The sick patient

Family medicine clinic is somewhat…buffering, as clerk. It’s certainly not as safe as when you are truly an inexperienced first or second year – the understood observer – but still, there is an aspect of safety to it all. The doctor takes the patients with the scary conditions; the cancer diagnosis, the manic depressive having an episode, and so on.  But occasionally, you get one;

A sick patient.

They come into the office shuffling, sweaty and weak like every step is an agony and you know immediately that this isn’t going to be about the routine post bloodwork follow up on the chart you’re now clutching to your chest like a shield.

But you do what you’ve been trained; ask your history, you do your steps, and then you hit upon something, and as the klaxons go off, you fight to keep calm, keep level.

Chest palpitations last night, shortness of breath, night sweats, general malaise.

It’s never the heart, might as well be the mantra of the third year clerk, because it never is.  It’s anxiety, it’s GERD, it’s muscle strain; the heart in active distress doesn’t come into a 10 minute appointment on a routine weekday.

This sounds like it’s the heart.

You go and get (an adult) the doctor.  They agree.

The answers become quick after that; ER, EKG, bloodwork.  You send them off, and you think you might even be proud of yourself for seeing it.

You’re also sweating, a little bit; like you just took an unexpected sprint.  You can hear the thump of your heart in your ears.

There’s 30 more minutes in the day, and another chart on the door.

You breathe, take a second, and then take it.

You open the door smiling.

4 thoughts on “The sick patient

  1. I think family medicine is not only about dealing with the chronic stable ones, but also screening red flags, emergency and serious cases. Did a great job there! 🙂

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