Once in a while I get a break from purely orthopedic stuff and wield a stethoscope as a “general practitioner”. I used to like the general medicine as a student but when clerkship bombarded me at least fifty patients a day giving nothing but prescriptions and prayers as “medicines”, I resigned myself to cutting it out in the surgical field. In my place of practice though, there are times when you’re the only doctor within 1 kilometer of a medical emergency and every other medical practitioner is busy handling other medical emergencies somewhere else. God knows what happens if the patient’s relatives find out you don’t know what atrial fibrillation looks on ECG. So when push comes to shove, I welcome instances where I can re-learn my rustic general medical skills. Or at least mount an attempt to re-learn.
Two days ago I started seeing patients for routine medical physical examination. The sheer volume of patients made me think I’d get bored or get tired sooner. Surprisingly, I found myself enjoying the “routine” job simply because its something not routine for orthopods like me. “A break in the monotony of bone breaking, hammering and screwing..” perhaps. The same fun feeling and excitement when you had your first few patients as a medical student. This routine physical examination also gives me the opportunity to look at the depth and effectiveness of my patient communication skills, especially in medical topics way beyond the orthopedic cram space.
The sheer volume of patients also brought in funny experiences and encounters you’d probably die of laughing out loud in the washroom.
Here are some of my (funny) encounters;
Patients chart says: Chief complaint: “occasional headaches”.
Me: “Masakit po ba ulo ninyo ngayun?” (Do you have a headache now?)
Patient: “Wala po”. (None)
Me to self: (Right, this encounter must not be an occasion for his headache to come out)
Me: “May “cough” po ba kayo ngayon??” (Do you have coughs right now?)
Patient: “Wala po. Ubo meron” (None, but coughs I have.)
Me:” Sino po ba nag bigay reseta ng “salbutamol” sa inyo?”(Who gave the prescription for your medicine, Salbutamol?)
Patient: “Tatay ko po” (My dad.)
Me: “Doctor po ba cya?”(Is he a doctor?)
Patient: “Opo, doctor po apilyedo nya!” (Yes, this patient’s last name is “Doctor”)
You couldn’t hide snickers whenever a patient answered like this:
Me: “Kelan po ba sumasakit ulo nyo?” (When does your headache usually occur?)
Patient: “Tuwing nag tatanggal kami ng damo sa school” (Everytime we’re tasked to weed out grass in the school grounds!)
Believe me I couldn’t contain my heart laughing out loud during these light moments. I don’t know if its because of the many misunderstood and trivial complaints you get whenever its an ambulatory clinic you’re conducting (or that I was just too confined with more serious, trauma patients). One thing though, we all needed the laugh just so we can finish some two hundred plus patients each day.
Who said my specialist life is too constricted and boring? If there are instances like this where you can find time to re learn your medical skills as a general practitioner, why not? Especially, when there are plentiful of laughs you can make out of the “routine-ss” of the situation. I can surely wield some stethoscope.