, doctors ought to avoid judging their patients through their use of language and their behavior, and should ask the patients what they want in terms of treatment goals and preferences. What patients truly want is to deal with medical staff who are knowledgeable and genuinely care about them.
#10
As a student in AE asking a patient who came in with head injury after a fight some questions. At the end he mentions that for the last several months he had been having blackout where he would wake on the floor sore all over or having hurt himself. That and he had woke feeling more tired than before. The dude had untreated epilepsyImage credits: Bubblycatty
#11
Saw a man early 70's who had a knee that was at least 3X its size. He had waited all weekend before going to the ER and went only because his wife insisted. He was kind of pissed. Of course his knee was broken. When they ask what he took for the pain his answer was : *"A couple of Tylenols."*Apparently wanting to feel young again :) he tried his son's motorcycle and it fell on him. He didn't tell anyone because he was too embarassed.
Image credits: sonia72quebec
#12
Patients not telling HIV status despite knowing they are positive.When further asked that why didn't they tell us, they say that they thought its not important.
How can HIV not be important, it changes everything.
Image credits: Dr_critical
#13
Quite common in Malaysia since some health products escape notice from the government. ‘ I don’t think this is important, but have you been taking supplements for weight loss or do you have an exam coming up?’Young women coming in with severe palpitations and crazy arrhythmias. Usually healthy, no prior health issues and or usually at the age where they’re in college or university. Initially most people would be thinking thyroid issues and a fair few have been treated this way.
Then I realized they’ve been taking caffeine supplements to help with weight loss/ increase concentration. Specifically some brands off label only put it in between the fine print of the product ingredients. Usually in near lethal quantities lol.
Image credits: Daily_Scrolls_516
#14
I'm a veterinarian. My favorites are foreign bodies (like a dog eating a whole bone, or a sock, or something similar).I get when you don't realize something was eaten, but I have had so many times where the client swears up and down that the dog did not eat anything, could not have eaten anything, and nothing is missing. Then when we remove a whole towel, the owner is like "oh, the kitchen towel? Yes I did see him chewing on that yesterday, and we haven't been able to find it since."
#15
I remember when I was 8 I had crashed on a mini bike. My dad didn't have parental rights after the divorce and the ER felt since I was only missing some teeth and had a split lip but was not reporting pain or anything there was no emergency and they needed to get a hold of my mom. A couple hours later mom comes and they take me back for X-rays. The X-ray tech looked at the prints and kind of hurried out to get the doctor who got on the phone and started calling for a clear room for surgery and a doctor to be called back. It turned out I had crushed my skull had a tooth in my eye socket fractures in my forehead making a disk of bone that had fallen in and swelling on my brain.Image credits: Ok_Dog_4059
#16
Had twins in the NICU with a rare genetic defect that was causing serious pulmonary distress….extraordinarily, one of our long time nurses recognized the last name and realized she had taken care of their mom while she was hospitalized on the pediatric unit some years before….the mom never thought to tell us she had the same rare genetic pulmonary insufficiency. Could have saved us about of week of tests.Image credits: Incubus187
#17
I was a Dentist in the Texas Jail System. I had a guy walk in whose lower 4 mandibular incisors were loose. He said they hurt a little. X ray showed therewas a perfect semicircle of bone containing those 4
Teeth that was completely fractured. No root canals in jail. Or dentures. I laid a flap and removed one whole piece of bone with all teeth in it. I was certain he’d been in a fight but he said he walked into a pole. There are serious penalties for fighting in the jail. He was really unhappy to lose those teeth.
So, a couple days later another guy walked in with his upper centrals broken off at the gums.
I figured he walked into the other side of the same pole.
#18
Not exactly an answer, just my experience as a nurse. I had a patient who was on strict input/ output, meaning we had to measure everything going in and …um… coming out. I went to measure his urine output from his urinal and it was dark brown and contained something that looked fibrous. Turns out he’d been using his urinal as a spittoon. Needless to say, I explained what it was really for after a horrified moment.Image credits: Fleecelined
#19
I once check in a guy and asked him if he'd had any previous surgery."No, never"
When I examined him he had a surgical scar from just above his pubic bone, to just below the sternum.
"What's that then?" I asked.
He stared down at it and said:
"I've never noticed that before"
WTF????
