“I’ve got terrible stomach pains,” she said, lifting her shirt to expose her belly. She rubbed her hand over it.
“What have you had to eat today?” I pulled up her file on the computer.
“Nothing. I woke with a stomach ache.”
I motioned for her to lay back. I was sure she didn’t have a stomach ache, but I couldn’t dismiss her on the off chance she really was sick. “Any diarrhea?”
She made a face. “God, no.”
“Vomiting?”
She shook her head.
“When was the last time you had a bowel movement?” Maybe she was constipated.
She made another face. “Why are you asking about my shit?”
I took a breath to hide my annoyance. “Clues to the reason for a stomach ailment can sometimes be determined by … your shit,” I said using her term.
I did my exam, checking for anything unusual in her abdomen. She pushed her shorts down far enough for me to see that she waxed.
I ignored that as I pressed the soft tissue. “Any pain or discomfort?”
“No.”
I ruled out a variety of possibilities including appendicitis.
I pulled up prescriptions on her chart and noted that she was on birth control. Even so, I asked, “Any chance you’re pregnant?”
Her eyes widened. “No.”
“You haven’t missed any pills?” I looked again at the medications and didn’t see antibiotics, which could
sometimes lower birth control pills’ effectiveness. “Have you been on any antibiotics?”
“No.” Her hand rested on my forearm. “The pills work great. Maybe we could test them.”
I tried not to roll my eyes. “You probably have a little bug. Have some broth soup, and maybe a few crackers, then see how you feel.”
She nodded. “Why don’t you come to Dina’s Diner with me for lunch. To make sure I don’t faint or something.”
“Have you fainted or felt lightheaded?” I asked, typing in the information into the EMR.
She hesitated and I turned to look at her. “Well … maybe a little.”
For the most part, I was amused by Joyce, but the truth was, she was wasting hospital time and resources each time she came in with a bogus ailment.
I turned my full attention to her. “Have you ever read the story about the boy who cried wolf?”
It took her a moment to grasp my meaning. “My stomach really does hurt.”
“Take some bismuth subsalicylate, it’s the pink medicine. Have a little soup and maybe a few crackers. If it continues, we can arrange to have a sample of your bowel movement brought in and tested,” I said, mostly to figure out how real this stomach ailment was. Anyone willing to gather a sample of their shit to bring in was likely feeling poorly.
She made a face. I suspected the next time she came in, it wouldn’t be for a stomach issue. She held her hand out so I’d help her down from the exam table. Since I was a gentleman, I did. And as usual, she jumped down in such a way as she bumped into me.
“Oh, sorry,” she said, her coy eyes showing she wasn’t sorry at all.
I gave a short nod as I stepped back. “Have a good day, Ms. Maynard.” I started to leave.