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.
- “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?)
- I entered the room and was blown over by the smell of cigarettes.
- He had a nice suit coat on-without underwear!
- And on his ankle was a police ankle monitor!! (A little incongruous). Bare butt on the exam table.
- 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)
- 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)
- “When does your knee hurt the most? “When I am performing my manly responsibilities!”(More Too Much Information)
- “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”