Tuesday, May 05, 2009

The Guileless Physician

After a long time, I found myself as the guileless physician if only for a few minutes.

My girlfriend Joy, who just came from a fabulous Boracay vacation, was in a hurry to finish up her OPD duty when another patient came into the door. The patient was escorted by one of the hospital employees, who appeared to be her friend.

Joy told me to examine her. From the get-go, it was apparent that the patient was suffering some kind of upper respiratory infection - dry, nagging cough. I did my history taking in the usual manner of graduates from the best medical school along Pedro Gil Street. I also did a systematic physical exam - old habits die hard.

But when it came to writing up my chart, I hesitated for a bit.

Of course, I knew that there were no rales, wheezes, or retractions during my chest exam. The rest of the physical exam was normal - no enlarged lymph nodes, no swollen tonsils, etcetera, etcetera, etcetera.

I hesitated because for an uncomfortable 20 seconds there, I strained to remember the archaic acronyms that I used to litter my charts with - (-) CLAD, NVE; AP, DHS, NRRR; ECE, CBS, (-) R/W; globular, NABS; FEP, PNB (-) edema.

When I realized that I have slightly dislodged the skill of creating an efficient physical examination note with "public static void main", "ipconfig /all", "shutdown -y -i5 -g0", I felt a small tinge of guilt. For five years I was a virtual automaton - writing those things down with modifications for significant PE findings - and now I seemed to have lost my touch.

Frankly, my patient did not notice it - but I did. And it had me thinking about things again. Which made me more tired than the whole 14 hour stay I had in the office.

Oh well, nothing that a little ambling around the Internet couldn't solve.

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