Stethoscope at the ready this time of year ... if the doctor can only find it
THE stethoscope has seen a lot of action this week with a continuous flow of expectorating patients wanting their chests examined.
The treatment decision has usually been made by the time the patient completes the 25-metre walk from the waiting room to my consulting room, with the likelihood of obtaining any antibiotics being inversely proportional to the volume of the cough (no amateur dramatics, please).
However, I wouldn't expect anyone to accept my advice if I hadn't gone through the ritualistic motions of an examination.
These days we can dazzle patients with a pulse oximeter, a finger-tip oxygen measurement device.
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This often cheers people up as the oxygen reading is usually 98 per cent, the highest score they have ever achieved in a test.
However, no check-up would be complete without the stethoscope. Doctors who wear pyjamas to work (accident and emergency, anaesthetics) carry theirs around their necks to look cool but for the humble GP its natural habitat is at the bottom of the bag with some leaking alcohol hand-gel and a tongue depressor that might actually have been a lolly-stick from last summer.
If one forgets this vital tool, the assumption that the stethoscope is always cold can be put to good use; a cold ten pence piece pressed to a patient's back fulfils the illusion that the chest is being thoroughly assessed.
Prior to the invention of the stethoscope in 1812, a physician would listen to the chest by placing his ear directly onto the skin.
This was clearly awkward for both doctor and patient and standard phrases such as "nice big breaths" were easily misconstrued by female patients.
The short length of tubing allows an acceptable and hygienic distance to be maintained and has become the iconic symbol for all healthcare professionals.
Ironically, when we are listening to your chest, we can't hear a word you are saying.