X7-qP2-mN9-v4/MTS_Dialogue-Clinical_Note huggingface dataset:
Doctor: Good evening, and welcome to A B C D General Hospital E D. 
Patient: Thank you, Doctor, I've really messed up this ankle. 
Doctor: Before we begin, how old are you? And which gender do you identify?
Patient: Thank you for asking, Doctor, I'm a fifty year old man. 
Doctor: Thank you, what happened? 
Patient: I fell off my liner, and I landed right onto my left foot. 
Doctor: How far did you fall? 
Patient: Um, it was really about ten feet. 
Doctor: Oh, yes, I see. I have some good news for you, there's no gross deformity in this ankle.
Patient: What does that mean, exactly? 
Doctor: I don't see any ankle dislocation, which is good. 
Patient: Oh, that's good news. 
Doctor: Have you had your x rays taken yet?
Patient: Yeah, the tech just brought me back. 
Doctor: Great, let me pull them up here. Okay, um, if you look here, you'll see a fracture of your talus. 
Patient: Which bone is that?
Doctor: That's your heel, to be specific, it's a grade I V Hawkins fracture of the left talus. You are still neurovascularly intact in the distal region. 
Patient: What are we going to do about this? 
Doctor: Do you have any other pain from the fall, aside from the ankle?
Patient: No, the ankle really took all of the weight of the fall. 
Doctor: Okay, I think we should do surgery in order to repair this ankle. 
Patient: Why is that?
Doctor: There is very weak blood flow to the body of this bone, there's a risk for avascular necrosis, which is bone death. 
Patient: Okay, you're right. What are the risks of this infection with this surgery?
Doctor: Overall, the risks of infection are less than one percent. We'll use antibiotics to keep everything clean. 
Patient: Will I be asleep for this?
Doctor: Yes, you'll be under anesthesia.
Patient: Okay, yes, um, I'd like to go forward with the surgery.

Clinical note:
Symptoms: left ankle pain, disfigurement
Diagnosis: grade IV Hawkins fracture of left talus
History of Patient: 50-year-old male, fell from approximately 10 feet onto left foot, no other injuries reported, distal neurovascularly intact
Plan of Action: surgery recommended due to risk of avascular necrosis, risks of infection discussed and antibiotics planned
Doctor: What medications are you currently taking? 
Patient: Augmentin, Detroal LA and lisinopril.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Did you ever have any surgery?
Patient: No.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: negative for any surgery
Plan of Action: N/A
Doctor: Hello, miss. How are you doing today? 
Patient: I have this massive headache. 
Doctor: I see. Do migraines usually run in your family? 
Patient: They do. Everyone has it. We've been having it for many years. 
Doctor: Oh, wow. I'm looking at your blood reports, and it shows you have high blood sugar. Does diabetes run in your family too?
Patient: Yup. We all eat too much rice for dinner.

Clinical note:
Symptoms: massive headache
Diagnosis: N/A
History of Patient: family history of migraine in siblings, family history of diabetes, high blood sugar
Plan of Action: N/A
Doctor: What's bringing you in today? 
Patient: I've had a terrible toothache. I can't stand the pain anymore. I have never experienced this pain in fifty eight years.
Doctor: Where are you experiencing the most pain? And when did this pain start? 
Patient: It started about three weeks ago. It's mostly on the left side of my mouth. Kind of on the lower end. It goes from my jaw all the way up to my left ear. 
Doctor: That doesn't sound the least bit comfortable. Let's get you feeling better. Do you think it's related to your tooth? 
Patient: No, I don't think so. I'm pretty good at making my dentist appointments, although I haven't been in since this new pain started. 
Doctor: I see. When was the last time you visited the dentist? 
Patient: About two months ago for a routine clean. 
Doctor: Have you noticed any facial swelling since all of this started? 
Patient: No, no swelling. 
Doctor: Any headaches, throat swelling, sore throat, difficulty swallowing or chewing? 
Patient: No. 
Doctor: How about any neck pain, swollen lymph nodes, chills, fever, or other symptoms? 
Patient: No, thank goodness.

