Thursday 4th May 1989   Morning surgery 10:50

“Right, Zoe, was Mrs Spencer coughing up any blood?”
“I don’t know, Dr Dennis. I forgot to ask. I suppose she would have said if she was.”
“You can’t be sure, Zoe.” My Dad explained. “Coughing up blood is very worrying for patients. Some would be too frightened to tell us. It is always important to ask.”

“Coughing up blood is a red flag,” he continued. “It’s Nature’s way of telling us that something serious could be going on. In a patient of Mrs Spencer’s age, we would be most worried about lung cancer. Chloe, can you think of any other red flags?”
“Vomiting blood, Dr Dennis.”
“Excellent, Chloe! If a patient is complaining of tummy pain or gastric symptoms we should always ask about vomiting blood. What about you, Dennis?”
“Blood in the poo, Dad.” I could still vividly remember my own painful piles. They were a bright, red flag in anyone’s book.
“Very good, Dennis. I prefer to call it blood in the stools. Two other red flags are blood in the wee and having a period after your periods have stopped.”
“Postmenopausal bleeding, Dr Dennis?”
“Yes, postmenopausal bleeding, Zoe. Well done.”

“You’ll notice that all these red flags involve blood. That makes them easy to remember. There are other red flags but these are the ones I want you to concentrate on today. Whenever you see a patient, always remember to ask about the relevant red flags.” My Dad looked at the three of us. “Never forget your red flags, students!”

Never forget your red flags!
Tagged on: