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Friday, April 20, 2007

Further adventures of Hello Kitty

Today, I have had the opportunity to have both a medical student and a pre-registration house officer (i.e intern) 'working' with me today.

Please note that the word 'working' is in inverted commas. This is because I was doing the work, whilst tidying up after my student and house officer. They are both lovely girls, as cute and keen as puppies and just as prone to accidents on the carpet.

I decided to teach them how to review patients on a ward round. On a ward round, one usually has about five or ten minutes to spend with each patient. This is because our ward has about 30 or so patients - so ward rounds can last up to six hours if we aren't careful with our time management.

Our first objective on the ward round is to ascertain if a patient is stable, improving or deteriorating and what outstanding investigations have yet to be completed. Our second objective is to identify new problems. This is actually more difficult as it sounds, because time is so pressing, one has to learn to be able to conduct a very brief interview with the patient - no time for idle chit-chat.

So when the patient starts to ramble on about something bizarre or inconsequential, this calls for the use of the 'Hello Kitty' expression. My student and house officer have not yet mastered the 'Hello Kitty' expression which led to disastrous results.

Case #1:
(Correct use of 'Hello Kitty' expression)
Rambler 1: ...it was yellow and it tasted like cheese.
TSCD: I see.
Rambler 1: But other than that, I have nothing else to report.
TSCD: Be sure to let me know if you do.
Rambler 1: I shall.
.....

(Botched attempt at 'Hello Kitty' expression)
Rambler 1:...it was yellow and it tasted like cheese.
Student puppy: (eyebrows frozen as per 'Pekkle') I see.
Rambler 1: Well, not the cheap kind you know. The really expensive Stilton with the purple wrapper that you get in the 'Taste the Difference' range at Sainsbury's. My wife only lets me have that once a week because I have bad stomach gas afterwards and it makes the house smell like sewage, although if you ask me, I like my natural smell, it's comforting....(enters the realm of Too Much Information)

Case #2:
(Correct use of 'Hello Kitty' expression)
Rambler 2:...and then I collect it into a little jar and keep it in the fridge.
TSCD: I see.
Rambler 2: But it's not infected or anything, so it doesn't bother me.
TSCD: Let's keep an eye on it, okay?
.....

(Botched attempt at 'Hello Kitty' expression)
Rambler 2:...and then I collect it into a little jar and keep it in the fridge.
House puppy: (eyes frozen in mid-twitch as per 'Bad Badtz Maru') I see.
Rambler 2: What? What? Is that not a normal thing to do? You young people are so rude. I've been doing this for years for my tomato plants. It makes a nice paste and seems to scare off the slugs. I also collect other things in jars such as....(enters the Realm of Too Much Information)

.....

Fortunately, I was around to curtail the discussions, otherwise we'd have been there all day.

I comforted the traumatised puppies afterwards and gave them a little treat. After all, we all have to start somewhere.

4 Comments:

Anonymous Anonymous said...

Ah ha ha ha ha! You are so right. It took me the longest time to learn the skill you so amusingly relate. I couldn't figure out why patient interviews always went something like this:

Me: "So have you had a fever as well as a cough?"

Patient: "Well, I had to take care of the baby yesterday since my daughter had the stomach 'flu' and..."

10:59 am  
Blogger tscd said...

dr bean: So, do you have a Hello Kitty face too?

3:08 pm  
Anonymous Anonymous said...

Well, until now I had thought of it as my Mr. Spock face. Hello Kitty is much more evocative, not to mention hip!

10:33 am  
Blogger tscd said...

dr bean: Oh, I started out trying to use a Mr. Spock face, but I found that it doesn't appear very feminine (makes me look unfriendly)...and I don't have that trick of raising one eyebrow questioningly.

3:40 pm  

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