WEBVTT FILE 1 00:00:00.030 --> 00:00:03.100 Okay so I thought it might be really fun if... 2 00:00:03.100 --> 00:00:04.620 You've seen my videos, right? 3 00:00:04.620 --> 00:00:06.840 Yeah yeah You know I have costumes? Yes! 4 00:00:06.960 --> 00:00:08.820 Let's imagine you come to London and 5 00:00:08.820 --> 00:00:14.220 then you have a pain or some problem that you really need a doctor for 6 00:00:14.220 --> 00:00:16.900 What do you do? How do you describe things? 7 00:00:16.900 --> 00:00:21.000 What might your doctor say and how do you understand everything? 8 00:00:27.620 --> 00:00:31.740 and like that, we're in your doctor's surgery! 9 00:00:31.740 --> 00:00:36.440 studio magic! this is my doctor surgery, but it's very similar to the set we were chatting on 10 00:00:36.520 --> 00:00:38.400 It's so similar but it's not! 11 00:00:38.400 --> 00:00:42.020 So one thing I love that you do on your channel is that you'll watch an 12 00:00:42.030 --> 00:00:48.750 episode of house and you kind of try and diagnose the patient but you explain it 13 00:00:48.750 --> 00:00:52.949 in such an easy way. I thought maybe we could practice something like that 14 00:00:52.949 --> 00:00:58.980 I'll have a symptom and maybe you can diagnose me? Sure, let's do it! 15 00:01:00.060 --> 00:01:03.600 In this scenario as well if you are struggling with English we always 16 00:01:03.600 --> 00:01:07.860 have options to get interpreters as well you know in hospital we can often get 17 00:01:07.860 --> 00:01:12.300 another member of staff who can sit in who may be able to speak the language or 18 00:01:12.300 --> 00:01:15.620 we can get people on the phone so that's always an option we can use 19 00:01:15.680 --> 00:01:17.720 So that's an option then? Absolutely! 20 00:01:17.720 --> 00:01:20.979 You could have an interpreter? Exactly! 21 00:01:20.980 --> 00:01:24.920 Perfect. But! You should try! Why not? 22 00:01:24.920 --> 00:01:27.810 So first of all whenever we talk to a 23 00:01:27.810 --> 00:01:31.580 patient the first thing we want to explore is ask you about what's brought you in so 24 00:01:31.580 --> 00:01:35.580 Tell me about what's been going on. Tell me about what's brought you in today. 25 00:01:35.740 --> 00:01:39.479 Okay well for two days I've been having cramps 26 00:01:39.479 --> 00:01:43.830 so notice grammatically I said I've been having cramps 27 00:01:43.830 --> 00:01:50.159 I used present perfect because it's from a past time until now I've been having 28 00:01:50.159 --> 00:01:56.759 cramps okay so with all symptoms something that a medical thing that's 29 00:01:56.759 --> 00:02:00.900 going on that's what we call a symptom with the doctor we want to explore that 30 00:02:00.900 --> 00:02:06.299 symptom in more detail okay so with this particular one and ask you where do you 31 00:02:06.299 --> 00:02:12.870 have the pain and it feels like it's in the bottom of my stomach in the lower 32 00:02:12.870 --> 00:02:18.090 part of my stomach okay so the stomach we actually think of being quite high up 33 00:02:18.090 --> 00:02:23.250 but actually people think the stomach means the whole of the abdomen whole of 34 00:02:23.250 --> 00:02:26.730 the tummy as well but we can use it interchangeably so that's why it's 35 00:02:26.730 --> 00:02:30.840 important for us it doesn't matter if you use these language terms we have to 36 00:02:30.840 --> 00:02:34.859 identify that and find out so I might say can you show me where you're having 37 00:02:34.859 --> 00:02:40.319 the pain so you could get me to point out I told you I was stupid 38 00:02:40.319 --> 00:02:45.930 so but no that's really interesting so in English we say my stomach or my belly 39 00:02:45.930 --> 00:02:52.080 just this whole area is my stomach or my belly mm-hmm right okay cool so so I 40 00:02:52.080 --> 00:02:56.610 know where the pain is now right and I'm a and you've given me a bit of a hint 41 00:02:56.610 --> 00:03:00.660 that's been going on for two days so with this I'd want to know what I'd call 42 00:03:00.660 --> 00:03:06.780 the Fido so I want to know its frequency so I'd ask you how often do you have to 43 00:03:06.780 --> 00:03:18.209 paint it's about every every hour and it lasts about 10 minutes okay good so 44 00:03:18.209 --> 00:03:22.619 within that as well you've also given me the duration so that's the D and Fido so 45 00:03:22.620 --> 00:03:25.950 you give me the frequency so how often you get it and you've given me the 46 00:03:25.950 --> 00:03:30.269 duration so when you get it how long it lasts for so the eye is for the 47 00:03:30.269 --> 00:03:35.910 intensity so I'd like you to give me a score like how at worst how bad is the 48 00:03:35.910 --> 00:03:42.090 pain okay so in general it's about a 5 but last night it was so bad that I 49 00:03:42.090 --> 00:03:48.840 fainted too faint means