Clinical note:
Symptoms: terrible toothache on left side of mouth, radiating to jaw and left ear
Diagnosis: N/A
History of Patient: toothache started 3 weeks ago, mainly on left lower side, goes up to left ear, regular dental visits but hasn't seen dentist since pain started, no facial swelling, no other associated Symptoms
Plan of Action: N/A
Doctor: How long has your finger been in pain, sir?
Patient: Well, at this point, it's been more than a few months. 
Doctor: Have you seen another doctor for this pain?
Patient: Yeah, I saw another guy a little while ago.
Doctor: Do you have the records from the visit?
Patient: Yeah, actually, they're right here. 
Doctor: Okay, so I see you have a trigger finger, and a mucous cyst, and this other doctor gave you injections. Is that correct?
Patient: Yes sir. 
Doctor: Did the injections help at all?
Patient: No sir, honestly, they did nothing. 
Doctor: So, your finger is still locking today?
Patient: Yes sir, the other doctor referred me over here to see if there was anything more we could do. I'd like to try surgery.

Clinical note:
Symptoms: finger pain, trigger finger, mucous cyst, finger locking
Diagnosis: N/A
History of Patient: finger pain for several months, previously treated with injections for trigger finger and mucous cyst, injections were not helpful, referred for evaluation and possible surgery
Plan of Action: N/A
Doctor: Hello, I am Doctor James.
Guest_family: Hi Doctor, this is my daughter Miya, and I am Jena. 
Doctor: Nice to meet you ladies. So, Miya how old are you? 
Patient: I am fifteen. 
Doctor: Okay, so tell me what is going on with you?
Patient: Well, I am having a severe headache.
Guest_family: She has been complaining about it for almost six hours now. 
Doctor: Oh wow. Can you tell me where exactly the pain is?
Patient: Um, it started from my neck and then moved up to the back of my head. 
Doctor: I see. Did you get hurt or bump your head? 
Patient: No.
Doctor: Does she have any history of headaches?
Guest_family: No.
Doctor: Okay, any nausea or vomiting?
Patient: I am having nausea, but it's coming and going but no vomiting. Also, I am not able to tolerate light at all.
Doctor: Hm, are you able to see properly though, any change in your vision? 
Patient: No.
Doctor: Any fever? 
Patient: No.
Guest_family: No, no fever.
Doctor: Okay.

Clinical note:
Symptoms: severe headache starting from neck and moving up to back of head, nausea, photophobia
Diagnosis: N/A
History of Patient: 15-year-old girl with occipital headache for 6 hours, no trauma, intermittently nauseated but no vomiting, no past history of headaches
Plan of Action: N/A
Doctor: And you said you're right handed, correct?  
Patient: Yep. Right handed. 
Doctor: Okay, great. I've made note of it in your chart. I have one more question to ask regarding tobacco and alcohol. Do you smoke or drink? 
Patient: I don't do either. I can't even think of the last time I took a sip of alcohol.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: right-handed, does not smoke or drink alcohol
Plan of Action: N/A
Guest_clinician: What brings him in today? 
Doctor: He's here for sepsis and I suspect he may have spontaneous bacterial peritonitis. 
Guest_clinician: Let me pull up his chart.

Clinical note:
Symptoms: N/A
Diagnosis: sepsis, possible spontaneous bacterial peritonitis (SBP)
History of Patient: N/A
Plan of Action: N/A
Doctor: Let's check your throat. Okay, I don't see any swelling or any mass. Is there any pain when I touch you? 
Patient: No pain. 
Doctor: I don't feel any kind of lump in your throat. That is a good sign. It looks very flexible and symmetric.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Patient: Good afternoon, doctor. 
Doctor: Remind me, please, how old are you?
Patient: I'm sixty nine years old, doctor. 
Doctor: Thank you, what seems to be the problem today?
Patient: Oh, I've had pain in these knees for years, but it's been getting a lot worse over the last few months. 
Doctor: Is the pain messing with your ability to do activities? 
Patient: Absolutely, sir, yes it is. 
Doctor: What kind of treatments have you had so far? 
Patient: Another doctor called it conservative treatment, um, I've taken antiinflammatories and had some injections. 
Doctor: Do you remember what kind of injections you've had? 
Patient: It was, um, cortisone, and Synvisc. 
Doctor: Did these relieve the pain at all? 
Patient: Well, it was only a temporary relief. Is there anything else we can do?
Doctor: Well, there is surgery for this.
Patient: What are the risks of infection from the surgery?
Doctor: Historically, it's less than one percent. 
Patient: How is this possible? 
Doctor: We use prophylactic antibiotics in order to eliminate the risk.
Patient: That's great, I've heard of D V T from the commercials, is there a risk for that?
Doctor: There's a risk, but it's low. Other risks are pulmonary embolism, need for further surgery, and further pain.
Patient: Okay, yes, I'd like to do the surgery.

