Be Succinct

Anonymous Doc provides a hilarious peek into the exam room.  “Ah, patient histories.  Consider this a crash course.”

“So, what brings you in?”
“I’ve been getting up every 45 minutes or an hour to urinate during the night.”

“You get up five, ten times during the night to go to the bathroom?”
“Well, maybe not five or ten. Three. Two or three. Most nights.”

“Okay. How long has this been going on?”
“The past couple of years, maybe four years.”

“Wow. That’s a long time. What brings you in now, specifically?”
“Oh, I have a rash.”

“You have a rash on your–”
“No, no, not there. On my stomach.”

“And you think this is related to the nighttime urination?”
“I don’t know.”

“Okay. Let’s talk more about the rash. How long have you had it?”
“About a month.”

“And you’re first coming in now because–”
“I had microscopic blood in my urine.”

“Microscopic?”
“Yes, very small amount. I could barely see it.”

“Okay, that’s definitely concerning. And this was this morning?”
“No, no, 1996. It was because of a weight loss pill I was taking. I stopped taking it.”

“Okay. So what changed today that you came in to see me?”
“My sleep has been very poor.”

“Because you keep having to get up to use the bathroom?”
“Yes, and because of my leg.”

“What’s wrong with your leg?”
“Well, I think have the rash because I’m not showering as much as I used to. I have trouble balancing in the shower. So I think I keep getting food on my stomach and that is causing the rash.”

“And the trouble balancing–”
“That is my leg.”

“So you’re having trouble balancing, or trouble standing?”
“Yes.”

“Which one is it?”
“I don’t know. My mother had an infection on her leg a few years ago.”

“Okay.”
“Do you think I could have the same thing?”

“I don’t think you caught an infection your mother had a few years ago, no. Whether you have an infection in your leg is something I can’t tell without examining you. I’m just trying to isolate exactly what’s going on now that we need to be most concerned about. Is the trouble balancing a new thing?”
“No.”

“Is the leg pain new?”
“I don’t have leg pain, no. I have a rash.”

“On your stomach?”
“And my leg.”

“Okay.”
“And it burns when I urinate.”

“Now?”
“It does not burn now. Only when I urinate.”

“When is the last time it burned?”
“In the night. I don’t urinate during the day.”

“On purpose?”
“I don’t know. But do you think it has to do with my mother’s leg infection?”

Clearly explain to your doctor the purpose of your appointment.  Maybe explain it to yourself first, so you know what you hope to get out of it.

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