Diary

"Dr Dan's Practice Diary"

A slice of physician life

By Dr Dan Ezekiel

MONDAY
Ah, the start of a new week. I'd had a particularly relaxing couple of days off and was looking forward to facing the problems of the day.

A young man presented complaining that his prostate hurt. "And how do you know it's your prostate?" I inquired.
"Oh, I know it's my prostate Dr Dan, because I did a rectal on myself."
"You did WHAT??" I asked incredulously.
"I performed a DRE," he confirmed. "It's very tender when I touch my prostate."

Well, I had to feel this for myself. I positioned him in the left lateral decubitus position, shaking my head all the while wondering how on earth he was ever able to contort himself in such a way as to reach his own prostate, and inserted my examining finger.

When the patient nearly jumped off the table with pain, I had to admit he was absolutely right. I wrote him a prescription for several weeks of antibiotics and thought this new breed of well-informed patient could easily put us doctors out of business. But if I ever needed a second opinion....

TUESDAY
Patients who are hearing-impaired present special challenges. On this rainy Vancouver Tuesday, an elderly gent came in for a routine check of his blood pressure.
Knowing he looked after his ailing wife at home, I thought to inquire about her. "Harry," I began, "How's Bella?"
"Yes," he replied, "I did forget my umbrella."

WEDNESDAY
I saw a new patient today who could not ambulate without the use of a walker. He appeared to be having difficulty with his balance and coordination so I asked him, "Do you need the walker because you feel unsteady, Mr Jones?"
"Yeah," he replied. "I had a stroke a couple of years ago, and now my legs don't work."
"I see. And was the stroke in the cerebellum?"
He looked at me like I was the stupidest physician he had ever met. "Um, no, doctor. As I said, it was in my legs."
Touché.

THURSDAY
I saw a young man today who was worried about a small compound nevus on his shoulder.
"Alan," I told him, "that lesion is benign. I'm certain it's not a cancer."
"Well, Dr Dan, I'd like you to do an autopsy anyway."

I'm sure that could be arranged, I thought to myself.

FRIDAY
By the time Friday rolls around, I am usually ready for a little break. I was doing a complete physical examination on a middle-aged man when he asked me if he could have a PSA test.
"Jim, your prostate feels completely normal to me. I don't think you need to worry about having prostate cancer," I said in reply.
"Oh, but I do, Dr Dan! I lost a sister 'cause of it!"
"Hmmmm, would you like a second opinion?" I asked politely.

Have a pleasant week.