Sunday, June 28, 2009

Doctor Patient Conversations


First adventure on the road was at the B--Hospital. A patient asks for some shots to get him through Peru. The doctor glances at a rough spot on the back of the patient’s hand.

“How long have you had this?"
“Two, maybe three months.”
“Not sure if that’s precancerous or cancerous, I’d like a biopsy.”
“What will the biopsy tell you?”
“The architecture of the cells. The structure and the depth of penetration of the growth. Whether it’s just precancerous, so we can just freeze it off with CO2, or if cancerous, determine if it’s aggressive or not. If it’s more aggressive, we must cut deeply, cut out a wider surrounding margin. Lab results will be back next week.”

“I’ll be in New York by then. You can email?”
“Sure. I’ll let you know how quickly you need to act. Different cancers require different treatments. They can’t all be frozen off with dry ice.”


Doctor-patient consultations start off with the doctor observing and then asking quiet questions. When possible diagnoses are proposed, along with treatments, accompanied by any mention of c--- any patient gets a little apprehensive. Then, roles reverse: it is the patient asking most of the questions.

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