Image credits: Underwritingking
#20
Had a male come in with pancreatitis. Asking him some basic history.."How much do you drink alcohol?"
"I don't use alcohol."
Ok, well not my first time so..
"Do you drink beer?"
"Yeah well after sauna I have some beer." (we are in Finland where sauna and beer go very well and frequently together)
"Ok, how many beers you have after sauna?"
"A case" (24 cans/case)
"And how many times per week you got to sauna?"
"3 to 4 times per week"
So he doesn't drink any alcohol, but 70-100 cans of beer per week.
#21
While pregnant with me, my mom was wrapping up an OB appointment. The GYN had already left the room, mom was gathering herself to leave and mentioned to the nurse her contacts were messing with her - she had spots in her vision.The nurse stopped and asked her to sit down. Brought back in the GYN, who had her stay and deliver me via emergency c section. Without anyone knowing it, she had spontaneously developed pre-eclampsia and her blood pressure was rocketing sky high.
She was dangerously close to having a seizure and that would've been that if she hadn't mentioned the spots in her vision and just left as the appointment was over, or the nurse didn't listen.
Image credits: AttorneyDense
#22
Emergency radiologist here.I see plenty of people presenting with understated symptoms that turn out to be mind blowing advanced disease.
The saddest one was probably the 4 year old boy who presented with a rigid abdomen for a few months. Was told by their pediatrician it was constipation months ago but his parents never followed up when it didn't resolve. When I imaged his abdomen I found his entire liver was replaced with a mass consistent with hepatoblastoma. I asked the parents why they waited so long to work it up. They said they were satisfied with the diagnosis of constipation. That one left a mark on my soul.
Image credits: abandnedsquirrel
#23
When I was in my final years of med school (English division of a European University in a country where I speak the native language fluently) we were to do patient interviews and physical examinations on our own and then circle back to our supervisor.I was translating back and forth between the patient (infectious diseases department) and a fellow classmate whom I was doing the interview with. The patient said "so you guys are coming in on a Saturday to do patient work? Good for you for going the extra mile" (it was a Friday, which I initially brushed off as a mistake)
My classmate asked me to ask the patient if he could tell us the date. I was like "are you sure? He's here for an infection not head trauma, he might think it's a bit degrading". I thought it wasn't important but she insisted so I translated the question.
Patient replies "ah well its 2002, of course!" (it was 2018).
After more questioning we realised all of his replies were all as if it were 2002 (eg. "The last trip I went on was to Africa in the 80's, so about 15 years ago")
As it turns out he had neurosyphilis that went unchecked for many many years.
Image credits: TAmedschoolnobody
#24
As a patient, but this is too fresh not to share. I'm 32 and at work Friday morning (as in 2 days ago) I started having pain in my lower molars around 10:40am. It eventually got so bad I left work and went to urgent care (noon). I thought it was a gum infection and I'd get some antibiotics and ibuprofen and be told to see a dentist or something. I had to keep apologizing to the intake person because I was stumbling over my words, unfocused because of pain.When the urgent care Doc came in (1pm) she talked to me for about 30 seconds before peeping in my mouth and saying my gums were fine, then checking my eyes with a flashlight and calling an ambulance. By the time I got to the hospital (2ish?) I was basically nonverbal and my attempts at texting had become disjointed. My spouse met me in the ER after a CT scan and helped me consent to an IV clot buster (TPA) at about 3pm. I'd had a stroke.
For those doing the timeline math at home, YIKES.
Good news: the TPA worked very fast and I'm hopefully getting discharged tonight. I owe that urgent care doc a thank you note.
#25
Just a reminder that a worsening unexplainable back pain should be taken very seriously. If you are having worsening back pain for more then like 2 weeks and you don't recall doing anything that could of cause it. Get it assessed. Tumours, cancer, infection can happen and quickly ruin your life if untreated. Remember, report unexplainable pains to your GP and be very honest about how bad the pain is. Saved a young 30yr old from being paralyzed just the other week.#26
Had a guy in his 50s who had been seeing an acupuncturist for an area of numbness and weakness travelling down his legs. He’d had 2 months of acupuncture for them with no improvement, so very reluctantly booked a routine GP appointment. At that point he’d stared to have issues with his urination too.As soon I started speaking to him it became obvious that the symptoms he presented with were consistent with spinal cord compression - an absolute medical emergency. We got him straight into hospital and imaging showed cancer, with a tumour pressing onto his spinal column. Although he started treatment and steroids that day, by then it was too late. He lost the ability to walk and died a few months later from the cancer.
