Another day, another crazy patient

Everyday starts out the same, a list of 20 patients to see before lunch. The fun part of internal medicine is that you have no idea what kind of crazy is going to walk through the door. I enjoy knocking on the door of the exam room and having no idea what i am in store for until i ask my favorite question, "what brings you into the office today?" the next few words uttered from the patient are no longer a shock to me...here are a few highlights from the last few days-

- it burns when i pee
- i have a pain in my right testicle
- i burned the lower half of my face with hot wax
- my husband is leaving me for a woman younger than my children
- i was a witness to a bank robbery and cant sleep
- i drink 9 beers a day, smoke 2 packs a day and need a physical for a discount on my car insurance
- my wife made me come
- i have had bloody diarrhea for the last 3 days (go to ER not the Dr office!)
- i have trouble breathing and have been having chest pain (also, go to the ER!!)

those were just a few of the fun ones.....of course there are the normal, i am here for my normal 3 month check up, i need refills, i have a runny nose, a cough, a headache....

The range of patients and range of complaints is fun, not knowing what is going to happen before going into the room is a blast!

A few days ago I experienced my first awkward moment with a patient. I performed a urethral swab (Dr was present) on a patient I suspected of having chlamydia...(btw i was correct) the male patient presented with pain at the end of urination, has been having unprotected sex with a partner who has not been screened for STI's, and he had never been screened for an STI...seriously, not a tough diagnosis. Unfortunately in order to confirm the dx I had to place a small swab into the urethra and hold it there for 30 seconds. This had to have been the longest 30sec of my life. (i imagine the patient did not enjoy the 30sec either, but maybe from now on he will learn to wear a condom!)

it seemed to be the day for urology complaints...that is possible another field that could see myself doing.....so far i am interested in GI, urology, infectious disease. I guess the nice part is i am starting to enjoy contact with patients...even the patients that are totally crazy are in their own way a little amusing....

speaking of crazy patients, there was another patient that came in because of anxiety. She seemed very overwhelmed and anxious, and shaking periodically during the H+P. Even while i performed an EKG, her body would shake. I spent a lot of time talking to her, trying to calm her down, keep the environment friendly and comfortable. after discussing some options with the doctor she left with a plan, and a follow up appointment. The next day i came into the office, and she had left a message for the Doc, mentioning how comfortable she was by the time she left, and how distressed she felt on arrival. She wanted the dr to know i did a great job making her feel calm and comfortable.

A lot of patients have mentioned to him, that they enjoyed talking with me, and that i make them feel comfortable and at ease. Seriously, i hope my attending doesnt think i am paying people to say nice comments about my patient/bedside manner....but either way, its nice to hear :)

I guess i cant cross psychiatry off the list....

well i need to finish reading Harry Potter, since my attending finished it on sunday is planning on questioning about it tomorrow since he cant believe i have not finished reading it yet.

will try and post again in a few days, tomorrow is my scrub class for OB/Gyn and Surgery...that should be interesting...