Myocardial Infarction
My friend, whom I'll call Anna, lives in a Foreign Country. I won't tell you which, but it's known for cheeses. And clogs. And windmills. And no hills.
After a strange incident involving an organic orange full of maggots, Anna ended up in their version of A and E, and having had some pain which she thought was indigestion, she had an ECG done to measure the heart's activity.
"You have had a myocardial infarction," announced the female doctor neutrally.
Now, had this been a medical roleplay, I would undoubtedly have reacted to this with a baffled "what do you mean?" to indicate to the doctor that this is not a good way to tell a patient such a thing, and to provoke the doctor into explaining what she meant.
However, this being real life, my friend went
"WHAT? AAAAAAAAAAAARGH! A HEART ATTACK? ARE YOU SURE? AAAAAAAAAAAAARGH!" - which was perhaps another way of pointing out to the doctor the inappropriateness of her approach.
"Oh yes, quite sure," said the doctor,"but we can't tell when it happened. You'll have to come back on Tuesday and see the cardiologist."
My friend pointed out that, at forty-nine, slim and very fit, and eating an extremely healthy diet, she really isn't top of the risk factors for a heart attack: but the doctor was adamant. Definitely a heart attack.
Having thought about this for a few days, made her will and written letters for her children, Anna decided she didn't fancy hanging about for nearly a week to see the cardiologist, so made a bit of a fuss and got to see the cardiologist today. He did lots of tests.
"I'm pleased to say you definitely have NOT had a heart attack," he said. Apparently her heart was slightly tilted the wrong way, possibly because of her slimness, and this had affected the results of the initial ECG.
So, two things here:
Firstly, the appalling communication skills of the initial doctor. Giving no "warning shot" so the patient has a moment to prepare herself for the bad news, coupled with using a medical term which the patient might misunderstand or not understand at all. Not to mention the lack of empathy.
Secondly, the first doctor should not have said "definitely a heart attack" - particularly taking into account my friend's lack of risk factors.
Of course, this all happened in the Land of the Cheese, where they are all barbarians and have barely invented hospitals let alone communication skills, and of course it could never happen here, not in the good old NHS, and oh look! a giraffe just flew past the window.
And, as a final point, if you click on the link to myocardial infarction, you will find out what it means - - but only at the cost of finding a lot of misplaced apostrophes as well.
"the heart muscle suddenly loses it's blood supply"
So, some good learning points here for doctors and medical students:
1) Don't use medical terminology unless you are certain that the patient knows what it means (but don't go down the "let's have a teeny look at your front bottom" route either, oh please no)
2) Don't break bad news unless you are certain, absolutely certain that you have bad news to break
3) It's only ever has an apostrophe when it means it is, and never at any other time.
Aah - - I feel a bit better now, and so does my friend Anna.
After a strange incident involving an organic orange full of maggots, Anna ended up in their version of A and E, and having had some pain which she thought was indigestion, she had an ECG done to measure the heart's activity.
"You have had a myocardial infarction," announced the female doctor neutrally.
Now, had this been a medical roleplay, I would undoubtedly have reacted to this with a baffled "what do you mean?" to indicate to the doctor that this is not a good way to tell a patient such a thing, and to provoke the doctor into explaining what she meant.
However, this being real life, my friend went
"WHAT? AAAAAAAAAAAARGH! A HEART ATTACK? ARE YOU SURE? AAAAAAAAAAAAARGH!" - which was perhaps another way of pointing out to the doctor the inappropriateness of her approach.
"Oh yes, quite sure," said the doctor,"but we can't tell when it happened. You'll have to come back on Tuesday and see the cardiologist."
My friend pointed out that, at forty-nine, slim and very fit, and eating an extremely healthy diet, she really isn't top of the risk factors for a heart attack: but the doctor was adamant. Definitely a heart attack.
Having thought about this for a few days, made her will and written letters for her children, Anna decided she didn't fancy hanging about for nearly a week to see the cardiologist, so made a bit of a fuss and got to see the cardiologist today. He did lots of tests.
"I'm pleased to say you definitely have NOT had a heart attack," he said. Apparently her heart was slightly tilted the wrong way, possibly because of her slimness, and this had affected the results of the initial ECG.
So, two things here:
Firstly, the appalling communication skills of the initial doctor. Giving no "warning shot" so the patient has a moment to prepare herself for the bad news, coupled with using a medical term which the patient might misunderstand or not understand at all. Not to mention the lack of empathy.
Secondly, the first doctor should not have said "definitely a heart attack" - particularly taking into account my friend's lack of risk factors.
Of course, this all happened in the Land of the Cheese, where they are all barbarians and have barely invented hospitals let alone communication skills, and of course it could never happen here, not in the good old NHS, and oh look! a giraffe just flew past the window.
And, as a final point, if you click on the link to myocardial infarction, you will find out what it means - - but only at the cost of finding a lot of misplaced apostrophes as well.
"the heart muscle suddenly loses it's blood supply"
So, some good learning points here for doctors and medical students:
1) Don't use medical terminology unless you are certain that the patient knows what it means (but don't go down the "let's have a teeny look at your front bottom" route either, oh please no)
2) Don't break bad news unless you are certain, absolutely certain that you have bad news to break
3) It's only ever has an apostrophe when it means it is, and never at any other time.
Aah - - I feel a bit better now, and so does my friend Anna.
posted by Daphne at 10:19 pm
2 Comments:
INFARCTION, now there's a word full of promise and foreboding. An infarction is the formation, not unpredictably, of an infarct.
An infarct is a pathological term for an area of tissue that has died because of lack of blood supply caused by an obstruction due to a thrombosis or embolism.
Infarct, you may be pleased to note, next time you are in a seafood restaurant, comes from the same route as farci as in moules farci namely: stuffed, from the neo-latin: infarctus - stuffed in. So there you go, you can eat with impunity.
When I had my first heart attack back in 1992 (I'm on strike 3 anytime now !!) as a 40 yr old, I didn't know I'd had one.
I went to my local GP with very odd symptoms (none of which involved crushing chest/heart pains of any sort) and he arranged for me to see a cardiologist and have a stress test done. At no time was the possibility of my having had a heart attack even mentioned.
So as I was with BUPA at the time (an ASDA employee perk), I got to be seen the next day at the BUPA Hospital in Leeds and after having a treadmill stress test, the consultant came to see me with the results.
I vividly remember his opening words............well when you had your heart attsck, part of the muscle tissue was damaged and can never be repaired. The stress test........and I never took in anymore of his speech as I was in total shock. My heart attack ???? What heart attack ??? This is news to me and not very nice news either !!!
He was amazed I'd been sent to the hospital without being told I'd had an attack but he never really softened his approach and just babbled on about angiograms and other tests I'd need.
So I understand your friend's situation a bit (oh God I hope I got the darn apostrophe in the right place) but at least her bad news went to good news eventually and I wish her well.
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