It was enormously sad and frustrating as that constellation of symptoms would have raised an immediate reg flag with anyone with medical training. Had he come in months earlier, maybe his prognosis would’ve been quite different.
#27
As a patient I had a doctor tell me "I don't think this is important".My physio had identified a mole on my back that had changed colours. Being fair skinned, and Australian, I was obviously concerned about melanoma so I went to my doctor for a checkup. He looked at it and said "it's nothing don't worry". I insisted that since I'd made the effort to come in he might as well take a biopsy and get it tested. He was reluctant but I insisted and he eventually removed the mole for testing.
A few days later the doctor rang and informed me that I had a very nasty malignant melanoma and needed surgery immediately if not before. Two days later I was in hospital and they removed a lump from my shoulder three inches across and two inches deep. Cancer free now for 8 years but if I had taken the doctor at his word of "it's nothing" I'd most likely be dead now.
#28
I was working in the ER as a paramedic intern. An older man came in with his hand bandaged stating he couldn't get his thumb to stop bleeding.As the nurse unwound the bandage there was a gaping wound oozing blood from where his thumb USED TO BE.
The nurse asked him where his thumb was and the old guy asked what day it was. The nurse said Thursday or whatever day it was. The guy said well, I guess the thumb went out with the trash this morning. He'd lost his thumb to his lawn mower three days ago and only now was coming in.
#29
This 20s guy came into the hospital, he had a lot of conditions where he wouldn't make it past 40 and he currently had some infection. We kept giving him antibiotics which helped, but not as much as we would have liked.After about a week of being in the hospital I walk in and I'm talking to him and he tells me that he got a medically necessary circumcision on his last admission to the hospital. I ask if it's okay if I take a look to make sure it's healing okay. It was black with all kinds of infection.
I'm just not sure how a 20s married man (or his wife) never thought to tell anyone about this for the past week.
#30
When I was a recent grad while working with the army, a soldier came to er, he had just returned from vacation and complained about severe headache, he had been hit with a beer bottle the previous day, I didn't think much at first because he was conscious and there wasn't anything more in anamnesis, that was until medical examination where I found that he had high blood pressure and bradycardia.Sent him to a larger hospital and surprise, surprise, he had quite the subdural hematoma. I still wonder how that man was walking as if nothing was wrong with him.
#31
I’m a midwife. Had a patient who was 4 days postpartum. (She’s the kind of person who never complains about anything - when she was in labour she didn’t want to go to the hospital yet because it “wasn’t bad enough” - she almost gave birth in the elevator!) Anyway, her husband called me and said she had a fever of 39C for 2 days and he was worried. I had to beg her to come into hospital. She ended up needed 3 days of IV antibiotics for endometritis. Even the doctor I called to consult didn’t believe it at first since she didn’t seem to be in pain!#32
Oops, I was the patient. I went in for severe pain in my right eye and reduced vision. Asked me for my family history and I mention everything I thought was relevant.“No immune disorders or anything like that?”
“Oh well, my mom has MS but there’s no possible way I have that.”
“…”
“…”
“You’ve got optic neuritis, and probably MS. Sorry.”
#33
Had to perform an extraction, took a detailed medical history. Patient said they were a diabetic and a hypertensive. Both a big contraindication in extractions due to uncontrollable bleeding. Unless they're meticulous about their taking their medicines and you stop the blood thinners five days prior to surgery, it's usually a blood bath.I asked the well educated, 50 year old woman a number of times if she took her diabetes medicines on time and if she does at home rapid tests to check her blood sugar. She said she takes them everyday without fail and hasn't missed a day in over two years. She said she's super disciplined about her health and would tell me if she hadn't taken them.
I sent her in for a Rapid blood sugar test anyway, as a precaution, and lo and behold her values come back as 282mg. Almost twice as much as the normal value so it wasn't even like she was JUST off the mark.
I ask her to explain and she gives a shocked expression and insisted that she took them. I ask her to physically show me her medicines instead of listing them out and she finally says oh I don't have it right now, I make it when I need it. 'make'.
