Indexing Title: MJCABAHUG’s Medical Anecdotal Report [05-03]

MAR Title: LANGUAGE BARRIER

Date of Medical Observation: April, 2005

Narration:

After a 24 hr duty at the Emergency Room, a patient was referred to me by a internal medicine resident.  He told me that the patient had a second degree burn on the Left hand but he did not know what caused it.  I then tried to interview the patient.  The patient was a retired banker from Mindanao and came to Manila to follow up his retirement benefits.  He was left alone in an office in Malate.  The one who brought the patient in was also from Mindanao and also does not talk much Tagalog. It was fortunate of me that we have the same dialect.  I was able to extract a good history.  The patient was last seen going inside the comfort room on a Saturday afternoon.  When the janitor came in on a Monday morning to clean the comfort room, he was found lying down unconscious and his left hand was erythematous with multiple vesicular lesions.  The patient was then brought to our emergency room and was diagnosed to have burn by the internal medicine resident without knowing the cause.  Through my interview, I found out that he is a diabetic patient.  It is my theory that the patient had hypoglycemia that saturday afternoon in the comfort room and lost his consciousness,  he was lying down with his left hand got caught between his body and the floor until he was found by the janitor.  The circulation of his left hand was compromised for three days.  When I saw the patient the hand had a good capillary refill, so we just treated it with flammazine.

Insights (Physical, Psychosocial, Ethical) (Discovery, Stimulus, Reinforcements):

It is fortunate of me because I understand several dialects cebuano, ilongo, ilocano, tagalog, bicol so I am able to communicate well with patients from these regions.  I am able to extract well their histories especially those with difficulty speaking tagalog.  So even if we cannot understand their dialect we should not resign and just guess what happened to the patient.   We should take a good history to come up with a diagnosis to be able to treat our patients right.