Clinical note:
Symptoms: pain in knees, worsening over last few months, affecting ability to do activities
Diagnosis: N/A
History of Patient: 69-year-old male with bilateral knee pain for years, worsening intensity, tried conservative treatment with anti-inflammatories, cortisone, and Synvisc, temporary relief only, opted for surgery
Plan of Action: risks of surgery discussed including infection, deep vein thrombosis, pulmonary embolism, need for further surgery, further pain, patient agreed to surgery with preoperative consent obtained
Doctor: How's this little guy doing today? 
Guest_family: I think he might have another ear infection.  
Doctor: Oh, I'm sorry to hear that. Let's have a look see.  
Guest_family: He's been telling me over and over again that his left ear is hurting him. He was here on April fourteenth and prescribed Amoxicillin.  
Doctor: Did that seem to help? 
Guest_family: It did at first, but the pain is back again. 
Doctor: Has he been running any fevers? 
Guest_family: No, no fevers. 
Doctor: He sounds a bit congested. 
Guest_family: He is. When he blows his nose, he brings up really thick mucous. This never really went away even with antibiotics. He's also been coughing a fair amount. 
Doctor: Is his cough productive? 
Guest_family: Yeah.  
Doctor: Does it seem to be keeping him up at night? How does the mucous look?
Guest_family: No, I don't think so. It is pretty thick and viscous. The cough isn't constant or anything. 
Doctor: And no shortness of breath or wheezing that you've noticed? 
Guest_family: No.

Clinical note:
Symptoms: left ear pain, congestion with thick mucous, loose and productive cough
Diagnosis: possible ear infection, unresolved congestion
History of Patient: previously treated with amoxicillin for left otitis, temporary improvement, Symptoms reappeared
Plan of Action: further evaluation for ear infection, assessment of respiratory Symptoms, consideration of alternative treatment options
Doctor: How are you feeling today, sir? 
Patient: I'm doing much better today, doctor. 
Doctor: How is your strength and muscular pain? 
Patient: They're both improving. 
Doctor: Do you have any other complaints today? 
Patient: No, I'm doing quite well, honestly.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: You have cholesterol issues, right?
Patient: Yes. 
Doctor: Okay. I see. Gemfibrozil? That sounds familiar? Do you take that?
Patient: Yes, I think that one. But I am not sure.
Doctor: Okay. Do you remember taking them at all as an outpatient?
Patient: I mean I don't remember.
Doctor: Okay don't worry I can look at your previous records. We do have them.

Clinical note:
Symptoms: N/A
Diagnosis: hyperlipidemia
History of Patient: N/A
Plan of Action: N/A
Doctor: Are you taking any medicine? 
Patient: No.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: So it looks like you're here today for a noticeable foreign body sensation in your eye. 
Patient: Yeah, my left eye. Never had this happen to me in my forty one years.
Doctor: First time for everything I guess! When did you first notice the sensation? 
Patient: Um when I was at work this morning. It felt like something was in my eye. I went to the bathroom mirror to check it out, but didn't see anything. I flushed my eyes with water in hopes of it helping with the weird feeling.
Doctor: Okay. Hm, are you experiencing any eye pain, blurred vision, or sensitivity to light? 
Patient: The pain has definitely gotten worse since this morning. My vision is fine and bright lights don't seem to be a problem.

Clinical note:
Symptoms: foreign body sensation in left eye, pain in left eye (progressively worsened), no blurred vision, no photophobia
Diagnosis: N/A
History of Patient: Symptoms started during work, attempted flushing with water but pain persisted and worsened
Plan of Action: N/A
Doctor: What brings you in today? 
Patient: I've had a lot of discomfort in my private area. 
Doctor: When did it start? 
Patient: It's been going on for about two weeks now. 
Doctor: Have you noticed any abnormal discharge? 
Patient: Not really, no. But it's been super itchy down there.  
Doctor: Any abdominal pain, nausea, vomiting?  
Patient: Uh no, but I'm having some pain here. 
Doctor: Near your pelvis? 
Patient: Yeah. 
Doctor: Have you started any new lotions or products? 
Patient: No. 
Doctor: Have you tried anything for the pain or itching? 
Patient: No, not yet. I thought it'd go away on it's own. 
Doctor: If it's okay with you, I'd like to do a pelvic exam. 
Patient: Fine with me. 
Doctor: Have you been sexually active prior to or after noticing these concerns? 
Patient: Uh once this past week, but it was pretty painful. 
Doctor: I see. You may have an infection, which is why I'd also like to send out samples to the lab. Did you use protection? 
Patient: Yeah, I take birth control. But I've been struggling a bit with my mood and I'm wondering if it's because of the new birth control pills. 
Doctor: We can look into that as well. Hang tight while I grab the nurse for the pelvic exam.

Clinical note:
Symptoms: discomfort in private area, itchiness, pain near pelvis, painful sex, mood swings
Diagnosis: infection (possible), pelvic pain
History of Patient: Symptoms started about two weeks ago, no abnormal discharge, no abdominal pain, nausea, vomiting, no new lotions or products used, sexually active with pain during intercourse, taking birth control and experiencing mood swings
Plan of Action: pelvic exam to check for infection, send samples to lab, investigate possible correlation between Symptoms and birth control pills
Doctor: Do you have any allergies?
Patient: No, I do not have any allergies.
Doctor: Okay so no medically relevant allergies then. Nothing?
Patient: Nope.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: I don't think we need to do any major procedure right now.
Patient: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Did you have any medical issues?
Patient: Nope.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Any known allergies?
Patient: Oh yes, I cannot take Sulfa drugs.
Doctor: Let me add that to your record.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: So how are you feeling? 
Patient: I am feeling well. 
Doctor: Any illness or fever?
Patient: No, nothing like that. 
Doctor: Any headache or nausea?
Patient: No.
Doctor: Any vomiting or stomach upset?
Patient: No.
Doctor: Okay, any numbness tingling or loss of sensation in the hand?
Patient: No, not at all.
Doctor: Otherwise feeling well? 
Patient: Yeah.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Welcome to the clinic. I am Doctor Frank. 
Patient: Thank you. It is nice to meet you. 
Doctor: What brings you into see me today? 
Patient: I think I may have had a stroke. 
Doctor: What happened to make you think that you had a stroke? 
Patient: This morning, I felt like something in my throat. It was a strange feeling. Then I felt really dizzy. My left hand and jaw felt numb. 
Doctor: Did you lose consciousness? 
Patient: I don't know. It is a bit confusing. I woke up this morning and I was so disoriented that I thought it was the middle of the night. My hand was numb. I also felt the numbness on the left side of my neck and my face. 
Doctor: Did the dizzy episode happen after you woke up this morning? 
Patient: Yes. I got dizzy when I tried to get out of bed. 
Doctor: Has anything like this happen to you in the past? 
Patient: About three weeks ago, I had a dizzy episodes and I ended up falling down. 
Doctor: Did you have any other symptoms like you did this morning? 
Patient: No. 
Doctor: Did you see a doctor after the fall you had three weeks ago? 
Patient: I saw Doctor X Y Z. Doctor X Y Z put me on Antivert. 
Doctor: Have you had any cold or any other resent illnesses? 
Patient: I have not had a cold, but I did have an earache about a day or so ago. 
Doctor: Okay. How old are you? 
Patient: I am seventy five years young.
Doctor: Fantastic.

Clinical note:
Symptoms: feeling like something in throat, dizziness, numbness in left hand, left jaw, left side of neck and face, earache
Diagnosis: N/A
History of Patient: experienced dizzy episodes about three weeks ago resulting in a fall, prescribed Antivert by Doctor XYZ, woke up disoriented with numbness in left hand, left side of face and neck, no recent cold Symptoms
Plan of Action: N/A
Doctor: What is your family medical history? 
Patient: My mom was healthy all her life. She died of old age. She was eighty nine years old. My dad died of a stroke. He was eighty nine as well. 
Doctor: Do you have siblings?
Patient: Yes I had a brother and a sister. My sister died way too young. She was only thirty when she passed away from cancer. My brother lasted until he was seventy four. He had coronary artery disease.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: Mother died at age 89 of "old age," father died at age 89 of stroke, brother had coronary artery disease and died at age 74, sister died at age 30 of cancer
Plan of Action: N/A
Doctor: Do you have any known drug allergies? 
Patient: No.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: None
Plan of Action: N/A
Doctor: Any history of heart attack? 
Patient: No. 
Doctor: Any chest pain, palpitations or shortness of breath on exertion?
Patient: No.
Doctor: How about your blood pressure?
Patient: It's normal.
Doctor: Any swelling?
Patient: No.
Doctor: Any history of irregular heartbeats? 
Patient: No.