She drinks bitter gourd juice on time everyday instead of her diabetic pills because they are too big.
And she 100% believed bitter gourd juice was the only medication she needs.
She's a high school teacher.
#34
I was having [what I assumed was] severe PMDD for the week of and during my period. I was a danger to myself. I have a long history of ADHD meds, Vyvanse specifically, and I'd been off it for a few years. So I recently started Concerta and when the symptoms started, I thought it was some side effect. Went to the doctor/OBGYN and she just gave me progesterone which made my period start WAY early (for some reason)Anyway, a week later I'm talking to my friend Sarah who's telling me about her unfortunate history with EDs. She mentions offhand that she did some research on it and if you lose enough weight, your cycle starts shutting down. I'm like, WHAT. I go weigh myself immediately and sure enough I'm like 100lbs! ADHD meds all have strong weight loss side effects, and I'd been on them for most of my developmental years. I'm dangerously underweight. I stop the progesterone and work on getting my weight up a little and would ya look at that! Symptoms magically disappear.
The kicker is that Sarah is trans! She's never had a period and she just figured out what my cis OBGYN (who knew my weight was a concern) never could!.
EDIT for accuracy: it's been pointed out to me that this wasn't PMDD! I've edited this post to reflect that :)
#35
One of my first patients as a medical student, we were asking her about prior medical history bc she was in a waitlist for an intestinal transplant, and we asked her in every possible way if she had any history and she was like "no, I was very healthy before this."Finally we ask her "do you take any medications at home?" and she goes "oh, just the meds I take for the lupus"
#36
Saw a dude in my ER once for a sore throat. He was coughing a bit when I went in. Looked in his throat and his uvula (hanging thingy in the middle) was just a tiny bit swollen but everything else looks ok. I asked about medication and he mentioned that he just started a BP medicine that had a nasty side effect of face and airway swelling. Long story short, we put a scope down his throat and saw swelling around his vocal cords and put in a breathing tube to keep his airway open.#37
Did an FME (full mouth extraction) on a guy .Half way through he’s bleeding constantly excessively . I was only a dental assistant for about 3 months at the time so I didn’t know much about the health part . Doctor was freaking out and we couldn’t get the guy to stop bleeding . Finally he tells us after 2 hours that he’s on blood thinners . He came back the next day with his son and he was still heavily bleeding everywhere . Had to call ambulance to go to er .
I am now ocd and over excessive/cautious about medical history before any procedure because of this .
#38
My mother had an epidural for neck/back pain a couple of days before an appointment with her cardiologist. Her cardiologist sent her for a standard chest x-ray (follow up for the quadruple bypass she'd had 9 months prior), then sent us home. A couple of hours later his office called instructing us to go to the ER for a CT scan because something looked off on her chest xray, maybe nothing, better safe than sorry. It turned out her colon had ruptured and was leaking fecal matter into her chest cavity. She didn't feel any pain because of the epidural and had no clue. She'd have been dead within 24 hours if not for that cardiology appointment.Edited to clarify that fecal matter was leaking into her abdominal cavity, not her chest cavity. It was visible at the bottom of the chest x-ray. If memory serves me correctly it looked like a cloudiness where it should have been clear. My apologies.
#39
Had a lady that fell once at work. I knew by the way she went down, that her hip had to be broke. My colleagues were just so sure it wasn’t broke and I even went AGAINST the doctor and ordered her X-rays.. all because she wasn’t crying, or saying it hurt.. That pelvis was broke in 3 different places, plus the femur head was also broke. That lady never once complained of pain. Even walked on it.. She had dementia.. I’ve often wondered if some forms of Dementia just cannot feel pain?#40
One of my uncles (married to my aunt) has a genetic circulatory disorder he inherited from his mother. Except his mother refuses to acknowledge that she has the disorder herself despite pretty typical symptoms, never had him tested for it, and never mentioned the possibility of him having it until he started having symptoms as an adult and was diagnosed. Such a bad case of denial.#41
While I was interning in my general surgery rotation we received a patient for an emergent exploratory laparotomy (emergent open surgery) from the ER with severe abdominal pain. ER had done an x-ray and saw that he had bowel perforation (you can see a bubble of air that collects underneath the diaphragm on a standing x-ray).The patient history we got from ER was that the patient had felt pain onset 3 days BEFORE checking into the hospital but decided it was nothing and attempted to self medicate with vodka for the pain until it was too unbearable.
