Sunday, May 17, 2015


    As a physician I come across many patients. When I was a medical student and started learning the 'History taking', I had to write demographic data,then the occupation and then chief complaints. Each of this has a meaning, as I was taught. The name tells us the religion, cast, origin etc. This is important as certain diseases are common in certain people. African American and sickle cell disease is well known . Certain age groups have certain diseases as common , congenital heart disease is not going to be seen in 70 years old ,or cystic fibrosis is not seen in 70 years old and 15 years old is not going to have heart attack. The demographic is important as in certain part of India kidney stones were common , the area was called 'stone belt' . In US , there are areas where certain fungal diseases like Histoplasmosis is very common. So if the chest X-ray is abnormal , one might think of Histoplasmosis. The same is true of the occupation. There are many occupation where the Lungs are affected. The silo filler disease,Bird breeder's disease or hair dresser's disease would be some examples. So ideally as a medical student we were suppose to ask the occupation of each and every patient. In my practice with the modern day medicine, very rarely this information is of great help in the diagnosis of the disease. But many a times I do ask as to what the patients do . Some times I use this information to encourage them to  write their stories ,so as to keep busy. So sometimes we come across unusual occupations.
      I used to see this elderly patient . She was about 78 and had worked up to age of 70 . I had never asked her as to the occupation. Sometimes these older patients start having memory issues and part of the time it is accentuated by depression. So I tell them to buy a digital voice recorder, and record the old memories . This may include funny stories of their children or the experiences that they may have had when they were working. This recorder can be attached to a computer and then one can can 'burn' a CD . In my mind this is of great value as it revives the memory and such original voice recordings for the grand children.So when I asked this lady as to what did she do . she told me that she worked for a funeral home . So I said I you must have some experiences that were funny or scary or at least interesting ,.So why don't you record them.She told me some of them . One time she had to take a dead body to Georgia from Florida in her van . I can't imagine or may be I don't want to even imagine such an en devour.
       On of my other patient  that I saw only in the hospital for pneumonia, had a another story. I saw this 45 years old patient who was admitted with pneumonia. He was a smoker , but had a regular pneumonia He had no health insurance. So I was asking him some questions.He had told me that he was a businessman., when he had a phone call . He told the caller to call back. But after that call he seemed to be upset . So I asked him as to if anything was bothering him . He told me that he was being 'harassed' by IRS. So I asked to tell me as to what had happened. The answer was a surprise to me . He had a business and owned a limousine. It was 'equiped ' with every thing. He would pick up a client and the escort, and then he would drive around . The client and the escort would have 'fun' in the limo. itself without having to rent a motel room and then he would drop them off. He made good money , but then his partner bought expensive car and then IRS audited. That started the trouble he had to close the 'business'?. So this was the oldest business with new twist !! 

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