Say what?

05/17/2010 at 5:57 AM Leave a comment

A story with few coments. A patient came in worried because he had a colonoscopy recently and he heard bad news. I was ready for the cancer/chemo/colostomy discussion when he said that he had Emphysema!

Say What? Emphysema he told me, right after the colonoscopy.

My reply is tactful, perhaps you were still under the anesthetic and did not hear him correctly?

My wife heard it also, to which she nods.

I joke, how long was this colonoscopy anyway? they both chuckle while I gather my thoughts. He did smoke but it has been over ten years since he quit. He is middle aged so he probably does have some damage from the 25 years of smoking, but the non-sequitur of diagnosing emphysema while looking up the rectum for colon cancer has all of our shorts in a bunch.

I look at the report from the specialist and sure enough he dictated the same thing. No polyps, no tumors, clean colon. Diagnosis: emphysema.

It is hard to make me speechless, something to which my wife and patients will gladly testify and this came close. I was fighting the urge to poke fun at this specialist that perhaps he had his head up his A** but actually it was up someone else’s A***. I know the patients and they probably would have loved the joke, but somehow it seemed to be the wrong time and place.

I also had to consider that the word emphysema can be used as an adjective and you can have emphysema of the skin or other areas if air gets into the tissues. But this is rather unusual and I had never heard of emphysema of the colon.

After reviewing the chart and some chest x-rays I saw evidence that he does indeed have the beginnings of COPD, (emphysema to you) but that it has been present for many years without any symptoms or decrease in exercise capacity. I suspect that once the procedure was done and it was normal the doc decided to mention something else as a ‘value added service’.

However the juxtaposition of the colonoscopy and a rectal specialist mentioning a lung disease was rather comical.


Entry filed under: humor, true story.

Bad Timing Can you take your clothes off and a copay please?

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