So I was called to do a breathing treatment on a lady who had a knee replacement. The patient was awake and alert with no signs of respiratory distress.
I said, "Are you short of breath?"
She said, "They say I am."
"So you feel fine?"
"Yeah. Except for my leg I feel great."
I listened to her lung sounds. They were coarse expiration. "Do you take treatments at home?"
"They made me take these the last time I was here, and I hated every one of them. I loved the company, but I'd rather be home watching TV than taking these. I got one of these for home, yes."
"Do you ever take treatments at home?"
"No. I never took one. My breathing is fine," she said, and looked intently into my eyes. "So, why do you think I'm getting this treatment."
"Can I be honest?"
"Yes, I only want honesty." She smiled.
"Well, to be honest, I have no clue."
"Yes you do," she said with a purposeful smirk. "You know."
"You're right. I do know."
"So what is the reason I'm getting this treatment?"
"You're getting this treatment because sometimes doctors -- quite often actually -- treat the lung sound rather than the patient. Because you're having annoying lung sounds you're being treated as an asthmatic."
"Well, I don't have asthma!" she said blatantly. "I can breathe just fine."
"It's like you said: you're not short of breath but they say you are. It's because you have that harsh expiratory audible wheeze and they don't like it so they have to do something!"
Man I love it when I can be honest with my patient, and when a patient truly understands. She made me give her Q4 treatments the rest of the day, and she took advantage of my company to discuss hospital politics, life and kids. She was 89.