Granting You A Second Life 140 Maybe I Should Take An Advil To Get Through The Day

Emergency Department

Li Xiuying had changed into her scrubs and was heading over to bed 17 to do a consultation.

Li Xiuying: "h.e.l.lo, I'm Dr Li Xiuying can you confirm your full name and age."

The patient was tapping away on her phone, she tapped another message before facing Li Xiuying: "I'm Hsiung Hien. 24."

Li Xiuying: "How can I help you today?"

Hsiung Hien: "Well yesterday I was in my living room and I decided to get a drink from the fridge because it was really hot and I was really thirsty. So I chose my drink from the fridge and I was going to head back to the living room to watch my favorite drama. I was trying to rush back because I heard the theme song playing in the kitchen. I don't know how but I slipped and fell backward. I don't know if there was something on the floor or whatever. I managed to steady myself on the kitchen table but I hit my back on the arm of the chair. It was so painful I had to call out to my mom to come and help me. What made it worse was I missed the first few minutes of my show. I had to take some Tylenol to get some pain relief and it hasn't helped at all. I never take any medication if I don't have to. That's how I knew this was serious."

Li Xiuying: "Can you point to where the pain is?"

Hsiung Hien pointed to her lower waist area and lifted her top to reveal some light bruising.

Li Xiuying: "Has the pain spread anywhere else? Are you injured anywhere else?"

Hsiung Hien: "Nope."

Li Xiuying: "Do you have any numbness or tingling anywhere?"

Hsiung Hien: "Nope."

Li Xiuying: "Have you had any blood in your urine?"

Hsiung Hien's phone vibrated: "One second." She then read the message and giggled a little as she typed a response.

Hsiung Hien: "Oh, what did you say?"

Li Xiuying: "Have you had any blood in your urine?"

Hsiung Hien: "Nope."

Li Xiuying: "Are you allergic to any medication?"

Hsiung Hien: "Nope. I'm allergic to nuts and watermelon though. Oh, wait I am allergic to Claritin."

Li Xiuying: "What happens when you take it?"

Hsiung Hien: "Well I get really, really drowsy."

Li Xiuying: "That is not an allergic reaction that is a common side effect."

Hsiung Hien: "Well if you say so. When I took the medication I was practically catatonic. That is definitely not normal for anyone. They shouldn't make you practically unconscious. I was meeting a friend that day and I was falling asleep at the table."

Li Xiuiyng chose not to correct Hsiung Hien: "When was the last time you took any pain medication?"

Hsiung Hien: "Ermmmm I took some Tylenol at Mmmmm, 8 am after I had breakfast."

Hsiung Hien's phone vibrated again: "One sec." She put the phone down after replying.

Li Xiuying: "I'll need to do a general examination."

Hsiung Hien looked over at her phone, picked it up and sent another message.

Li Xiuying spoke a little louder: "I'll need to do a general examination."

Hsiung Hien: "Cool."

Li Xiuing proceeded to examine Hsiuengs's back which had mild bruising pattern consistent with Hsiung Hien's story. She also listened to her lungs and heart and did an abdominal examination for completion. During the examination, Hsiung Hien constantly paused the consultation because she was on and off her phone.

Li Xiuying: "I will need you to give a urine sample, if that is normal then I will let you go with some pain relief."

Hsiung Hien: "Is that it? What sort of pain relief?"

Li Xiuying: "Advil and Tylenol."

Hsiung Hien: "Seriously, that's all? Can't I get something stronger? You saw the ma.s.sive bruise. I'm sure I have some internal bruising deep in my muscles."

Li Xiuying: "I'm following hospital guidelines and the World Health Organization's recommendations."

Hsiung Hien: "The pain is really bad though. Tynelol didn't help at all, it didn't even touch the pain."

Li Xiuying: "If the pain still remains after taking these medications for a few days then you should visit your regular doctor for something stronger. A cold pack may also help with pain and swelling. You're also welcome to come back here. A nurse will be here shortly will a sample pot."

