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Friday, February 26, 2010

Show and Tell: Crabs

Doctors are like hookers, I've already explained that in earlier posts.

Doctors are also like priests, in that we are in the very privileged position of being told secrets.

(This humbles me without fail. Every time I am privy to such sacred and volatile information, I am humbled immensely.)

Totally top secret.

Makes me feel like a supercool secret government agent handling top secret state-of-the-nation information.

Like James Bond.

Oh yes!

Did you see how I did that? Are you smart enough to follow my logic?

I just proved that doctors are cool like James Bond.



Uh...Oopsy...sorry!

Don't mind me, just got a little carried away there.

I should have warned you that my mind is usually served twisted, not stirred.


What I mean to say is this:

We are human vestibules for people's secret fears and whispered confessions...

For example, "Hi Doctor, I have crabs."

Which was how my last patient of the day introduced himself.

I was thereafter also politely introduced to the actual crabs, enshrined in a little plastic bag and thrust in my face for me to inspect.

"Hi crabs." I said.

They were dead though, suffocated I think, so they didn't return the greeting.

The recognition of crabs (pubic lice or pediculosis pubis to those in the know) is immediately followed by the feeling that one has them crawling all over one's body.

Suddenly scratching myself vigorously, I thanked him for being clever enough to bring the offending evidence in for me to scrutinize.

I do love it so when my patients play "show and tell" with me.

Reminds me of being at pre-school.

(Hey Teacher! Look what mommy got as a present from the poolboy!)

Tuesday, February 23, 2010

Why I will NEVER be a paediatrician.

I just remembered the reason I will never ever ever ever ever ever EVER be a paediatrician.

Not because I hate children.

Nope.

I love children, and I feel too much pain when they're ill.

But that's not the main reason.

The main reason is that children come with MAJOR baggage.

Two big lumbering overladen travelling trunks of baggage,

Namely...

THE PARENTS!

I just really can't deal with the parents.

Sorry.

The Sore Sound

This one's for you, Dr MJ.

There is a sound, made by patients, that I am incapable of reproducing.

This sound is akin to nails screeching down a chalkboard in its ability to cause me physical pain.

Needles, like poison-tipped needles puncturing my tympanic membranes.

It is not the agonising groan of the patient with the ruptured appendix.

Nor is it the gasp of the patient being given the horrifically painful bicillin injection to cure their syphilis.

Oh no, it is the sound made by the “otherwise well” patient.

The patient that you spot happily chatting away to the receptionist in the waiting room.

The patient, that jumps up when the receptionists calls their name.

The patient that, as soon as they walk into your office, and see your face, immediately makes “THE SORE SOUND”.

No, “ Hello Doc”.

No, “This is my problem”.

Just. This. Damn. Sound.

I can’t even describe it – let me try,

“SSSsssthhhhhhmm”.

NO wait, that’s not right, it’s more like,

“Phffffffffffffffhhhhhshhhtttmmmm”.

Jees, I’m not doing this properly...

It’s like the sharp indrawing of a breath while at the same time exhaling and whistling through one’s teeth and moaning.

It is also invariably accompanied by sorrowful head shaking, the avoidance of eye contact and the slow rubbing of a fat thigh.

They make the sound for about sixty seconds. Unmercilessly.

By this time I am hiding under the desk...whimpering, clutching my knees, and rocking slowly back and forth while a little drool dribbles out the side of my cheek.

My regression into a basket case is due to the knowledge of what the Sore Sound actually means. It is signal that announces that the next seven hundred hours of your life are going to be spent listening to this patient complain about a painful something - usually a knee, or foot.

A knee or foot, that is under immense physical pressure from the unjust weight of the gargantuan monstrous thigh and buttock that is certainly the cause of the pain in the first place.

Oh no you don't, don't you dare call me a fattist!

Only when you have a morbidly obese patient sitting across from you making the sore sound, who:

1:Refuses to listen to your multiple counselling sessions to lose weight.

2:Refuses to keep the many appointments you have made for the dietitian because they coincide with the annual church cake sale.

3:Never went to the orthopaedic surgeon you referred her to because the state health service is so overwhelmed that an appointment could only be made for 7 months down the line and therefore was forgotten about.

4:Prefers to sit in your office and make the sore sound, and complain about the pain, so that she can just be prescribed the damn voltaren tablets that, "the other doctors know to give me, Doctor."


