Asking about the Present Complaints

D: Hello Mr. Nicol, I haven't seen you for a long time. What seems to be the problem?

P: I have been having these headaches, doctor.

D: Which part of your head?

P: Mostly along here, along this side.

D: Oh, I see, the left side. How long have they been bothering you?

P: Well they started about three weeks ago. At first I felt as if I had the flue because my shoulders were aching, you know, pains in the joints and I had a bit of a temperature.

D: I see, and did you take anything for the headaches?

P: I took some aspirin but it didn't seem to make much difference to me.

D: When do they come on?

P: They seem to be there all day long, and at night I just can't get to sleep.

D: So they are bad enough to keep you awake?

P- Yes.

D: And how do you feel in yourself?

P: Very weak, and I'm tired of course. I think I've lost some weight.

D: Have you had headaches in the past?

P: Just one or two, but never anything like this.

Аsking about Pain Characteristics

D: Good morning, Mr. Hall. What's brought you along today?

P: Well, you see doctor, I've been having these headaches, you see, and ...

D: And how long have they been bothering you?

P: Well, they started about, well, it must have been about three months ago.

D: I see. And which part of your head is affected?

P: Well, it's, it's right across the front here.

D: And, can you describe the pain?

P: It's a sort of dull, dull, and throbbing kind of pain.

D: I see, and, do they come on at any particular time?

P: They seem to be…, they're usually worse in the morning. I notice them, when I wake up.

D: And is there anything that makes them better?

P: Well, if I lie down for a while, they seem to get, they go away.

D:Yes, and has there been anything else apart from these headaches?

P: Well, the wife, my wife, she says that I seem to be getting a bit deaf.

D:Well, Mr. Hall, I think at this stage I'll start by checking your ears to see if there' s any wax...

At the Cardiologist’s

D: Come in, Mr. Green, come and sit down here. I've had a letter from your doctor and he tells me that you've been having pain, pain in your chest.

P: Yes, and in my arm, and also tingling in my fingers and …

D: Yes, now when did you first notice this pain?

P: Well, I suppose about six months ago.

D: And can you remember when it first came on?

P: Yes, well… I remember, I got a bad pain in my chest when I was shopping. It was so bad I couldn't breathe and...

D: And where, in which part of your chest did you feel the pain?

P: Right across my chest,

D: And how long did it last?

P: About ten minutes.

D: And what did you do when it happened?

P: I had to stop and, wait for it to go away.

D: So, have you had this, the pain again since then?

P: Yes, I often get it when I overdo things, and when I...

D: Well, I think at this stage I'd like to examine you, your chest. So if you could strip to your waist. I'll just check your pulse first of all. That's fine. It's quite normal, seventy per minute. Now your blood pressure. Fine. That's quite normal too. 130 over 80.

P: I'm pleased to hear it.

D: Now I'm going to listen to your heart, so I want you to breathe normally. Your heart sounds quite normal.

P: Well, that's a relief.

D: Well now, 1 want you to take deep breaths in and out while I check your lungs. In… Out… In… Out… Fine. They're completely clear. Well, Mr. Green, the pain you've been having sounds very like the pain of what we call angina, and this occurs when not enough oxygen is getting to the heart. I'd like to check a few tests, and, following that I’ll be able to advise some treatment for you...