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A WORKING DAY OF A DISTRICT DOCTOR
Some days ago George was on duty at the polyclinic, which is on Svoboda Street. There he got acquainted with doctor Ivanov, a district doctor. He is an experienced therapeutist working in his field for more than ten years. It was useful to George to be present at the examination and watch some of his cases.
Dr. Ivanov’s working day begins at nine o’clock in the morning at the polyclinic, where he sees about ten or sometimes even 15 out-patients during his consulting hours. In the afternoon he usually makes his daily round of visits to the district. He examines all those patients who are seriously ill and can’t come to the polyclinic.These patients must follow a strict bed regime.
That day the first patient was the man who said that he felt rotten. Indeed this patient was in a poor condition: his face and hands were damp with sweat, his pulse was accelerated and faint. He was running a high temperature. The doctor asked him to lie down on the couch and began questioning him thoroughly. Making the physical examination the doctor applied a stethoscope to the patient’s chest and listened to his lungs and heart. The patient’s respiration was accelerated and turned out to be 30 per minute. Some moist rales could be heard. Dr.Ivanov made the diagnosis of lobar pneumonia and said that the patient had to be admitted to the hospital. It was necessary to arrest the process in his lungs immediately to avoid complications.
A woman of about 45 entered Dr. Ivanov’s consulting room next. She complained of a sore throat and a bad pain in her back, so that she couldn’t sleep.
“Well, the doctor said, let me have a look at your throat. I see, there is a bad inflammation. Is it hard to swallow?” When the doctor examined her thoroughly it turned out that the woman suffered from quinzy. He prescribed to her an antiseptic mouth –wash with which she had to gargle her throat five or six times a day. The doctor said it would give her instant relief. As her condition was rather bad the doctor put her on a sick leave for several days. A nurse had to come to her place to give her penicillin injections. When the patient was better she had to undergo a five day course of physiotherapy. The doctor also advised her to apply mastard plasters every other day before going to bed.
The next patient complained of a sharp pain in the stomach. The doctor examined his stomach and made the initial diagnosis of the ulcer of the stomach. But to be sure in his diagnosis the doctor directed the patient to be X-rayed. He prescribed the patient a light diet. The patient had to take the prescribed tablets before meals to relieve the pain.
After his consulting hours at the polyclinic Dr. Ivanov and George made several calls. He was called to the patients whom he had visited before. One of the patients was ill with lobar pneumonia, the other suffered from angina pectoris.
First they visited the patient ill with angina pectoris. Before examining the patient doctor Ivanov washed his hands, put on his white gown and only then entered the room where the patient was lying. The doctor asked the patient: “How are you feeling today? Do you feel any pain in the chest?” The doctor was eager to know if the medicine, which the patient was taking, relieved the pain.
Unfortunately, the patient couldn’t say that the medicine gave him any relief. The pain in the substernal area was particularly sharp on physical exertion. Dr. Ivanov asked the patient to strip to the waist, listened to his heart and lungs, took his blood pressure, felt his pulse and palpated his abdomen. After five days of home treatment the patient did not feel any relief, and the doctor decided to hospitalize him.
Then they visited the patient ill with lobar pneumonia. This patient was recovering: he felt better and was cheerful. He thanked the doctor for his kind attention and care. As the condition of the recovering patient was rather good
the doctor advised him to be out in the open air as much as possible, to start morning exercises again, to have rubdowns and by and by begin going in for sports.
George saw that doctor Ivanov dealt with every case carefully and attentively and tried to calm those who were excited. In some cases his words seemed to act better than medicines, it’s no wonder that all his patients love and respect doctor Ivanov.