This may seem familiar especially to Patients!
So many times someone would come with complains of say Right ear pain.
The doctor would check the nose, throat, even chest and even the left ear while the patient keeps on telling that it is the RIGHT EAR which is having issues!
The patient would think the doctor has hearing loss himself or herself!
Once a patient even remarked in his own language to himself that the doctor is checking all over instead of the ‘Organ’ which is causing the issue!
Sometimes I even clean the wax and other discharge from the ‘normal’ ear taking my own time (according to the patient!) much to the chagrin of the already tensed patient!
Finally when we see the particular organ with the issue you can feel the relief of the patient!
If you are a patient then you must understand that this is the major difference between a senior and a junior doctor!
The senior or experienced doctor would never examine the affected part first! There are many reasons for this;
All other parts such as the nose and the throat are linked to each other and MUST be examined to get a proper diagnosis! Even if you have ear pain, the problem may be a nasal obstruction or even a referred pain from the throat! This is true for most body systems! No organ or body part works in isolation! They are all a part of the unit! Of course you do have specialists and super specialists now, but the fact of the matter is that the Body is one UNIT!
Another issue is that if the affected area is infected then there is a very high chance of spreading the infection if that area is inspected first! Which is why the infected part MUST be examined last! This is also true when we do the cleaning for surgery! The infected and non infected parts are kept as distant as possible and cleaned separately!
If the affected area is having pain and the patient is a child then he or she may not show other areas since examination of the affected area will cause pain!
Most important is that once you find a finding in the area pointed out by the patient, you may MISS out other important SILENT findings in other areas! Once I got a patient who had very obviously placed a plastic bead on the nose! Luckily I examined the ears first and found more in each of the ears! Nothing in the mouth though!
Another important thing you must realize is that every doctor has a set pattern of examination regardless of the symptom. He or she would ‘cover’ all the areas and then come to the area of YOUR concern! All you got to do is have patience!
Many times it does happen that in your stress you would forget that the doctor had seen the other ear! After cleaning the ‘affected’ ear the patient would ask about the ‘other’ normal area much to our chagrin now completely forgetting that we had seen the normal ear first!
In any case, every medical examination normally has to follow a systematic approach starting from the history to inspection to palpation and finally auscultation!
This is also important to establish a baseline trust especially if it is a minor or tense patient!
So all you have to do is be PATIENT! We will get to the point by the end of the century!
Anyways that’s just how some do their duty! Which reminds me of T N Sheshan!
Another day new stories!
Shubh ratri!
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