After the interview, the resident will give you a thorough examination. Again, the order in which the resident examines you may vary. He or she may begin by examining the physical signs of the actual condition or by delaminating the head and neck, and then continue with the rest of the body. If the disorder is associated with a limb, the physician always begins by examining the healthy limb. This is so he or she knows what the limb usually feels like before examining the condition. A pelvic or rectal examination may also be included.
At the conclusion of the examination, the resident usually makes some comment about the impression he or she has formed. You must remember, however, that the first physician you see is usually less experienced than the consultant and will not have any results of tests or X rays, so it is unlikely that he or she will be able to make an accurate diagnosis at this point. If the first physician was an intern, you may have to go through the questions and examination again, this time by a more senior house staff member, an assistant resident, or a chief resident. Finally, you will see the physician in charge. If you ask all three for their opinion, you may get three slightly different answers, and many people get worried in this situation, because they feel there is some uncertainty about the case. A patient may worry because one physician orders a stomach X ray, whereas another suggests a gall bladder X ray first. Both have a good reason for their opinion. The final diagnosis will be achieved either way, but techniques do differ. Another cause of worry is confusion about the terms that a physician uses. A patient may be told by one physician that he or she has a peptic ulcer, whereas another may say the patient is suffering from a duodenal ulcer. This is because a duodenal ulcer is a type of peptic ulcer, not because the diagnosis is different. The safest policy to adopt is to always talk to the physician in charge of your case. He or she can give an opinion based on the information from the other physicians and explain any confusions or misunderstandings.
Hospitalization - Admission Procedures
The procedures you follow on admission to a hospital vary from one hospital to another, but basically the process is the same in most institutions in the United States.
Care of the Dying - Reaction of Children
A child's reaction to death depends on many factors. A child's first experience with death is often the death of a pet. A child under the age of eight cannot understand that death is irreversible and may expect the mother or father to bring the pet back to life. After the age of eight or nine, the child's understanding is usually as rational as an adult's understanding.
Care of the Dying - Moment of Death
Do not be alarmed if the patient's breathing makes a groaning or croaking sound. It does not mean that he or she is in pain. When a dying patient slips into a coma, the position of the neck and body produces the noise, which can be reduced by gently turning the patient's shoulders or body.
