Doctor Curmudgeon®: Why? Oh, Why? Oh Why?
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By Diane Batshaw Eisman, M.D. FAAP
Doctor Curmudgeon® sighed inwardly as she scanned the Review of Systems document filled out by her new patient.
This was a relatively comprehensive paper with a multitude of questions, such as: “Are you short of breath? Does your stomach hurt? Are you sick of reality TV?”
She had been trained in the Miocene era when Mastodons roamed outside her waiting room grazing on leaves, grasses, swampy plants and assorted twigs for fiber, thus leaving a clear path for her patients to traverse that early landscape to the opening of her cave. In that era, she had performed the essential review of systems portion of her history differently. She would simply sit facing the patient and ask many, many, many questions.
Shaking her curly, somewhat messy head, she had to agree with herself, that this new form, at first glance seemed to be a good thing. It allowed people to sit quietly and think about each query and respond to it.
As Doctor Curmudgeon® reviewed the form; she asked her patient, “Oh, I see that you have circled ‘yes’ for shortness of breath. How long has this been going on?”
Answer: “About a day.”
Question: “Are you having chest pain?”
Answer: “No, I was just short of breath.”
Question: “Does this happen every day?”
Answer: “No, it just happened once.”
Question: (as a light bulb exploded over Doctor Curmudgeon’s® head). When did this shortness of breath happen?”
Answer: ” About a year or so ago, when I had this horrible flu.”
Question: “And you have not had any shortness of breath for at least a year?”
Answer: “No, of course not, it only happened when I had that thing that everybody in the office had.”
Question: “I see that you have circled ‘depression, Are you feeling depressed now?”
Answer: “Oh, no, Doc, that was about ten years ago, when our basketball team lost the championship game, but we all felt fine the next day, because vacation had started.”
The soul-satisfying sound of papers labelled Review of Systems being ripped up resonated through the office as Doctor Curmudgeon® recalled the good old days when she asked the patient lots of question and the patient responded and so they conversed with each other
Sighing, her thoughts went back over 10,000 years to the days when her pet Mastodon chomped away outside her cave, happy with his vegan diet, and her patient approached her cave for a consultation.
There were no reams of forms for patients to fill out, no electronic records with drop down menus fraught with the possibility of errors, no gate keepers to call and beg for studies that her patients needed, no medications that cost so much, her patients had to decide between meds and food…no…
Just that adorable Mastodon daintily chewing his vegan diet
Doctor Curmudgeon® is Diane Batshaw Eisman, M.D., a physician-satirist. This column originally appeared on SERMO, the leading global social network for doctors.
SERMO www.sermo.com “talk real world medicine”
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