Monday, April 16, 2012


This is an actual conversation I had with a patient during my primary care clinic as an intern:

Me: "So do you have any medical problems?"

Patient: "No, nothing."

Me: "Nothing at all?"

Patient: "No."

Me: (flipping through the chart) "Wait, do you have AIDS??"

Patient: "Oh. Yes."

That was sort of a weird situation.... I have never seen a chart of a HIV+ patient that was so completely stripped of any information on her disease. It's almost as if her denial transmitted itself to her chart.


  1. That happens to me a lot... *facepalm*

  2. My personal favourite was of a woman who denied ever having had surgery yet had scars from at least eight surgeries - including a mastectomy! It's amazing the things that people can forget or not include in their list of medical problems.

  3. It gets even more amazing when said surgeries are in the same area as the problem.

    "So, you have abdominal pain. Any surgery anywhere in your tummy?"

    Only to go on and find a Pfannenstiel, a right subcostal incision and a median laparotomy that had to be covered with a VAC.

  4. I used to get the following:
    "Do you have any medical problems?"
    "No, I'm healthy."
    "Do you take any medications?"
    "Yeah. A white pill, I take it in the morning."
    "Oh...well...why do you take it?"
    "The doctor gave it to me! Why, isn't it good for me?"

  5. I was asked the other day if I had any chronic conditions and I said no, then my doctor said, "you have a history of rheumatoid arthritis?"

    Oh...this is awkward...yes.

  6. My favorite -
    "Do you have any health problems?"
    "Do you take any medicatons?"
    "Yes." patient takes out a plastic bag full of prescription bottles.

  7. Some of these seem like grey areas to me... Most patients don't like to think of themselves as sick. I don't think they define health "problems" the same way medical professionals do.

  8. This is all-too-common, unfortunately:

  9. Ugh. This happens all the time at my ER. I usually don't find out until after I've started the IV that the patient is positive and they just happen to mention it in passing. Not that general precautions aren't sufficient, but still. It helps to know these things. I've gotten to where I've adjusted my triage questions to "do you have any problems you have to take medicine for on a regular basis?" because so many people seem to think if it isn't immediately bothersome it doesn't count as a medical problem.

  10. This happened to me to. Dude rocks up to ED with one month history of worsening dyspnoea with bilateral hazy opacity on Xray, vascular lesions on roof of his mouth, neutropenia and vision change. Referred to respiratory (me) as simple pneumonia (don't even get me started on the conversation I tried to have with ED about how this was clearly not simple pneumonia and don't you think this is more of an ID admission?).

    Dude tells me he not only has no health problems but is extremely healthy and never gets sick. Forgets to tell me about that pesky HIV +ve test two years ago even when I council him about testing for HIV. Continues to forget to tell me about said positive test until AFTER I sweat my way through breaking the bad news that he not only has HIV but has AIDS, a CD4 count of zero, PCP pneumonia, CMV retinitis and Kaposi sarcoma.