Clinical note:
Symptoms: Negative chest pain, negative dyspnea on exertion, negative palpitations, negative edema
Diagnosis: N/A
History of Patient: No history of heart attack, no history of arrhythmias, no history of hypertension
Plan of Action: N/A
Doctor: Hi, do you smoke? 
Patient: No, sir, I don't. 
Doctor: Do you take any drugs? 
Patient: No. 
Doctor: What about drinks? Do you take alcohol in any form? 
Patient: No, none of those.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: Denies tobacco, alcohol, or illicit drug use
Plan of Action: N/A
Doctor: Hi there, so you are here for your follow up?
Patient: Yes, I had a surgical removal of multiple abscesses on my right thigh. 
Doctor: Okay, let me quickly check your discharge sheet.
Patient: Sure. 
Doctor: It says you had multiple extensive subcutaneous abscesses on your right thigh and there was a massive open wound as well.
Patient: Yes, that sounds about right! 
Doctor: Okay, and then they did multiple abscesses excisions on your thigh.
Patient: Yes, on my right thigh.
Doctor: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: multiple extensive subcutaneous abscesses on right thigh, massive open wound on right thigh, status post excision of multiple subcutaneous abscesses on right thigh
Plan of Action: N/A
Doctor: Hi Gina, how are you?
Patient: I wish, I was in better state but yeah, I am okay. 
Doctor: I understand. So, you are here for your follow up post your surgeries, right?
Patient: Yes, I am.
Doctor: Alright, I see you recently had your left breast removed due to cancer.
Patient: Correct.
Doctor: And then you also had your right knee replaced due to arthritis in your kneecap, right?
Patient: Yeah, I had arthritis in my knee bone so I got it replaced. 
Doctor: Hm.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: status post left mastectomy due to breast cancer, status post right knee replacement due to osteoarthritis
Plan of Action: N/A
Doctor: Hello. How are you all doing today? 
Guest_family: We're doing fine. I'm the mother of my four year old boy. 
Doctor: Hello, ma'am. What seems to be the problem?
Gest_family: We just wanted to follow up after my son's E R visit.
Doctor: Oh, no. What happened?
Guest_family: He was playing at the park and thought it was a good idea to jump off the swing. Crazy kid, right? 
Doctor: It happens. Live and you learn, as they say. Do you have any information from the E R visit.
Guest_family: I gave it to the nurse. Did you not get it?
Guest_clinician: Sorry. I got really busy, but here is the report. 
Doctor: Could you read it to me, please?
Guest_clinician: Of course. So, their son severely injured his left distal humerus. No problems were claimed before the injury. The E R saw him for his deformed elbow. 
Doctor: Are there any exams on the report? 
Guest_clinician: There is an x ray and physical exam. They both confirmed a closed type three supracondylar fracture of his left distal humerus with severe puckering of the skin anteriorly with major ecchymosis in the same region. He did have a radial pulse palpable
Doctor: Thank you, nurse. Mom, were you there before his surgery? 
Guest_family: My husband and I were. My husband rushed from this cultural event he had planned. 
Doctor: I see. What do you all identify as?
Guest_family: We identify as white. 
Doctor: I see. I'm going to perform a neurological exam on your son now. Hi buddy. Is it fine if I do a quick exam? 
Patient: Sure. 
Doctor: Thanks. It'll be quick.  
Patient: Okay. 
Doctor: After doing the exam I see his ulnar, median, and radial nerves are intact. I couldn't do the entire exam because the pain might be too much for him.
Guest_family: Thank you so much for your help.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: patient had cardioversion for atrial fibrillation, taking Coumadin, history of smoking but quit several years ago, denies COPD or emphysema, no family members are sick
Plan of Action: N/A
Doctor: You had a heart procedure done couple months back right?
Patient: Yes, they had to do a cardioversion on me because of my heart rhythm disorder.
Doctor: Okay.
Patient: And I am taking a blood thinner right now.
Doctor: Yes, I saw, you are on Coumadin. Do you know other medications you are on?
Patient: Yes, I have a list with me. Here, look.
Doctor: Wow! That is great. Thank you for being so thorough.
Patient: Sure.
Doctor: So you are on Pacerone, Zaroxolyn, albuterol inhaler, Neurontin, Lasix, and some other. 
Patient: Yes.
Doctor:  Do you have diabetes?
Patient: No, I do not.
Doctor: Okay, have you smoked in the past?
Patient: Yes, I have, but I quit some years back.
Doctor: Okay. Have you ever had lung problems?
Patient: No, I have not.
Doctor: Okay. How about your family? Anyone sick?
Patient: No, no one is sick in family.