you lose consciousness you fall over or another 50 00:03:48.840 --> 00:03:55.739 phrasal verb to pass out so I could say last night the pain was so bad I passed 51 00:03:55.739 --> 00:04:01.680 out ok so I want to explore those symptoms of what led you to pass out but 52 00:04:01.680 --> 00:04:06.569 we'll leave that for the moment so the O stands for the onset so tell me about 53 00:04:06.569 --> 00:04:12.389 what happened when it first came on okay so for about a week it's been hurting a 54 00:04:12.389 --> 00:04:19.470 little bit but progressively over time it's it has been getting worse okay fine 55 00:04:19.470 --> 00:04:23.130 so with this particular symptom I'd want to ask a few more questions we actually 56 00:04:23.130 --> 00:04:26.910 use a slightly different framework but this isn't a medical thing we'd normally 57 00:04:26.910 --> 00:04:31.560 use Socrates so a few more mnemonics to explore but one of the things in 58 00:04:31.560 --> 00:04:36.478 Socrates is does the pain radiates anywhere so radiate means does it move 59 00:04:36.479 --> 00:04:41.038 from one place to another so you said the pains here so does the pain go 60 00:04:41.039 --> 00:04:47.130 anywhere else and yes it's moved to the side now okay fine and have you had any 61 00:04:47.130 --> 00:04:50.669 changes in your urine or any changes opening your bowels 62 00:04:50.669 --> 00:04:56.910 nope they are beautiful very good so we will kind of end that 63 00:04:56.910 --> 00:05:00.420 particular roleplay thing there right because we kind of I'd worry about 64 00:05:00.420 --> 00:05:05.220 something like an appendicitis so you're a young person with abdominal pain that 65 00:05:05.220 --> 00:05:11.100 started centrally and is now radiated to the side now and that's what we'd worry 66 00:05:11.100 --> 00:05:15.330 about in that circumstance and you'd also have other symptoms so feel 67 00:05:15.330 --> 00:05:19.440 generally unwell fevers but because the pain made you pass out you know that's 68 00:05:19.440 --> 00:05:23.820 the type of thing we'd be looking at okay what happens next like what 69 00:05:23.820 --> 00:05:29.279 questions would I expect yeah so then I'd want to know about any medical 70 00:05:29.279 --> 00:05:33.299 conditions you have so your past medical history how does that question go 71 00:05:33.300 --> 00:05:36.870 so I'd say anything that you see your doctor regular belt or any medical 72 00:05:36.870 --> 00:05:42.810 conditions you have will say no cool and then I'd ask any previous operations 73 00:05:42.810 --> 00:05:49.950 you've had okay and I had my tonsils removed a few years ago is that relevant 74 00:05:49.950 --> 00:05:55.110 it is relevant because although it may not be relevant to this body system we 75 00:05:55.110 --> 00:05:58.800 know that you may have had certain medications certain anesthetic drugs 76 00:05:58.800 --> 00:06:03.210 that we know you're probably comfortable having again okay so then after we've 77 00:06:03.210 --> 00:06:06.810 done the kind of looked at your past medical history and past surgical 78 00:06:06.810 --> 00:06:12.150 history I talked about any medications that you're on so I'd ask you any drugs 79 00:06:12.150 --> 00:06:17.970 that you take regularly so this is an interesting thing so you said drugs now 80 00:06:17.970 --> 00:06:23.580 if your doctor asks you about your what drugs you take probably you don't mean 81 00:06:23.580 --> 00:06:29.040 heroin that would still be important to tell your doctor but when we talk about 82 00:06:29.040 --> 00:06:33.180 drugs we're not talking about illicit drugs so drugs you smoke or drugs you 83 00:06:33.180 --> 00:06:37.230 inject we're talking about medications you take okay treat medical conditions 84 00:06:37.230 --> 00:06:43.320 right so do I take medication we don't say I eat a pill or I eat medicine we'd 85 00:06:43.320 --> 00:06:51.750 say I take the medicine or if it's maybe long-term I could say I'm on the 86 00:06:51.750 --> 00:07:03.339 medicine name so I don't know last month I was on antibiotics for an infection 87 00:07:03.339 --> 00:07:08.839 fine and then within the when I'm exploring your medications I'd want to 88 00:07:08.839 --> 00:07:15.199 know about any allergies any drug allergies okay perfect now if I have an 89 00:07:15.199 --> 00:07:22.099 allergy I use this structure I'm allergic to name of thing so this is 90 00:07:22.099 --> 00:07:26.868 true I'm allergic to penicillin okay I've just told everyone how to kill 91 00:07:26.869 --> 00:07:30.679 me that's all right 92 00:07:30.679 --> 00:07:35.779 we won't be giving you that you should be given in that you could also say I 93 00:07:35.779 --> 00:07:42.680 have an allergy to penicillin or I have a penicillin allergy so the last thing 94 00:07:42.680 --> 00:07:45.919 we talked about in the history after we've done the drug