Here's the kicker - the bowel perforation was caused by acute pancreatitis (too long to explain the how and why) which was likely due to his prior alcohol abuse. So his "self medication" only worsened the state he was in.
#42
This is sort of the reverse of the question, but I had a follow-up phone call after an in-person appointment with a pelvic pain specialist. At what was supposed to be the end of the call I asked if she had any ideas as to why I’d been in so much pain for three years at that point. She said it was probably fibromyalgia, which no one including her had ever mentioned before to me. She was literally wrapping up the phone call when I asked, and I had some follow up comments and questions which confirmed I have fibromyalgia. The worst part is if I hadn’t asked her I wouldn’t have known and she wouldn’t have told me.#43
Couple of years ago, while i was a student - during an exam i had to examine a patient. Talked to him about his medical history:‘Have you ever had surgery?’
‘No’
‘So you were never hospitalized?’
‘No’
I finish with the history and tell him to remove his shirt to do a physical, first thing i see, a big scar in the middle of the chest..
‘Sir, how did you aquire this scar?’
‘Oh, that! Thats from my open heart surgery a few years ago’
…..
#44
As a patient, I went to the doctor because I had some kind of infection in my mouth. The doctor had a look at me and was like ‘how have you been otherwise?’ A bit tired, but my new sport had lots of 4am starts, so that made sense. That was also why I assumed I’d been losing weight.We talked through a few more things and the doctor said ‘this might be diabetes. Let’s take some blood and meet back up next week.’
A few hours later, the doctor called me at home telling me to go to the ER *right then* because my blood sugar was sitting over 40 mmol and he didn’t think I’d make it through the night without going comatose.
The surreal thing was that I felt fine (at least, I felt how I’d been for months) and I was walking around looking healthy enough. When any of the staff asked me what I was in for, the blood drained from their face and they freaked out.
Anyway, I have type 1 diabetes now.
#45
A patient of mine (anaesthetics) neglected to tell us that he had a difficult airway, fortunately we picked up a faded cric scar before induction.#46
Saw an old lady as a med student with a broken foot. We were chatting a bit and she mentioned a discolouring on her hand she was only mildly worried about. My supervisor wasn't quite sure what it was so we asked a dermatologist. Ended up being melanoma.#47
I'm in vet school, i hope this counts?Sometimes we have classmates bringing in their own pets for us to train different techniques (for example, how to handle a pet that is aggressive, a pet that for some reason has to be handled a certain way, or that has x condition so we get to see in class what it's like, etc).
This girl brought in her two elderly dogs. One of them actually had several health conditions and was blind, the other one was brought along just because they hate being away from each other. Of course we were focused on the dog that had health conditions, but at some moment the "healthy" one made a weird noise with her throat and the girl went "oh, she does that sometimes, i think it's just allergies or something, don't worry". The teacher thought it would be a good idea to train auscultation on the "healthy" dog as well anyways.
It was an ugly tracheal collapse, the student hadn't known the signs up until that point, and would never know if our teacher hadn't decided to check anyways out of curiosity.
#48
I had a headache, and a few hours later noticed that my irises were different sizes. I went reluctantly to the emergency room. Minutes after presenting myself I had neurologists looking at me and I was rushed to get scanned. The artery about an inch and a half below my brain had torn. The Drs were basically just waiting for me to have a stroke.I didn’t. Somehow.
#49
Me: I know my vision is a bit funny at the moment - I will go and get an eye test soon.Wife, after 4 weeks of me pulling my glasses to the end of my nose: Enough! I'm booking you a test.
Optician: Yeah, something isn't right - something is pushing in to your eyes from in your brain. You need to go to hospital. I'll call them now.
Phone call from hospital, while I'm in the opticians...
Me: Yeah, I can come in - but I'm taking my car in for a service on Weds - will Thursday be okay?
Them: Err.. okay?
Turns out I had a brain tumour in my Pineal Gland that was blocking the normal exit of brain fluid. Three surgeries and a round of radiotherapy later and it's 90% gone.
My wife, the optician and the brain surgeon saved my life, because I was too casual to save it myself.
