THE DOCTOR INSIDE US ALL
I remember the conversation quite clearly. A woman in her early 50s, who was a regular patient, called my office to make an appointment, and she insisted on speaking to me. The receptionist offered to have me return her call later that day, but no, she said, she had to talk to me right now.
My receptionist pulled me out of an examination room where I was with a patient and told me about the situation. To my knowledge, this patient hadn’t had any serious health problems before, and I felt she wouldn’t be so insistent if it was something minor. So I picked up the phone and braced myself for the worst.
Here’s how the conversation went:
“Oh, Doctor Lowell, I don’t feel so good,” she said in a voice verging on panic. “And I don’t know why!”
I asked her to describe her symptoms.
“I just feel weak, Doctor, I don’t feel like myself and I’m belching a lot—”
I interrupted her. “Do you have a headache, or has your stomach been upset lately?” “No.”
I kept going. “Have you been tired lately? Do you feel short of breath?”
“Yes, and I have no energy. And this morning I started to sweat heavily when I tried to clean up the house.”
I then proceeded to run down a list of general symptoms. When some of them appear together, they make for an easy diagnosis, while others point to the need for further testing to narrow down the possible causes. Her negative replies to most symptoms became more frenzied with each answer. I started to become concerned as well.
“Well, then, exactly what is it that doesn’t feel well?”
“I just don’t know,” she blurted out. “I hate to say it, Doctor Lowell, but I think I’m going to die. Please help me.”
I tried to calm her down and focused more on her belching and upset stomach. I asked her if she was taking aspirin or eating spicy foods; she said no. She had said that the belching had appeared suddenly that morning and that she couldn’t stop. Since she had also said that she was sweating heavily and lacked energy, I asked her what she had eaten recently, and she replied that she had eaten her usual dinner. Though she told me she did not have any chest pains or palpitations, I told her to call 911 immediately and go to tne emergency room. She became a little panicked, but she said she would meet me there.
When she described all of her symptoms, I knew she was having a heart attack, since belching and sweating are typical symptoms of a heart attack in a woman who’s 50 years or older. The symptoms of a heart attack aren’t always chest pain and pain down the left arm. The doctor inside her told her that her life was in jeopardy, even though she wasn’t sure what was wrong. This is what had prompted her to make that very important phone call to me. The doctor inside her was telling this woman, who usually doesn’t call physicians, that she had to contact me immediately. Listening to the doctor inside her saved her life.
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