Wednesday, November 4, 2020

Exam Questions

Few things are more impressive in their function than the combination of medicine and technology. In most cases, it’s impressively good, like laser eye surgery, MRI’s, and cyborgs.

In some cases, it’s impressively bad, like when our three sons became “medically independent” at the age of twelve under the idiotic HIPAA rules and now they all have their own user names and passwords to access their secret medical records that I am not supposed to know anything about and I’m not supposed to have access to their accounts except for the fact that if you let a twelve-year-old set up their own medical user name and password, no one, including the twelve-year-old, will ever know what they are, and also I am not allowed to know anything about their medical records or activities right up until it comes time to pay for them and then all of a sudden I am allowed to be involved and no one can seem to see why that is the dumbest thing in the world.

But I digress.

One of the lesser but nonetheless impressively good features of modern technology and medicine is the ability to log into your medical account and see all your files and notes that they take during your doctor’s visits.

I had a yearly physical appointment the other day, and just for kicks I read the notes afterward. While the technology is cool, I do have a few questions about the notes themselves that have me wondering just how precise this whole “physical exam” system is.

For starters, my body mass index was listed as 29.27, which really meant nothing to me until I read further and saw that I was in the 25-30 = Overweight category. I would generally agree that I’m overweight, especially after my impressive Halloween candy intake this year, but a closer look at the numbers had me questioning the data.

Noting that I was on the high end of Overweight, I found a BMI chart that told me I was only two pounds (or six Snickers, in Halloween math) away from being Obese. It’s not just that “obese” for me is unrealistic, but that the chart wants me to lose 40 pounds just to get out of Overweight and into Optimal. And I can lose as much as 80 pounds and still be in the Optimal category.

Now, you may not know me personally, but let me assure you, if I lost 80 pounds, I would look like I was just freed from a two-year stint in a POW camp. I’m not putting a lot of weight in the BMI chart. (See what I did there?)

Under GENERAL in the notes, I was listed as “well developed, well nourished, in no distress, and alert.” I will take all of that as a compliment.

However, under HEAD, they wrote, “skull is normal in size and shape.” Nothing could be further from the truth. My head is abnormally large and dented and scarred from years of poor timing and/or decision making. I think my doctor may have just been trying to be nice, but facts are key here.

EYES: “normal in appearance.” I would agree with that, but would also like to add “kind, bright, and wise.”

EARS: “external ear normal.” Again, they are rather large and I think she was just being nice. Same situation with my nose.

LUNGS: “normal chest excursion.” I have no idea if that was a typo, but if not, then I don’t know anything about how my lungs work.

HEART: “regular rate and rhythm.” Maybe here in this office, but you should feel it when I try to take my 29.27 BMI's on a run!

Under MUSCULOSKELETAL and EXTREMITIES, I am proud to report that I have a normal spine ROM, no cyanosis, no clubbing, and no edema, assuming all of that is good, since I have no idea what any of it means.

MOTOR FUNCTION has me a little confused. They noted “grossly normal strength.” On the one hand, “grossly” would suggest that I am super buff. On the other hand, “normal” is not a word associated with an excess of anything. I am either offended by this, or pleased with my workout efforts. I’m not sure which.

As confusing and questionable as all that was, the note that really had me wondering was under CORTICAL FUNCTION. My doctor listed me as having “normal intellectual function, normal memory, and good judgement.”

C’mon! These are the notes on me, right? It’s as if they got my file mixed up with someone who can keep a thought in their head for more than ten seconds, can remember what they had for breakfast, and doesn’t have an impressively long list of bad decisions that haunt them to this very day.

Technology is great and all, but having notes available online is only helpful if the notes are true. Trying to be nice about it isn’t helping anyone.

Now if you’ll excuse me, I think I need to go eat a salad.

See you soon,



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