#50
While I was a psychiatry resident, I did a graded 30 minute interview on front of my attending on a new patient without knowing any previous chart history.I spent 29 minutes collecting high yield medical and psychiatric history, and since I had an extra minute to spare, decided to ask him more about his childhood.
"Well, it was pretty shitty after I watched my dad murder my mom and then kill himself."
Needless to say, I did not have enough time to unpack that and failed my exam lol.
#51
Did a bunion & hammertoe surgery on a lady with no allergies. New patient packet, primary care note all had “no known allergies”. I always ask about metal allergy anytime I plan on putting in hardware…Surgery goes great. I’m on call for the practice and receive a phone call for the group 18 hours post op. Her nerve block had worn off and she was in excruciating pain. Give instructions on what to do.
Next morning she is in my office before I even arrive. 10/10 pain, sweating profusely, blood pressure elevated, foot is massive. Clearly not faking it.
Have to send her to hospital for intractable pain. Blood work indicates elevated eosinophils but everything else normal. No blood clot or infection.
Hospitalist convinced its complex regional pain syndrome. I rack my brain and think of WTF could be going on. I am only 5 months out of residency. My butt is puckering so hard.
Since eosinophils elevated, ask if she is allergic to jewelry? ??
“Yeah, my tongue swelled up when I had it pierced. I had it removed the next day”
She had a freaking NICKEL allergy. No allergist will see her to confirm so this is all speculation but makes sense with the hardware I used.
Once the hardware is removed and exchanged for titanium, her pain resolved.
There was one case in my residency of hardware allergy (1/3000 cases I was first or second assist on). If I did not scrub into that case, I don’t know if I would have figured this out so quickly.
Crazy case. Now I always ask: “have you ever had any reactions to jewelry?” A lot of patients won’t tell you about problems with jewelry and may not know they have metal allergies!
#52
Was called to the ER to do a psych consult on a patient that was complaining of GI symptoms but his story was sorta strange and he had no overt abdominal signs or symptoms. He was complaining that he suffered from "Barrett's stomach" (not esophagus) and had been diagnosed by a world famous gastroenterologist.He stated that if he could lose weight that his GI issues would resolve. I spent some time talking with him and, other than this strange fixation on his "Barrett's stomach," he seemed okay.
Until...he mentioned that his most recent weight loss method was to shoot himself in the thigh so that the leg would become gangrenous and eventually need to be amputated. This would allow him to quickly lose the 20 or so pounds needed to cure his stomach ailment.
The man actually had a self-inflicted gunshot wound to the thigh from several days before.
I didn't actually assess the would because I was there for a psych consult but did immediately alert the ER staff. I was all calm and nonchalant like ohh sir, excuse me for a sec - I'm gonna pop out and let another staff member know about this so they can take a look at it for ya!
The ER was located in a county that employed a staff of mental health social workers to place psych patients so I had to call one of them out while he was getting (thoroughly physically) assessed. I have no idea what happened to him but I hope he's doing okay.
#53
I was an internal medicine resident who had a patient come to my clinic for “persistent flu”.I had never seen her before, and she was a healthy appearing woman in her 60s. About a month before seeing me, she was seen by her PCP with persistent coughing, and otherwise had no shortness of breath or other infectious symptoms. Just a dry cough. She got tested for flu and was negative, but got tamiflu just incase it was a false negative. She had a chest X-ray which was normal. She came to me a month later because her cough persisted despite completing her therapy.
Everything sounded great. Heart, lungs, everything. To be honest I don’t usually do this, but something in my gut told me to feel for lymph nodes. I felt around and found something above her left clavicle. It was hard, round, and she was completely unaware of it. I told her it was probably a reactive lymph node, but just incase, I wanted to get an ultrasound. This cascaded into her getting a biopsy, which showed squamous cell lung cancer. A CT scan showed stage IV lung cancer, not seen on her chest X-ray. All diagnosed because of a lymph node that almost by chance I was lucky enough to find by being thorough.
I checked her chart about a year ago, and she was doing well. She got therapy and was in remission after a very long road and many obstacles. I’ll never forget her or her case.
#54
Me: Any prior surgeries?Patient: No
Me (examining them): Did you know that you only have one testicle down here?
Patient: Oh yeah. I had one cut out.
​
I always asked specifically about gallbladder, appendix, and testicles because patients forget about having A F*****G ORGAN CUT OUT.
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