Then, only then, after suffering all of this, are you allowed to tell me I'm being rude...

Of course,by then it will be too late...

I won't be able to listen to you seeing as the patient has just successfully worked on my last nerve, namely the cochlear!

Wednesday, February 17, 2010

A little pee to help you see?

Please note:

Urinating onto a dirty washrag and then squeezing drops of urine into your eye is NOT the correct treatment for conjunctivitis.

Regardless of what 'Aunty Marie down the road with the daughter who is a cleaner by the chemist' told you.

Wednesday, February 10, 2010

Private Practice

A young lady Dr, beaming, opens the door of her very own, clean, air-conditioned GP consulting room. Feeling particularly professional in her black satin pencil skirt, silk blouse and expertly applied make-up, she represents the polar opposite of the cranky, pee-stained, sleep deprived trauma doctor she was a few weeks ago.

A mornings only stint in a lovely private practice for the month of February.

This should be a breeze.

Would she like it? A gentle GP breeze as opposed to the tornado of trauma she's used to.

Snotty noses versus gunshot face?

Sore throats versus panga to the cranium?

Will she even have to engage in any taxing cerebral activity?

Flashing a radiant smile at the long queue in the waiting room she welcomes her first patient.

The patients all look at each other nervously.

Nobody makes eye contact with her.

Nobody stands up.

This is not going as planned.

She tries again, this time clutching the stethoscope around her neck. This serves both to remind the patients that she is a doctor, and to remind her of what that stethoscope has helped her to achieve in terms of patient care.

Number 5 in the queue, a middle-aged gentleman, eventually stands up and makes his way into her office.

“Are you new here?” He asks her.

She responds, “Yes, I’m filling in for one of the doctors who are on leave. How can I help you sir?”

“Are you really a doctor? You look too young. And you don’t look like a doctor. They are saying outside that you’re too young to know anything and that they would rather wait to see the older Doctor that’s been here for years. But he’s not here yet and I’m in a rush so I thought I’d try you out. I hope you can help me.”

She takes a deep sigh, this is not the first time she has been sorely accused of youthfulness.

She wonders if a few greying streaks and some crow’s feet would help instill confidence in her patients.

As the morning progresses and she is confronted with skin rashes that didn’t read the textbook definition of their supposed morphology, vague symptoms that do not tie neatly into one specific diagnosis, complaints of being stressed, and other such symptoms that she was not taught how to treat at medical school...it dawns on her that there is more to being a GP than meets the eye.

Thankfully, The Universe has decided not to punish her completely for being so blasé about GP’s in the past, and has given her the gift of Dr BD in the consulting room next to hers. Dr BD, is a bubbly, enthusiastic doctor with what can only be described as an inspirational passion for GP medicine. (Who knew these Dr's actually existed!)

Dr BD is in possession of all the little secret GP tricks that one can only gain with experience and she makes excessive use of his knowledge throughout the day.

Luckily for her he is keen to teach her the art of this general practitioner stuff!

That first brave patient who took a chance on her poured out his soul in 20 minutes, and discussed very intimate details of his troubled relationship with her.
She is supremely humbled by this, and unsure of what concrete medical treatment to give him, she lets him talk, probing gently here and there for signs of depression or suicidality. There are none that she can detect. He leaves her office with a referral to a psychologist and social worker.

“I hope that I helped you in the end, sir.” She says before he leaves, wondering if the patient would be satisfied with the lack of anti-depressants/anxiolytics she had not prescribed.

“You’re young, but at least you listened to me.So yes, you did help me.” He says.

Hmm...Listening.

A new weapon to add to her medical arsenal?

Sometimes no medicine is the best medicine, apparently.

And like a war veteran returned home after surviving the battle, nervous that she would be bored by anything other than the constant adrenaline rush that had so dominated her life, she ended her morning satisfied that wherever she goes, there are knew things to learn and secrets to discover, both about herself and the world around her.

It's just a matter of being receptive to the lessons...






p.s. Stupidosaur, Deluded, Ketan...this one's for you. I have recently moved residences and have been without an internet connection for days, with no wifi on the horizon for at least a few more weeks thanks to the non-efficiency of our telecommunications company in SA. I won't go into the details of the killing,maiming, pleading and selling of my soul I had to go through to be able to publish this post...I'm just saying...I hope you're satisfied?!?! :)

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