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Doctor's Appointment: Cough and Chest Pain

This dialogue was written by Dr. Hernán Posada and Ana Ramírez. The voices are from two Kenyon students, Elizabeth Hieronymus as the doctor and .... To listen the dialogue, click on each blue sentence.

P:Good afternoon.

D:Good afternoon. What have you come for today?

P:I am here to see you because I have a dry cough and chest pain.

D:For how long have you had this cough?

P:For a month, and I can't stand it anymore.

D:How old are you?

P:I am 23 years old.

D:23 years old. Tell me, besides this cough, do you have any other kind of health problems?

P:No doctor. I only have this cough and my chest hurts.

D:Is your cough productive of phlegm?

P:No, my cough is very dry.

D:Have you had a fever or chills?

P:Yes, I have had fever up to 38º C. It comes and goes frequently.

D:Does someone at work or in your family have the same cough?

P:No one suffers from this cough in my family, but at work a woman does.

D:Are you very close to her? Do you work in the same office?

P:No, we don't work in the same office.

D:Are you allergic to anything?

P:Yes, I am allergic to strong odors such as perfumes and flowers. I am also allergic to dust.

D:Have you taken any medicine for this allergy?

P:No doctor.

D:Do you smoke?

P:Yes, I have been smoking for the last 5 years.

D:How many packs per day do you smoke?

P:I smoke 2 packs per day.

D:Have you lost your appetite?

P:Yes. I am so stressed at work that I am not hungry anymore. Besides that my chest hurts so much when I swallow that I really don't want to eat.

D:Have you been seen by another doctor?

P:No.

D:When was your last physical exam?

P:A couple of years ago.

D:Have you had any X-rays taken lately?

P:No doctor.

D:I wish to give you a thorough medical examination, paying special attention to your lungs. Have you ever been tested for tuberculosis?

P:Yes, two years ago, but it was negative.

D:I am going to listen to your lungs. Breathe deeply through your mouth. I hear some lung dimunition and wheezing. Tell me, do you get out of breath when you go up the stairs or when you walk fast?

P:Frequently, I suffocate myself.

D:What do you in these cases?

P:I try to stop walking and relax a little bit. I also try to breath as deep as I can.

D:I will schedule a chest X-ray at the hospital for you. While you are there we will have the lab get a sporum for evaluation. Also you are going to take the tuberculosis test again. Depending on the test results, I will meet with you again to talk about our treatment plan. I will prescribe some antibiotics for you. Are you allergic to any antibiotic?

P:No, doctor.

D:I advise you and everyone who smokes to stop smoking. The air we breathe is already contaminated by car and industry pollution. You also have to take into account that lately, females suffer more from lung and larynx cancer than males because they tend to smoke more. There are several methods to quit smoking, but the cheapest I know is to stop buying cigarrettes. Do not ask for one, stay away from them.

P:Doctor, how does smoking damage the lungs?

D:The lung tissue starts to deteriorate with the inhalation of toxic substances, and the interchange of gases decreases. Therefore, the more the person smokes the less he/she can breathe.

P:Thank you very much, doctor.

D:My pleasure. I will see you as soon as I have the result of your medical tests.