The HPI We’d Really Like to Write

The HPI We Write:

Mr. Smith is a 65 year old man with a history of diabetes, prostate cancer, HTN, CHF, renal insufficiency who has had lower back pain since 1975. The pain is located over his right lumbar paraspinal muscles. Aggravating factors include walking, sitting, and lying down. The pain is alleviated with a medication prescribed by his PCP. He rates the pain as 10 out of 10 in intensity. He denies bowel or bladder symptoms. He underwent x-rays in the past that are currently unavailable. he has ever had physical therapy or undergone injections to his back.


The HPI We’d Really Like to Write:

Mr. Smith is a 65 year old incredibly annoying man with a history of every freaking medical problem who has had lower back pain since before I was even born. The pain is located in this big area where the patient was waving his hand. Aggravating factors include everything, especially “talking to you.” The pain is alleviated by a medication that is “white and starts with an E.” He rats the pain as 15 out of 10 in intensity, despite repeatedly being told that 10 is the worst pain imaginable and he’s sitting there looking completely comfortable. He’s not sure if he has bowel or bladder symptoms, so he proceeded to tell me about every bowel movement he’s had in the last two weeks. He thinks he had some kind of x-ray or MRI of his back, done somewhere, at some point in the last 30 years. He hasn’t done physical therapy because he thinks it’s “stupid and pointless.” And there’s no way any quack doctor is touching his back with a needle, no offense. [Editor’s note: Dr. Fizzy is a PM&R physician]





22307 Total Views 10 Views Today

Dr. Fizzy

Freida McFadden is a midwestern physician who has finally finally finally come to the end of her grueling medical training, and at last she has enough time to publish the wealth of cartoons she's created over the years. If you enjoy them, please comment. If you don't enjoy them, then you can just keep your fool mouth shut. Read the rest at, and make sure to check out her books, A Cartoon Guide To Becoming A Doctor, and The Devil You Know, on Amazon!