The staff was concerned that she came to the office without her interpreter.
How would we communicate? How would I assess her symptoms?
“Should we get a translator from the hospital?” they asked.
I knew this patient well. I had done battle with rogue circuits in her left atrium more than once. I could even remember the fractions of the fractionated potentials–the squiggles of the squiggly line. I could recall my body’s joyous sensations when burning that precarious ridge of heart muscle steadied her heart’s rhythm.
“Got it,” we say.
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*This blog post was originally published at Dr John M*
Every once in a while we physicians make an astute (or perhaps lucky) observation that becomes a turning point in a patient’s life.
I’ll never forget the time that I placed a hand on an elderly woman’s belly after she said that she felt a little bit dizzy – the pulsatile abdominal mass that I discovered set in motion a cascade of events that resulted in life-saving surgery for an disecting abdominal aortic aneurysm (AAA). It was incredibly gratifying to be involved in saving her life – and now anyone who so much as swoons in my vicinity gets a tummy rub! (Yes, Dr. Groopman I know that’s not necessarily a rational response to one lucky “exam finding.”)
Last week I made a fortunate “catch” on the order of the AAA discovery from years ago. I was giving a close friend of mine a hug (he’s significantly taller than I am) when I noticed that his heart was beating rather quickly through his shirt. I instinctively grabbed his wrist to check his pulse, and voilà – it was irregularly irregular. My friend had new onset atrial fibrillation – and although he was initially resistant to my idea of going straight to the ER, I eventually convinced him to come with me. An EKG confirmed my clinical diagnosis, and blood thinners (with Pradaxa) and a rate control agent were administered. He will undergo cardioversion in a couple of weeks. We were both relieved that our intervention may well have averted a stroke, heart failure, or worse.
My peers at the hospital have been poking fun at me for my hug diagnosis, and my reputation as the “hug doctor” now preceeds me. I continue to protest that I do know how to use a stethoscope – but alas, there have been more requests for stat hugs from me than cardiopulmonary exams.
I don’t know if I’ll ever be able to top this clinical diagnosis, but a life of trying to find my next case of atrial fibrillation through hugging will likely make a few people smile.