Bad Prognostic Signs

All physicians know what this means.  Something about the patient’s medical condition that is not a good omen.

I’d like to introduce a new version of Bad Prognostic Signs. The non-medical side of a patient’s presentation that does not bode well for a good outcome.

We see lots of patients, but some stand out.  Afew are so memorable they will never be forgotten.

William (not his real name) below had 8 Bad Prognostic Signs in one visit-a record for me.   They are numbered below.

  1. “William”, 25 years old, came in to see me about his knee. Warning lights started to go off very quickly. His occupation listed on his form was “all-around esque work” (What is that?)
  2. I entered the room and was blown over by the smell of cigarettes.
  3. He had a nice suit coat on-without underwear! 
  4. And on his ankle was a police ankle monitor!! (A little incongruous).  Bare butt on the exam table.
  5. I like to find out what name they like to be called and I said “Do you go by William or Bill or Will?” He said “The ladies call me Billy”  (Uh oh!-that I didn’t need to know)
  6. I then started the interview and he said “my knee feels hollow”.  ((What is that? I’ve never heard that before in 30 years of seeing knee patients)
  7. “When does your knee hurt the most? “When I am performing my manly responsibilities!”(More Too Much Information)
  8. “What kind of work do you do?” “I wait tables, but I am really an entrepreneur” By now I am quite skeptical of any answer. “How can you be an entrepreneur-you are only 25?” ‘I have one share of GE stock” 

His mother, at the end of the room, shakes her head!

He replies “Maybe I should get  married!”

My assistant, who by now was rolling with laughter, said “Maybe if you got a real job you could find a girl you would be proud to bring home to your mother here”

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