Absolutely nothing of interest last night, the most interesting job being someone with a two month history of muscular back pain that had been getting worse that day.
“So”, I asked all innocently, knowing full well the answer I would get, “Have you taken any painkillers as the pain got worse?”
I wasn’t surprised by the answer she gave.
Then two calls to two regulars, one of which had only been discharged from hospital three hours previously. Then finally to a patient who was actually sick, but that would only be because he earlier discharged himself from hospital against medical advice.
There is nothing more disheartening than to attend to a patient, and to see them clutching a little pink slip of paper. “Why so?”, I hear you ask.
When you visit the local hospital, and the doctors and nurses are finished poking and prodding you they decide if you need to be admitted to hospital, or if you can safely be sent home with treatment. If you are to be sent home they give you one or two bottles of pills, explain how the pills work, and then write a letter to give to your GP (family doctor). The letter tells your GP exactly what tests they have done, and the treatment that they have prescribed.
This letter is on a pink bit of paper.
All too often I get called to a patient who has been seen with a minor condition earlier in the day, but after one dose the medicine hasn’t cured them, this is most common in the case of antibiotics, but you will also find people who tell me that the pain has gotten worse, and that they don’t like to take the painkillers the doctor has prescribed.
Inevitably they still have the discharge letter with them.
In these cases all we can do is take them back to the hospital they were seen in just hours ago, so that the doctors and nurses can repeat all the tests they ran the first time.
Sometimes this happens three of four times. And each time they call an ambulance.
Don’t get me wrong, sometimes things do indeed get worse, and in that case a return trip to hospital is warranted. But in most cases I come across it is simply the inability of a single dose of a tablet to make your symptoms disappear instantly and permanently. Still on the up side, it makes diagnosis really easy, all you have to do is determine if the symptoms are the same as the last time they were in hospital, or if they have gotten worse or changed in any way. If the symptoms are the same, then they are unlikely to drop dead in the back of the ambulance (thus causing a lot of unnecessary paperwork).
I have two or three days off now (don’t ask me how many, I need sleep before doing any serious thinking), so I may raid my ‘Ideas File’.