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10 April 2012

One very unique patient

During my training, I have to do 6-month placement in general practice. During GP sessions, we have 10-minute slots for each patient. It actually is not easy to see one patient in 10 minutes. We have to ask a few questions, examine them, make data entry on computer system, and provide medical prescriptions if needed. Although I do not like it, I have no choice but to rush and speed up when seeing patients to keep up with my time frame.

There is one lady, who I think is very lonely at home, likes to come to GP surgery everyday for no reason. She just likes to come and chat or sometimes complains some random non-medical stuff. Not only that she likes to come and chat at reception but she also likes appointments to see a doctor every now and then. 

One other problem with her is that she is extremely deaf to the point that she can not hear anything at all. She doesn't like wearing hearing aids either, so how do we communicate with her? She shouts and we write on the paper for her to read.  Joy!

One day she ended up in my GP clinic session. So here we were! (lets say her name is Doreen)

She said:                 "Doctor, thank you for seeing me. how are you?"
I wrote:                   "I am good, thank you. How are you Doreen? How can I help you today?"
She replied:            "Look doctor, everybody called me Miss, I am not a miss, I was married. we were married for 20 years, and my husband died during World War. (here she talked about all her husband war experiences). So I am a Missus. I tried to change people but they keep calling me, miss, that makes me angry ........... ........... " and she carried on .....

Although I tried to stop her, she didn't hear me. What a surprise! So she kept talking on and on, non stop. Finally, as it went on maybe over 5 mins, I had to put my finger on my lips, said "Shooo" and told her to stop. 
Then I wrote:          "Doreen,  its very nice to hear all your life stories, but what can I do for you today?"
Then she said          "Oh yes, why did I come here today?"           "Oh I remembered, I had this leg swelling for over 2 years now. I went to the doctor and he said, not to worry, but it was because of my weak heart. I am using this medications. I also have weak legs for 10years. Look at these rash, there are there for nearly 20years now. What can I do? ...... " and she kept talking non-stop again for maybe another 10mins of her very chronic medical problems. 

To add on here, although she has a few medical conditions, I think she is amazing for her age. She is 93years old and she dresses up like a Barbie Doll everyday, with beautiful lipsticks, makeups and eyeshadows, and walks to our practice everyday. Sometimes, we see her fighting at shops on the street when we comes to work. 

I gave up my plan of keeping up with my time and I just let her talk. Its already about half an hour with her anyway, how much more could I be late?

But even when she finally finished her non-stopped talking, I still could not find anything i could do to help her. Then I thought, maybe she just liked to come and chat with a doctor, maybe I had nothing to help for her for the day. 

I wrote:                 "Doreen, I know you have a few medical conditions, but as they are long term problems and they are very well controlled, for now just continue taking your usual medicines"
Then she suddenly said:                 "Oh I remember now what I wanted to talk to you doctor"
I asked:                 "Ok what is it, Doreen?"
She replied:          "I swallowed my loose tooth"
I wrote:                 "Ok let me have a look, Did you cough, vomit or choke?"
She:                      "I can't remember. It might be in my stomach"
I :                          "Ok, let me look at your throat and listen to your chest, just in case it went into your airway"
After examination, I:      "Everything looks Ok, maybe it will pass when you open your bowel"
She said:                        "NO it hasn't, its been 5 years that I swallowed it"

Erm?? Groan **