Who’s on first?

November 20, 2008 at 2:58 pm (Clinical rotations)

Sometimes I encounter patients who are so inept that I wonder how they can remember to breathe and feed themselves. I occasionally have people show up to the emergency department who give a history that closely resembles Abbott and Costello. The following is a real honest-to-God encounter I had recently.

Me: what brings you to the hospital today?
Her: I fell and hurt my arm.
Me: how did you fall?
Her: I slipped in a chair.
Me: did you fall on the floor?
Her: no, I was in the chair.
Me: did you fall into the chair?
Her: no, I was already sitting there.
Me: so let me get this straight: you were sitting in a chair and then fell into that same chair.
Her: exactly.
Me: and you hurt your arm?
Her: yes.
Me: where on your arm does it hurt?
Her: right here on the inside.
Me: how did you hurt the inside of your arm?
Her: I fell in the chair.
Me: did you hit something?
Her: I hit the chair.
Me: on a scale from 1 to 10, how bad is the pain right now?
Her: it’s a four.
Me: I see here that you have a previous history of arthritis. What is your pain level usually?
Her: it’s a four
Me: so let me get this straight, you’re in the same amount of pain right now that you are always in?
Her: yes.
Me: what’s different about today than any other day?
Her: I hurt.
Me: is this a new kind of hurt?
Her: yes.
Me: what’s different?
Her: I fell.
Me: I see. How about I just send you out on some ibuprofen?
Her: okay.



  1. thehillbillyhealer said,

    Isn’t that one of the main reasons to do this? Life is all about those moments when all you can do is shake your head and smile.

  2. anon said,

    ahh, that’s not the part that gets you. Wait until the senior doctor walks in the room and the patient then gives a perfect history!

  3. dragonfly said,

    I am so with anon, happens so often.

  4. cremasterflash said,

    if you’re going to use the word “inept” to describe someone else, you might want to make sure that sentence is free of misspellings. it’s “breathe”.

    you can be pompous or human, not both.

    Half M.D.: Thanks for the correction

  5. AFDoc said,

    That’s precisely what copays are for!!!!!

    Trust me, without copays, there’s nothing to make someone think twice about coming in for a bloody nose, a hangnail, or URI sx on day 1.

    It’s great that you are writing these encounters down–they keep the edge off when patients aren’t so nice.

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