Clinical note:
Symptoms: N/A
Diagnosis: Atrial fibrillation, on Coumadin
History of Complaint: Had cardioversion two months ago for atrial fibrillation, past smoking history (quit several years ago), denies COPD or emphysema, no family members sick
Plan of Action: N/A
Doctor: What is your family medical history? 
Patient: My uncle on my dad's side of the family had kidney failure.  I lot of my family members have diabetes and asthma.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: positive family history of asthma and diabetes, positive family history of renal disease on father's side
Plan of Action: N/A
Doctor: What is your family medical history? 
Patient: My dad passed away from a heart attack. He was fifty nine. My mom died from complications with her diabetes.  
Doctor: Do you have any siblings? 
Patient: Yes. My brother had a bypass with a graft in August of ninety five.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: father died at age 59 from valvular heart disease, mother died from complications of diabetes, brother had coronary artery bypass graft (CABG) in August 1995
Plan of Action: N/A
Doctor: Hello, how are you? 
Patient: What? 
Doctor: How are you related to the patient? 
Guest_family: Hello doctor, I am his son. 
Doctor: Hello. How old is he?
Guest_family: He is eighty years old. He is suffering from dementia. 
Doctor: I see. Do you think he will be able to provide me with his medical history?
Guest_family: I don't think so. Sometimes he even forgets his name. 
Patient: He's kidding. I know my name. I also know his kids' names. I do agree that sometimes I forget my things or feel lost. 
Doctor: I don't blame you. I forget my things at my age.
Guest_family: Yeah, it is something like episodic that he forgets everything and sometimes he's absolutely normal. On good days, he's very nice to talk to. 
Doctor: What is his living status?
Guest_family: He lives at a board and care. It is a cozier homelike place.  
Doctor: That's good. So what brings you here in the emergency today?
Guest_family: He started complaining of stomach aches. Luckily, I was there. It was very sudden at one moment he was talking to me nicely and then all of a sudden he started complaining of severe pain in his stomach area. That's when I decided to bring him here in the emergency room. 
Doctor: Do you have any previous reports? 
Patient: I have these reports. 
Doctor: Do you remember when was this scan done? 
Patient: I have no idea. I just had these reports with me. 
Doctor: Do you remember of any medical issues before? 
Patient: Huh uh. 
Doctor: Okay, let me see what your scan says. I am reading the C T Scan report provided by the patient. It states that patient has dilated bladder with thick wall suggesting an outlet obstruction as well as bilateral hydronephrosis and hydroureter.
Patient: Hm. 
Doctor: I see that you have already been given some I V fluid along with antibiotics by the emergency room doctor. 
Guest_family: Yeah. 
Doctor: Did he ever complain of pain during urination or nausea and vomiting?
Guest_family: Yes, he had fever a few days back. When we asked him about other symptoms, he said, it's hard to urinate and it is painful. Nausea and vomiting are something that I am not sure about. He was normally rushing to the restroom and every time used to say he didn't want to pee as it hurt him. He also had a few accidents in the last few days where he wet himself. 
Doctor: Thank you for providing me with all his history. It will be very helpful for me to treat him now.

