Mr Ramesh is a good friend and also a patient, a dreadful combination. He came to me complaining of chest discomfort and insisted that it was due to drinking scalding tea that morning. Ignoring his diagnosis, I started asking him the usual questions we doctors ask to exclude pain due to heart disease. Where was the pain, did it go up to the neck and down the arm, was there any sweating, how long did it last, etc.
When I was asking these questions, he sat there giving me a bored look. I knew what was going on his mind. ‘I came here with some trivial problem and this fool is asking these stupid questions’. He looked at his watch twice in those few minutes I spent trying to get a proper history.
Despite his protests, I did a cardiogram. The tracing showed severely compromised blood supply to a portion of the heart. I explained the gravity of the problem, gave him a note for hospital admission, called the cardiologist friend of mine and sent him on his way.
The same afternoon I went to the hospital to see him. I went directly to the coronary care unit. I did not find him there. Then I went to my cardiologist friend to find out what had happened. Before I could open my mouth, he asked me, ‘where is your friend?’ Having made sure that he was not in the hospital and worried, I called his office only to be told by his well-meaning secretary that he was fine but in a meeting and would I mind calling him after an hour or so? The knowledge that he was alive was reassuring but all the same the worry was no less.
I went to his house to apprise his wife about the serious nature of the problem. I found her having her prized afternoon siesta. After I finished my tale regarding her husband’s erratic behaviour, she gave me a splendid piece of advice. ‘Doc, you always worry too much. He gets these pains after drinking hot tea. You have advised him to stop this bad habit [I did not remember this piece of expert advice having been given] and if he does that, he will be OK, you wait and see!’ I requested her to please send her husband to the hospital with out wasting any more time, drank the cup of tea which she had made and returned home thoroughly depressed and worried.
Are you wondering what happened to my friend? He didn’t want to go to the hospital, especially when all the pain had gone and he felt very good. He made an uneventful recovery. His subsequent ECGs showed a small scar and his treadmill test came back negative. According to his wife, he gets no chest pains now because he has stopped drinking hot tea. No credit whatsoever to the poor me who spent several sleepless nights and anxious days looking after an unwilling and, I suspect not very grateful patient! Even now he says he takes the medicines to keep me in good humour!
This true life story I wrote several years back. This episode illustrates the fact that many patients do well despite us doctors.
3 comments:
There is no need to feel bad. No doctor can cure a hypochondriac or a patient who is not co-operative.
Seetharam
I second that, Doc.
As you wrote, a friend and a patient may be a 'dreadful' combination. But I imagine that patients who self-diagnose and eventually prove themselves right in some way can test the limits of a Doctor's "patience" :-)
Rajiv.
As a matter of fact it is not too bad. Most illnesses are self limiting and you can get away with it.I even encourage my patients to treat these simple ailments them selves.It is only when they do so with serious disease the problem arises!
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