.

.

Thursday, September 22, 2005

Pannus

The average person that I see in the clinic will refer to their anatomical abdomen as the "stomach." To me, "stomach" refers to the actual organ. But I don't really care one way or another what my patients call their abdomen as long as they can successfully articulate and further delineate the location of their pain. I just want to accurately identify what part of their body is the culprit for their pain. What they call it doesn't matter all that much. "A rose by any other name..."

In order to reduce any confusion, I often just refer to the abdomen as "stomach" as well. The patients seem to understand me better. It's just easier.

Today I had a woman come to clinic with abdominal pain, but she was unique in that unbeknownst to me, each section of her obese abdomen had different names: The upper portion was called the "stomach." She referred to the mid-portion as her "tummy." And the overhanging lower portion was known as her "belly."

Patient: Ooh Doctor, my belly's been hurting bad. You've gotta do something.

Me: OK. Tell me, how long has your stomach been bothering you?

Patient: My stomach never bother me.

Me: [A bit confused] I'm sorry? I thought you were having pain...

Patient: Yeah, in my belly. It's been going on for a few weeks.

Me: [Confusion not any better] So... where in your stomach?

Patient: [A bit aggravated] No, Doctor. Not my stomach. My belly. Geez, aren't you listening?

[I stare at the patient in silence, trying to figure out what she just said]

Me: So... where exactly in your abdomen are you having pain?

Patient: [With a puzzled expression] "Abmen?" What's that?

Me: It's another word for your sto-... [I pause]
[sigh]
Can you point to where you're having the pain?

Patient: [Patient points to her lower abdomen] Right here in my belly. [Then points to her upper abdomen] My stomach never bother me. [Moves her finger down to her belly button] My tummy never bother me either...