Monday, 15 October 2012

Misunderstanding #2

After a very painful Misunderstanding #1, today I had to endure through another one. Thank God it was short but it still frustrated me a little.

Enter the clinical nutritionist. She's a soft-spoken elderly woman with a somewhat belittling gaze (don't you love such a creepy contradiction? She sort of reminds me of Professor Umbridge). Since the mastery of clinical nutrition is not in our syllabus, rounding with her is not an obligation. In fact, most of us does it out of politeness, without really understanding what's going on (but hey, we try our best!).

This morning she asked me about a patient's complaint. Now let me explain first to you English speakers who might be reading this, that in English the wording of her question would be along the lines of "Tell me how the patient feels today", which will cause no problem. However, in Indonesian she was asking about the patient's "keluhan" (complaint) and because Indonesians love to shorten things down, she didn't bother to add "hari ini" (today).

I assumed the latter, because that's usually what attendings on round cared for for the first time. So I gave her just that, the patient's complaint that morning. And she stared at me squarely and told me simply, "You're all over the place." She explained that I should not be led astray by the patient's story, that it is *I* who must direct the conversation, that I shouldn't have told her everything the patient told me without first sorting them out and condensing them. [Do you agree? Discuss.] And she finished off her quick lecture by reminding me, like I needed reminding, that a good history contributes 80% to the final diagnosis.

History, history, history. SO she was waiting to hear that patient's history, the chief complaint that had made him seek help in the first place.

Good grief.

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