Being an Urban Legend
Wikipedia describes an URBAN legend as a story or myth that "carries some significance that motivates the community in preserving and propagating it."
When, where and how a story becomes a legend is interesting by itself but is rarely divulged, much more authenticated.
Let me share an "urban legend" born in the walls of the Philippine General Hospital (PGH)...
A long long time ago, there was a female intern rotating at the surgery out patient department ...
She was repeatedly reminded of the relevance of getting a DETAILED history and complete physical examination because 99% of the diagnosis is based on this.
If the diagnosis is inaccurate, then proper work up and treatment cannot be instituted.
This was the " GOLDEN" RULE.
Since PGH is a government hospital, the number of patients seeking consult can be overwhelming and to save time, she sometimes simply take whatever information the patient gives without asking additional questions to confirm the veracity of the information given, breaking the GOLDEN RULE.
One morning, a middle aged man sought consult for a "bukol" on his penis which he wanted removed.
The intern sensed his hesitancy when he saw her and guessed that given the "sensitive" nature of his complaint, he would have preferred a man to examine him. The intern too wanted a male co-intern to see him, but choosing patients was not an option for interns.
The whole interview process and examination was filled with awkwardness.
" When did you first notice the "bukol" sir ?", she asked.
" Two years ago." He was working as an engineer in Saudi when he had it.
" Is it growing?"
He hesitated for awhile then said, " No, it is not."
She inquired if he had other associated symptoms like pain or irritation and redness. He said he was fine except that he felt uncomfortable having the "bukol" on his penis thus wanted it removed.
The intern uneasily examined the "bukol".
It was around 0.5x 1cm in size, hard, not painful, movable and located at the dorsal part of the shaft of his penis.
Penile cancer was the first thing that came into her mind.
Being under-board, all interns were mandated to present all the cases they see to the resident physician for checking and disposition.
When her turn came, she brought the patient to the resident, gave her history and physical examination and with such certitude said, " Sir, I am ruling in Cancer of the Penis.".
She proceeded with her proposed plan to surgically remove the lump and send it for biopsy.
The resident then ushered the patient to the examining room and after a few minuted came out laughing.
" Inday, this is not penile cancer. This is BULITAS.".
A few years later, as a resident physician in Internal Medicine, I heard a colleague tell the story of an unnamed intern diagnosing BULITAS as penile cancer. The story apparently survived through the years, through constant retelling as an anecdote.
The funniest part of the story though, which nobody knew was that the unnamed intern had no idea what a BULITAS was and for what purpose it served!
She had to ask a co-intern who also had difficulty explaining it and instead gave her a book by Joan Collins which revealed the true nature and purpose of the "bulitas".
A long long time ago, there was a female intern rotating at the surgery out patient department ... and that intern was ME.
When, where and how a story becomes a legend is interesting by itself but is rarely divulged, much more authenticated.
Let me share an "urban legend" born in the walls of the Philippine General Hospital (PGH)...
She was repeatedly reminded of the relevance of getting a DETAILED history and complete physical examination because 99% of the diagnosis is based on this.
If the diagnosis is inaccurate, then proper work up and treatment cannot be instituted.
This was the " GOLDEN" RULE.
Since PGH is a government hospital, the number of patients seeking consult can be overwhelming and to save time, she sometimes simply take whatever information the patient gives without asking additional questions to confirm the veracity of the information given, breaking the GOLDEN RULE.
One morning, a middle aged man sought consult for a "bukol" on his penis which he wanted removed.
The intern sensed his hesitancy when he saw her and guessed that given the "sensitive" nature of his complaint, he would have preferred a man to examine him. The intern too wanted a male co-intern to see him, but choosing patients was not an option for interns.
The whole interview process and examination was filled with awkwardness.
" When did you first notice the "bukol" sir ?", she asked.
" Two years ago." He was working as an engineer in Saudi when he had it.
" Is it growing?"
He hesitated for awhile then said, " No, it is not."
She inquired if he had other associated symptoms like pain or irritation and redness. He said he was fine except that he felt uncomfortable having the "bukol" on his penis thus wanted it removed.
The intern uneasily examined the "bukol".
It was around 0.5x 1cm in size, hard, not painful, movable and located at the dorsal part of the shaft of his penis.
Penile cancer was the first thing that came into her mind.
Being under-board, all interns were mandated to present all the cases they see to the resident physician for checking and disposition.
When her turn came, she brought the patient to the resident, gave her history and physical examination and with such certitude said, " Sir, I am ruling in Cancer of the Penis.".
She proceeded with her proposed plan to surgically remove the lump and send it for biopsy.
The resident then ushered the patient to the examining room and after a few minuted came out laughing.
" Inday, this is not penile cancer. This is BULITAS.".
A few years later, as a resident physician in Internal Medicine, I heard a colleague tell the story of an unnamed intern diagnosing BULITAS as penile cancer. The story apparently survived through the years, through constant retelling as an anecdote.
The funniest part of the story though, which nobody knew was that the unnamed intern had no idea what a BULITAS was and for what purpose it served!
She had to ask a co-intern who also had difficulty explaining it and instead gave her a book by Joan Collins which revealed the true nature and purpose of the "bulitas".
A long long time ago, there was a female intern rotating at the surgery out patient department ... and that intern was ME.
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