The reason for the patient's visit only said "difficulty sleeping," and the inexperienced first-year medical student had been sent in to take a preliminary interview.
It was going well, as usual. The patient was asking about work stress, home stress, and the like, and the patient kept responding that there wasn't any stress in those areas.
"Is there anything else that could be causing you stress right now?" the student asked.
The patient replied, "Well, nothing, other than my trial."
"Your trial? Are you a lawyer?"
"No," replied the patient. "I'm currently on bail, but I have a trial date coming up next month. I have to go on trial because I murdered my boss."
Note the patient didn't say "on suspicion of murder." The patient flat out admitted that he was on trial "BECAUSE I murdered my boss."
Apparently the doctor knew about this rather unsettling part of the patient's history, but sent the student in unaware... just to teach the student that you should never make assumptions about your patient.
Lesson learned? I'd say.
I am so glad that my family practice supervising doctors never put me in a situation like this.
Oh, and yes, while identifying details have been changed, this is a true story.
Monday, March 24, 2008
Is there anything in your life causing you stress?
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4 comments:
That would be awkward... Wow.
It's like, excuse me? You did what?!
That must have made the rest of the history taking pretty awful. How would you respond to that? I'd have probably thought he was joking at first.
Ha. That reminds me of a patient I saw who when I asked about medical history said: "Well, there was that time one of the Hell's Angels tried to kill me. By putting a meat cleaver through my skull."
I interviewed an elderly lady who told me a harrowing story about vacationing in Mexico and was accosted by a bunch of threatening men who showed up outside her house. She threw a kitchen knife at one of them and they took her hostage. She spent about a week without food and water in a hole and was moved to an airport and then... she somehow made it safely back -- to the psych ward.
Her story was very convincing, mind you. Only after the fact did we learn that she was recently diagnosed with Alzheimer's after attacking a police officer with a knife.
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