Clinical Dialogue Three A Dialogue in the Hospital Jay Zhuang General Surgical Department Ren Ji Hospital
Sentences Commonly Used by Medical Personnel • What can I do for you? • May I help you? • Please take a seat! • Wait a moment, please. • Sorry to have kept you waiting. • It is not serious. • Don’t worry. / There is nothing to worry about. • You need a thorough examination.
Sentences Commonly Used by Medical Personnel • You will have to stay in hospital for several days. / We think that you had better be hospitalized. • You should stay in bed for a few days. • You can keep on working. / You can carry on with your work. • You should be very careful for a week or two. • Try to relax and keep calm.
Sentences Commonly Used by Medical Personnel • You’ll soon be all right. • I’m sure this medicine will help you a great deal. • Feeling well again is a rather slow process, I’m afraid. • You will have to wait for twenty minutes. • Complete recovery will take a rather long time.
Sentences Commonly Used by Medical Personnel • If you feel worse, please come back to the clinic right away. • If you feel worried, don’t hesitate to go to the clinic anytime, day or night. • I’ll come right away. • I’m going to make arrangements for your admission
Sentences Commonly Used by Medical Personnel • Please come with your interpreter next time. • Do you understand what I’m saying? • Is there anything else you would like me to explain to you? • Shall I explain it again?
Sentences Commonly Used by Medical Personnel • If the trouble persists, come back again. • There doesn’t seem to be anything serious, but we’ll take an x-ray just to be certain. • Please wait until we get the result of the x-ray (blood-test).
Sentences Commonly Used by Medical Personnel • It’s difficult to say just now exactly what’s wrong. • This is quite common among people of your age. / This often happens to people of your age. / This often occurs at your age. • This kind of illness usually occurs among people whose work requires a lot of concentration (who undergo a lot of stress).
Sentences Commonly Used by Medical Personnel • I suggest you do some light exercises. • I suggest you have a course of acupuncture. • I suggest you take Chinese herbs. • I suggest that you get physiotherapy treatment. • I would like to transfer you to the gynecology (surgery,dermatology, urology) department.
Sentences Commonly Used by Medical Personnel • Your WBC (RBC, hemoglobin, urine, stool, sputum) should be checked. • A smear should be taken. A culture should be done. • Please don’t eat anything tomorrow morning before blood test. • Please wait for the result of your hemoglobin test.
Sentences Commonly Used by Medical Personnel • What’s your trouble? • How long have your been feeling unwell? • What medicine did you take? • Have you taken any medicine? • Did you take your temperature?
Sentences Commonly Used by Medical Personnel • Do you smoke (drink)? • Have you any temperature (a cough, a bad headache)? • Have you ever had jaundice (low grade fever, any chronic ailments, cold sweats at night, attacks of asthma)?
Sentences Commonly Used by Medical Personnel • Do you suffer from heartburn stomachaches (loose bowel movements, chest pains)? • Do you want to have your tooth extracted (tooth filled, dressing changed, blood pressure checked)? • Let me examine you please.
Sentences Commonly Used by Medical Personnel • Please take off your shoes and lie down. • Please unbutton your shirt and loosen your belt. • Please take off your trousers. • Please lie on your back (stomach, right side, left side). • Please bend your knees.
Sentences Commonly Used by Medical Personnel • Please relax. • Please breathe deeply (normally). • Please stick out your tongue. • Please let me feel your pulse. • Let me take your blood pressure. • Please lift your left leg (right leg).
Sentences Commonly Used by Medical Personnel • Please open your mouth and say “Ah”. • It is normal (essentially normal). • Have you ever received any treatment before? • Has it gotten worse? • Has it happened before?
Sentences Commonly Used by Medical Personnel • Are you feeling better? • Is the pain getting less? • Does it still hurt? • How long have you had this pain? • What kind of pain is it? • Please tell me something of your past illnesses. • Is there any blood in your stool (urine, sputum)?
Admission and Discharge • Doctor: We are going to do the operation on you tomorrow. I hope you don’t worry. • Patient: I will try not to, but will it hurt? • D:We’ll give you anesthesia. If you feel any pain during the operation, just let us know. Have you handed in your consent yet?
Admission and Discharge • P: How should I write it? • D: “I (name) the undersigned have requested and consented to a certain operation.” That’s all. We need the seal of your embassy and the signature of your Ambassador on the consent form.
Admission and Discharge • Nurse: I’d like to shave off the hair around the operation area. • P: I have never been in a hospital before. I’m so scared.
Admission and Discharge • N: There is nothing to worry about. The doctor who will operate on you is very experienced and considerate. If you have any discomfort during the operation, please don’t hesitate to tell him. • I will give you an enema tonight. After that please don’t take any food or water before the operation.
