Tuesday, 6 March 2007

Patient: "So...what do you think is wrong with me?"

As a medical student I dread this question, I never answer the question with a direct diagnosis because its not my place to do so as a student. In fact, often I've got no idea anyway but we've all got some knowledge tucked up somewhere and usually have some idea, in our own little heads, what might be going on.

It's worst when its a textbook case of something sinister. Today for example I was asked the question by an elderly lady who'd given me an almost textbook history of a certain pathology with an extremely poor prognosis. She had no idea that what she'd described to me might be serious and she was the nicest of old ladies who offered drinks and biscuits despite being barely able to walk. She had no idea that I had a diagnosis running through my head, I just politely replied that I had no idea what was wrong and the doctor who would be seeing her later would be able to discuss the problem further. As far as I'm concerned this was the right thing to do and although we've had 'training' on breaking bad news, I'm not looking forward to the day when it's my turn to give some life changing information to a patient or their family.

I pray that I'm wrong, perhaps she didn't have anything wrong at all (although the GP did send her for urgent investigations.) In a few weeks I'll chase up her results and see for myself, in the meantime all I can do is hope that she is ok.

6 comments:

HospitalPhoenix said...

Ah, she sounds sweet. She might have full well known her diagnosis and just been testing you. Like a spy, or a plant, to find out whetehr you have the makings of a good doctor or not.

Seriosuly though, I think you did the right thing. Even if you're correct about her Dx, it's not your place to tell her, or counsel her about the treatment options and prognosis. That has to be done by someone experienced.

Cal said...

I think that you did the right thing. I'm just a third year, I haven't faced that situation yet...

Cal said...

By the way, thanks for the advice at my blog! Was really decent of you!

Oh, and I read your rant in the Student BMJ. I guess our gripes are kinda similar that way...

The Angry Medic said...

Hey, you've been silent for some time. What, you not planning on making it into the next BritMeds, you lazybum? :)

I don't envy you your position in that interview. It makes it so much harder to inform patients of their diagnoses when they're the archetypal nice guy/sweet little old lady, doesn't it?

HP's right though, you did the right thing. Keep us updated...I've got my fingers crossed for that lady.

the little medic said...

HospitalPhoenix - Thanks for the confidence. Maybe she was a spy indeed.

Cal - Thanks, and yeah, sounds like we have similar problems.

and last but not least Angry - What can I say, I AM a lazy bum! Hopefully will get round to posting later but I'm still having computer issues. And I will of course keep you updated on the little old lady.

HospitalPhoenix said...

Who's having problems..?

Is there anyone I can beat up for you?