Thursday, June 25, 2015


Me: "do you have any medical problems?"

Patient: "no."

Me: "do you have diabetes?"

Patient: "yes, but it's controlled."

Me: "with diet?"

Patient: "no, with two medications."

Me: "And do you have high blood pressure?"

Patient: "yes, but it's controlled."



  1. I had that issue when a patient came to the ER with severe shortness of breath. She said she did not have asthma nor any other medical problems of any kind, and was never sick a day in her life, but all of a sudden she was feeling like she just couldn't get enough air.

    Five minutes later she said, "While I'm here, can the doctor write me a refill for my insulin? I've been out for a couple of weeks."

    And that's how I learned what Kussmaul respirations look like.

  2. Better questions to ask are "Are you currently taking any medications?" How about any supplements?".

  3. Even patients with back pain sometimes forget to tell me they had spine surgery until I ask directly. Chronic health problems become old news and a "new normal" for folks and they forget to tell us about so many things if we don't ask specific questions. Or they think, "It's all in the computer [of a different doctor/hospital]," so they don't need to tell me.

    One completely cognitively intact woman forgot to tell me she had brain surgery(!!) -- I'd asked about surgical procedures for pretty much the entire rest of her body and we'd discovered a few other remote surgeries she hadn't included in her paperwork.
    I used to assume that any cognitively intact patient would consider brain surgery a big enough deal to mention. These days I assume nothing.

  4. Did someone tell this patient to say this?

  5. I've found that patients don't consider issues to be "problems" if they are controlled with medication. Because they aren't a problem! At least not to the patient. Doctors and other health care providers need to realize this. They may think themselves perfectly healthy, as long as medications and/or lifestyle interventions (diet, exercise) keep their conditions from being problematic!

  6. I was always caught out on this when I started my clinical placements
    "do you have any long term conditions"
    "do you take any regular medications"
    -oh yes *cue the longest list of pharmaceuticals

  7. I recovered from an encephalitis complicated by a brain abscess. I really don't remember anything other than visual perception problems and dizziness. My neurosurgeon always said to consider myself lucky to have this amnesia that it wasn't worth remembering. I never mention this when questioned about my medical history because it has nothing to do with my current self and does not seem real without any memories of the experience. I really enjoy reading your blog.

  8. I guess diabetes and hypertension are becoming too common a problem, for them to acknowledge it as a medical problem. Like, everyone has eyebrows. So, that's not a problem. Similarly, nothing seems abnormal if everyone around you has diabetes as well.
    P.s.You have an amazingly humorous blog. :-) I am a regular, silent reader.

  9. Patient seen today for leg pain - "Do you have any chronic medical issues with the leg?" "No." I pull back the blanket to find an above the knee amputation with wound vac in place. What precisely do people think constitutes an issue - elf infestation?