Li Xiuying went to speak to the nurse and discuss the plan for Hsiung Hien. She then went to the desk to write up the admission. She had a feeling that the urine dip would be negative for any blood.

10 minutes later a nurse approached Li Xiuying.

Nurse: "Dr Li the urine dip stick is negative, here are the results."

Li Xiuying looked at the results. She printed a prescription for Advil and Tylenol and took extra care to cross out any s.p.a.ces, so no one could edit the prescription.

Li Xiuying went back to bed 17.

Li Xiuying: "Miss Hsiung Hien, your urine test has come back normal. On examination, I didn't find evidence of anything to be worried about. Here are your prescription and discharge letter."

Hsiung Hien gave Li Xiuying a dirty look before s.n.a.t.c.hing her doc.u.ments. She strutted out shaking her hips from side to side.

Li Xiuying shook her head 'maybe I should take an Advil to get through the day.' Today was going to be one of those days.

....

Bed 13

Li Xiuying: "How can I help you today Mr Jin?"

Mr Jin held the side of his face: "I have a terrible toothache that's causing my entire jaw to ache. It hurts to eat, it hurts to talk. It's making me miserable."

Li Xiuying asked a few more questions and examined the patient's mouth.

Li Xiuying: "I can prescribe you some pain relief but you will have to go to a dentist, for any teeth related problems."

Mr Jin: "I've waited 2 hours and now you're telling me you can't do anything? Why can't you do anything? Aren't you a doctor?"

Li Xiuying: "I understand you are frustrated. However, I am a medical doctor and you need to see a dentist. Dentists provide dental care."

Suffice to say Mr Jin left with a prescription, discharge summary and a bellyful of complaints.

....

Bed 20

Li Xiuying: "What's brought you in today Mrs Qiáo?"

Mrs Qiáo: "I have been feeling awful, just awful these past several days. I went to see my doctor 2 days ago and he said I have a cold. I asked him for antibiotics and he just flat out refused. I think it's because he's new to the clinic and doesn't know what he's doing. My old doctor just retired and he would always prescribe me antibiotics whenever I felt this awful."

Li Xiuying proceeded to take a history and do an examination and then she ordered some tests including a rapid influenza diagnostic test.

Li Xiuying: "Mrs Qiáo you are recovering from a cold, most commonly caused by the rhinovirus. I suggest you take some Tylenol, keep yourself well hydrated and get plenty of rest."

Mrs Qiáo: "I want you to prescribe antibiotics."

Li Xiuying: "Mrs Qiáo, antibiotics are generally used for bacterial infections. In some instances when the patient has a serious disease such as a chronic lung disease where a viral insult can cause serious ramifications, we would prescribe antibiotics for viruses. We do not prescribe antibiotics for the common cold especially, in an otherwise healthy individual."

Mrs Qiáo: "I don't care about other patients and what you would generally do. I want antibiotics. Dr Yi had worked as a physician for over 50 years and he would always put patients first and give them whatever they needed. I need antibiotics. I would like to see someone more senior who knows what they're doing." She looked away from Li Xiuying.

Li Xiuying: "I'll get my colleague to give you a second opinion. You may have to wait a while because we are currently short-staffed."

Mrs Qiáo snapped her head back. She raised her voice: "You are clearly unhappy that I have questioned your judgment and now you want to pressure me to leave by making me wait around. I demand to see someone else right now! This is power hara.s.sment!"

Li Xiuying was completely unphased: "Mrs Qiáo, as you have seen for yourself the waiting room is filled with patients and you can clearly see there aren't many doctors here. I will ask my colleague to give you a second opinion but I can not control when they will be free."

A nurse quickly asked Dr Fa Xin for help.

Dr Fa Xin approached bed 20: "h.e.l.lo Dr Li, I have just finished with my patient. I can a.s.sess your patient if you would like?"

Mrs Qiáo pointed: "It's not up to her, I'm the patient. I want someone more senior to this doctor whose still wet behind the ears."Antihistamine -helps to relieve allergy symptomsMedication to relieve pain and feverMedication for pain reliefC92