The Curious Case of the "Patient" who eats "Too Much" spice!
It was back during my internship year. I had just finished my placement in Internal medicine and was probably a few weeks into my surgery rotation. The department of surgery never had that appeal. I don't know, maybe it was the type of toxic people I encountered there, maybe I found my seniors a bit incompetent. I don't really know. Medicine was love, the one and only for me!
My dedication to that department was unprecedented. I used to come up the most creative ways to skip my allocated duties in other departments to go and help out in the Department of Medicine. Maybe cover a few hours during a busy outdoor shift. Maybe receive some indoor patients and help out the other interns to present the case histories (I was surprisingly good at organizing and presenting case histories).
During my 3 months placement in internal medicine, I had made my mark and the Medical Officers, Assistant Registrar and even the Dept. head got very fond of me. At one point, I was being called the "Outdoor MO" of the department because I used to spend a few hours in Medicine outdoor while my placement was in Surgery! Not that I used get paid anything extra for consulting 100 extra patients!
The reason for telling all of this is not to brag.
Okay, maybe a little!
Outdoor departments in teaching hospitals have to have a few medical officers, to supervise the interns handling patients. The patient rush in outdoors is pretty high, especially during the morning shifts. And that time period also coincides with the indoor ward rounds. It gets pretty difficult to juggle between indoor which is on the 3rd flood and outdoor, which is on the ground floor.
On one such day, slippery me wriggled my way out of the hell-doors of the surgery ward and slid in to where i felt at home, the medicine outdoor! The medical officer seemed to come back to life seeing me and without wasting a minute,
ভাই একটু আউটডোর টা সামলা, ৫ মিনিট জাস্ট ভাই। ৫ মিনিট।
That "just 5 minutes" was never "just" 5 minutes and I knew it all too well. I knew each and every move of my Medical officers, I spent so much time with them lol!
Because I was just an intern, he wasn't supposed to leave me alone to handle the entire outdoor by myself. But just because it was me, he could trust me to handle it, and I should have stopped it. That was the right thing to do. But I got cocky and the devil inside me showed me the allure of "bragging rights."
That day went pretty well and I have since then handled outdoor by myself on many occasions. But there was one patient that found me out of my depths that day and to this day I still tell that tale to anyone who is willing to listen :))
A middle aged lady entered with a young girl, probably in her mid teens. I ask who is the patient and the lady says, my daughter.
Okay, have a sit.
And then I ask the daughter, what problem are you having.
She laughs and says, I don't have a problem.
And I'm already thinking of differential diagnoses. Probably something psychiatric...? Could me menstrual, young girls are generally very shy to talk about this and I was preparing myself to refer her to Gynecology department.
And then the mother speaks, and boy oh boy! I was not prepared for it.
_Translation : My daughter eats too much spice._আঁর মাইয়া ঝাল বেশি খায়।
I stared at her, baffled. I wasn't sure how to respond. But we have always been told, never behave like a patients' problem is ridiculous. No problem is ridiculous. Maintain your composure.
With as much composure as you can maintain after hearing that, I asked quite calmly, okay, what else?
_Translation : And she keeps the fan at full speed at night._আর ইতি রাইতে ফ্যান এক্কেবারে ফুল স্পিডত চালাই রাখে।
Beat that!
So the girl was indeed right, she wasn't really the patient!
I nodded my head pretending to have identified the underlying mechanism of full-speed fan and eating too much ঝাল! I had no idea what the F this case was, and I said like I possess all the knowledge in the world,
"Listen mam, I think your daughter feels too hot."
I paused for a moment, thinking what my next line could be. Young female, I tried doing some hormonal correlation. And then it hit me like a thousand bolt lightning! Bingo!
I then gave them a lecture on how Thyroid hormone excess creates "heat intolerance." I myself wasn't convinced this was a case of heat intolerance. So I tried hinting that out as well that it's very likely nothing is wrong with her daughter.
But the mother was adamant I prescribe her some medication. And I wasn't going to prescribe something I'm not convinced of (I'm a bit of a "গোঁয়ার" when it comes to such).
And thus we "settled" for a panel of Thyroid Function tests and prescribe based on the results.
I never saw that patient again, they were not impressed with a doctor who wouldn't even prescribe them a "গ্যাস্ট্রিকের ওষুধ."