Admission and Discharge • P: How do you do it? Does it hurt? • N: I will insert a rubber tube into your anus and let the soap suds solution flow into your rectum. Please let me know if you feel distension. I’ll stop the flowing. Hold it for several minutes before you expel it. That may produce a better result.
Admission and Discharge • N: The operation went very well. Please turn from side to side every two or three hours. • P: I only feel a mild pain. I don’t think a pain-killer is necessary. • The pain is very severe. I can’t stand it. Please give me a pain-killer at once.
Admission and Discharge • N: I’ll help you get up. You can try walking around the room or corridor. • P: I think I’m quite all right now. • N: You are going to be discharged the day after tomorrow. • P: Is that so? I’m so happy. • N: You have been in the hospital for two weeks, Haven’t you? • P: Exactly, but the doctor told me I still have to rest for one more week.
Admission and Discharge • N: The doctor has written a certificate for you. There are two suggestions. First, avoid any mental stress and have a good rest. Secondly, examinations fasting sugar and an EKG should be done regularly. • P: My organization (doctor) needs my medical history. May I have it tomorrow? • N: Certainly.
Open Injury • Doctor: How were you injured? • Patient: I tripped and fell, banging my forehead quite hard. My wife wrapped a bandage around it to stop the bleeding. • D: Did you lose a lot of blood? • P: Not too much. • D: Were you unconscious? • P: No.
Open Injury • D: Did your nose or ears bleed after the accident? • P: No. • D: The wound is rather large, so I’’ll stitch it up. • P: Will it hurt? • D: Oh, no. It won’t be painful. We’ll give you a local anesthetic. You’re a brave fellow. Well, we’re all finished. That wasn’t so bad, was it?
Open Injury • P: No, not very. • D: Have you had an anti-tetanus injection lately? • P: I think the only one I have had was about five years ago. • D: Well, I think you’d better have another one. • P: Whatever you say, Doctor. • D: Come again after three days and we’ll examine the wound.
Fracture • D: Hello, I’m an orthopedic surgeon. What happened to your leg? • P: I fell down the stairs. Immediately, I felt a bad pain in my left hip and I couldn’t stand at all. • D: When did it happen? • P: Two hours ago. • D: Have you taken any pain-killers? • P: No, I came directly here.
Fracture • D: Please lie on the bed, loosen your belt. Point to the spot where you feel the most pain. • P: It’s here, Doctor, around the left hip. • D: I’m afraid your femur is broken. We’d better x-ray it, just to be sure. Take this paper to the office; the nurse will show you the x-ray department. • The x-ray shows a fracture of your left femur.
Fracture • P: Doctor, will it heal properly? • D: Of course, it will, don’t worry. I think you should be admitted to hospital. You need an operation to fix it. • P: I have hurt my right elbow. I can’t move it because of the pain. • D: How did it happen? • P: When I was getting into the bus, I fell on my elbow. That happened this morning.
Fracture • D: Is it still painful? • P: Yes. Since the accident it has been stiff and looks black and blue. At times it feels numb. • D: Can you feel this, when I put it in your hand? • P: Yes.
Fracture • D: I’m afraid you may have broken your elbow, I’ll send you to the x-ray department to check. • The x-ray reveals a fracture of the lower humerus. We’ll give you a “U” type plaster cast on your elbow and shoulder. • P: How long will I have to have it?
Fracture • D: About six weeks. • P: Is there anything else I should do? • D: You’d better rest in bed and keep your elbow higher than your heart. Move your finger joints from time to time. Keep an eye on the color of the fingers. If you have pain and numbness or if the color of the fingers turns pale or dark, come right away.
胆石病 • 病人：医生，我突然觉着右上腹疼痛． • Patient: Doctor, I suddenly felt a pain in the right upper side of my stomach. • 医生：什么时候开始的? • Doctor: When did it first start? • 病人：大约在三天前． • P: About three days ago.
胆石病 • 医生：疼还向别的地方窜吗? • D: Does the pain move anywhere else? • 病人：是的，向右肩部窜． • P: Yes, it goes towards my right shoulder. • 医生：是什么样性质的疼痛? • D: What kind of pain is it? • 病人：先是绞疼，很快就变为持续性的疼了． • P: It’s colic at first, but soon it became constant.
胆石病 • 医生：你发冷还是发烧? • D: Have you had any chill or temperature?病人：我仿佛觉着发烧． • P: I feel as though I have a temperature. • 医生：发热在先还是疼在先? • D: Which came first, the temperature or the pain? • 病人：疼在先． • P: The pain.