history we talked 95 00:07:45.919 --> 00:07:50.329 about your family history so ask you if you have any medical conditions that run 96 00:07:50.330 --> 00:07:54.169 in your family nope we're pretty we're a healthy Bunch 97 00:07:54.169 --> 00:07:58.430 good good good and then we'd ask about your social history so I'd basically 98 00:07:58.430 --> 00:08:04.789 keep it very open so I'd say what job do you do I'm a teacher yeah and I say have 99 00:08:04.789 --> 00:08:11.269 you had any foreign travel recently um I went on holiday to Italy okay 100 00:08:11.269 --> 00:08:15.550 and but no we're sort of outside of that in the last few months 101 00:08:15.550 --> 00:08:21.559 no cool and then I'll ask do you smoke cigarettes no have you ever smoked 102 00:08:21.559 --> 00:08:25.639 cigarettes no okay and do you drink alcohol yes 103 00:08:25.639 --> 00:08:30.799 so they're not ask you what you typically drink in a week um maybe I 104 00:08:30.800 --> 00:08:38.208 have one or two beers a week okay so one or two pints of beers yeah okay fine so 105 00:08:38.208 --> 00:08:42.708 there's about three units in a beer so I'd say you have about six units of 106 00:08:42.708 --> 00:08:49.518 alcohol a week so that may be relevant but in those quantities cool okay and 107 00:08:49.519 --> 00:08:54.170 the last thing we should be talking about is any concerns you have so how 108 00:08:54.170 --> 00:08:57.230 are you feeling is there any particular worries you have because very often 109 00:08:57.230 --> 00:09:02.300 people know it's not just they come with illness they have preconceived ideas and 110 00:09:02.300 --> 00:09:05.420 worries about why they're coming to the doctor right it would always be an 111 00:09:05.420 --> 00:09:09.350 opportunity so I'd say is there anything worrying units brought you in today yeah 112 00:09:09.350 --> 00:09:14.000 I've probably got cancer that's always my that's always my worry if anything 113 00:09:14.000 --> 00:09:16.309 hurts I'm dying I've got cans 114 00:09:16.309 --> 00:09:20.869 and I'll google it you're so right google often doesn't help these things 115 00:09:20.870 --> 00:09:24.800 because caps can have lots of symptoms but a doctor will be able to take a look 116 00:09:24.800 --> 00:09:29.450 at the whole picture and be able to reassure you okay so I don't have cancer 117 00:09:29.450 --> 00:09:35.630 with the given symptoms here it would be very low down on - okay good that's 118 00:09:35.630 --> 00:09:41.029 that's put my mind ease so then after we've done our history would then do an 119 00:09:41.029 --> 00:09:45.979 examination of you so in this instance with the abdominal pain we'd probably 120 00:09:45.980 --> 00:09:50.539 want to take some observations so check your blood pressure check your heart 121 00:09:50.540 --> 00:09:53.000 rate measure your temperature and a few other 122 00:09:53.000 --> 00:09:57.529 things and also want to have a feel of your tummy or your belly as we said 123 00:09:57.529 --> 00:10:02.630 earlier and then from there organize some investigations like blood tests and 124 00:10:02.630 --> 00:10:07.160 possibly a scan you as a patient you might say I'm going to have a blood test 125 00:10:07.160 --> 00:10:12.230 or what would you say is a doctor how would you tell me that so we can say I'm 126 00:10:12.230 --> 00:10:17.589 going to take a blood test or take some of your blood or take a blood sample 127 00:10:17.589 --> 00:10:21.800 it's it's very much a take action because you'll give it us something 128 00:10:21.800 --> 00:10:31.850 right you're not borrowing and finally might I need surgery okay for with this 129 00:10:31.850 --> 00:10:36.770 particular condition yeah we're thinking about absolutely I mean that this would 130 00:10:36.770 --> 00:10:41.480 be an emergency so if you were presented to your family doctor we'd want to refer 131 00:10:41.480 --> 00:10:46.160 you into the hospital for these blood tests and for the scan because we can do 132 00:10:46.160 --> 00:10:51.440 that very quickly we can't do them in a GP practice straight away and then from 133 00:10:51.440 --> 00:10:55.370 there you will certainly be under the surgical team to rule out the 134 00:10:55.370 --> 00:11:01.190 possibility of needing surgery okay but if I do need surgery the way I can say 135 00:11:01.190 --> 00:11:08.120 it is I'm going to have surgery or have an operation or have an operation seat 136 00:11:08.120 --> 00:11:13.370 now you're an English teacher that's it so let's get out of your practice let's 137 00:11:13.370 --> 00:11:19.458 go of your surgery yup and we're back back in the studio I asked you guys to 138 00:11:19.458 --> 00:11:24.559 send me your questions about medicine in the UK and any medical questions that 139 00:11:24.559 --> 00:11:28.929 you might have we'll answer them for you so let's have a look...