Sunday, February 01, 2009

Straight from the Medical Record

Sometimes information in medical records cracks me up. Take for example these excerpts from a note for a patient I helped care for:
Interval History:
Had a good day, with an especially lucid morning. Enjoyed throwing rubber chicken into sink. Family pleased with progress.

Exam:
NEURO: Continues tremulousness, is mostly non-verbal (per family, is exhausted and getting cranky after busy morning). Throws rubber chicken onto attending physician and into sink.

ATTENDING STATEMENT:
I personally saw and evaluated the patient. She did seem to enjoy throwing a rubber chicken at me and into the sink. I discussed the patient with Dr. XXX. I agree with the findings and plan as documented in his note.
The moral? Rubber chickens never fail to amuse.

Critical and identifying information has been changed to protect this patient's privacy.

1 comment:

Dragonfly said...

Hehe. And the subtext in some of those notes can be hilarious as well.