My new recent pet peeve in the hospital is examining a patients throat. Especially adults. I have my little light turned on. I ask the patient to open their mouth. Then I ask them to stick out their tongue. And then usually their big fat tongue is blocking their pharynx so I have to ask them to say "ahhhhh", which will raise their uvula and pushes down their tongue bringing their pharynx (back of the throat) into clear view. Do you know how many times I have to ask before the patient actually does it? It usually takes three.
This sort of perplexes me because they followed all the other directions prior to that on the first command. They will even roll onto their side with ease for the rectal exam without a hesitation. But there is something about saying "ahhh" that people just do not want to do. So I ask them to say it multiple times. I'm even doing it when I ask it. And generally without a response. Until I explain why I am asking them to say it. Then I finally get an "ah" but not an "ahhhhhh."
With kids they don't understand the "say ahhhh" command. Which is why I have to gag them with the tongue blade. And then they cough onto my open mouth and I get mycoplasma pneumonia. But they are kids, and are cute, so I quickly forgive them.
But I am fed up with resistant adults. So adults beware. I know we all have flashbacks to our pediatricians using a device to see our throat. I'm pulling out the tongue blade. Thats right. Without me asking you to say "ahhhhh" first.
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the H & P of a medical student
2 comments:
I hate throats too. Especially adult throats. You want to know who got me sick during my peds rotation? Was it a two year old? No. It was some 16 year old who coughed in my face while I was examining her throat. I was most displeased.
I say they don't want to do it he first time because a) seems childish b) they think you're joking. Best bets on B.
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