胆石病 • 医生：你胃口好吗? • D: How is your appetite? • 病人：我一看见食物就想吐． • P: When I look at food, I feel sick. • 医生：三天来你吐过吗? • D: Have you vomited in the past three days? • 病人：是的，一共吐了10到15次．我总感到疼 • P: Yes, about 10 to 15 times. I always felt pain.
胆石病 • 医生：吐过血吗? • D: Have you vomited blood? • 病人：没有，只是一些白的粘稠的东西． • P: No. Just a kind of whitish, thick stuff. • 医生：吃得过多或吃得油腻你肚子胀吗? • D: Did you feel full after eating heavy or greasy food? • 病人：是的，三天前我连续参加了两次宴会．以后我就感到腹胀．暴食后似乎就带来疼痛．这是发病的原因吗? • P: Yes, I went to two parties in succession three days ago. I felt bloated. Heavy eating seems to bring on the pain. Could this be the reason for it?
胆石病 • 医生：暴饮暴食可以引起这些症状． 你的皮肤和眼球发黄过吗? • D: overeating or drinking too much can cause these symptoms. Have your skin and eyeballs turned yellow? • 病人：没有． • P: No. • 医生：你的大便的颜色变浅过吗? • D: Have your stools been light in color? • 病人：是的，昨天我发现我的大便是沙土色的． • P: Yes, I found my stool was a sandy color yesterday.
胆石病 • 医生：你的尿色深吗? • D: Has your urine been dark? • 病人：是的，象茶一样． • P: Yes, just like tea. • 医生：让我给你检查一下．请躺下．放松．深呼吸．好．看起来你象是胆石症．我们给你照一X线片以明确诊断． • D: Let me examine you. Please lie down. Relax. Take a deep breath. Fine. You may have gallstones. We’ll do an x-ray to see if that’s so.
胆石病 • 病人：需要做手术吗? • P: Would an operation be necessary? • 医生：在没有看到X线片和试验结果之前，我还不能做结论．你最好住几天院以便观察． • D: I can’t say until I’ve seen the x-rays and done some tests. You’d better come into hospital for a few days of observation.
Coma, Extradural Hemorrhage • Women: Doctor, my husband tripped and fell, hitting his head quite hard. He has a headache, so I thought I’d better bring him in and see what’s wrong with him. • Doctor: When did it happen? • W: This morning. About two hours ago. • D: Does he have high blood pressure or diabetes? • W: No.
Coma, Extradural Hemorrhage • D: Did he lose consciousness after the injury? • W: Yes, he did. He blacked out for about half an hour. Then he regained consciousness. • D: (asking the patient) Do you remember how you were injured? • P: Oh, oh. (patient vomits) • D: Well, he is unconscious again now. Has he been vomiting all the time before coming to hospital? • W: Yes.
Coma, Extradural Hemorrhage • D: Now, let me have a look at him. The pupil on the right is dilated and does not react to light. There’s no reaction to pain in the left extremities. I’m afraid your husband has torn a blood vessel when he hit his head, and the blood is compressing his brain, causing his present condition. I’ll talk over his problem with the neurosurgeon and decide what to do. • W: Thank you, Doctor. I’m so worried. Do you think my husband will live?
Coma, Extradural Hemorrhage • D: Don’t worry. We’ll do everything we can to save him. • I’ve just finished talking to the neurosurgeon. Your husband is in a coma due to extradural hemorrhage. In order to save him, we think we should operate on him. (In order to be more certain what has happened to him, a lumbar puncture is necessary). We need your permission to do this. • W: Anything you say, Doctor, as long as he gets well.
Coma, Extradural Hemorrhage • D: Well, the operation has certain risks with the anesthetic and your husband may not be able to stand the operation. Post-operative complications could also occur. But we’ll do all we can for him. • W: Yes, I understand. Please help him. I agree to the operation. • D: Well. Could you sign this paper to give your consent for the operation? I think everything will be all right.
Coma, Extradural Hemorrhage • W: Shall I stay here? • D: If you want to, you can wait, and I’ll let you know the result of the surgery. (Please wait in the sitting room. I’ll keep you informed of what is going on).
Intestinal Obstruction • Patient: Doctor, I’ve had abdominal pains and vomiting for the past three days. • Doctor: What kind of a pain is it? • P: Like colic, with spasms every 4 or 5 minutes. • D: When did the vomiting first start? • P: Two days ago. I’ve had about five bouts of nausea and vomiting up to now.
Intestinal Obstruction • D: How about your bowel movement? • P: Nothing for two days. • D: Any wind? • P: No, not since last night. • D: Have you ever had any abdominal surgery? • P: I had my appendix out, but that was a long time ago.