Clinical note:
Symptoms: acute onset of abdominal pain, dilated bladder with thick wall suggesting outlet obstruction, bilateral hydronephrosis, hydroureter, painful urination, nausea, vomiting, accidents with urination
Diagnosis: N/A
History of Patient: patient is a demented 80-year-old male living in board and care, son confirms acute onset of abdominal pain, CT scan findings, IV antibiotics and hydration given in ER
Plan of Action: N/A
Doctor: What is your family medical history? 
Patient: My mother had cancer.  She had multiple myeloma.  She passed away at age eighty three.  My dad died when he was eighty one.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: father passed away at 81, mother had multiple myeloma and passed away at 83
Plan of Action: N/A
Doctor: How are your parents doing?
Patient: Unfortunately, they both passed away. 
Doctor: Oh no, I'm so sorry to hear that. 
Patient: Thank you, its okay, I manage.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: patient's parents are deceased
Plan of Action: N/A
Doctor: What's going on?
Patient: I am having a bellyache.
Doctor: Since when?
Patient: Oh, it's been a while now.
Doctor: Okay.
Patient: Yeah.

Clinical note:
Symptoms: chronic abdominal pain
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: So, you are following up for your high blood pressure and high cholesterol?
Patient: Yes.

Clinical note:
Symptoms: N/A
Diagnosis: hypertension, hypercholesterolemia
History of Patient: N/A
Plan of Action: N/A
Doctor: Hey, what's going on with you today?
Patient: Oh, I have a chest pain.
Doctor: You have fever too?
Patient: Yes, I did.

Clinical note:
Symptoms: chest pain, fever
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Hi, how are you?
Patient: I am feeling not so good.
Doctor: What happened and how long since it started?
Patient: Oh, I don't remember it. Just my head is hurting so much.
Guest_family: Hi doctor, she is my mother. Her dementia has progressed and most of the time she does not remember anything. 
Doctor: Oh, I see. Let me try and see if she can answer few questions
Guest_family: Sure.
Doctor: Did you have any nausea or vomiting?
Patient: I don't know.

Clinical note:
Symptoms: moderate-to-severe dementia, unable to provide history or review of systems
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Any past medical history I should be aware of? 
Patient: Nope.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Do you have allergies to any medications? 
Patient: Um I'm allergic to Clonidine and Medifast.
Doctor: What happens when you take Clonidine? 
Patient: I get a really bad rash. 
Doctor: And how about with Medifast? 
Patient: I get very tired after taking it. The last time I took it, I had trouble getting out of bed.

Clinical note:
Symptoms: allergic reaction to Clonidine, fatigue with Medifast
Diagnosis: N/A
History of Patient: known allergy to Clonidine causing rash, Medifast causes fatigue and difficulty getting out of bed
Plan of Action: N/A
Doctor: Good morning, ma'am. My nurses tell me that you're thirty nine years old, is that correct? 
Patient: Good morning, Doctor. Yes, that's correct. 
Doctor: So, what seems to be the problem today, ma'am?
Patient: I hurt my knee while on the trampoline back in late August. 
Doctor: Do you remember the mechanism of injury to this knee? 
Patient: What do you mean? 
Doctor: Well, was it a twisting, pulling, snapping kind of injury?
Patient: Oh, I twisted my knee. 
Doctor: Okay, have you seen another doctor for this?
Patient: Yeah, and I got an M R I. 
Doctor: Can I see the report?
Patient: Yes, here you go. 
Doctor: This M R I shows an A C L tear. Do you have any instability in this knee?
Patient: Yeah, I feel like my knee joint has been unstable for years. 
Doctor: Have there been any dislocations? 
Patient: Yeah, there have been. What can be done about this?
Doctor: Well, there's surgery to fix this. I can repair that A C L.  
Patient: What are the risks of infection with the procedure?
Doctor: Historically, it's less than one percent. We use antibiotics to control for infection. 
Patient: Will I go under for this?
Doctor: Yes, you won't feel a thing. 
Patient: Okay, yes, I'd like the surgery done.

Clinical note:
Symptoms: knee pain, instability in knee joint, history of multiple dislocations in knee
Diagnosis: anterior cruciate ligament (ACL) tear
History of Patient: twisted knee on trampoline in late August, diagnosed via MRI, multiple episodes of instability and dislocations in patellofemoral joint
Plan of Action: surgery to repair ACL and possibly plicate medial retinaculum to prevent further dislocations, risks and benefits discussed and patient agreed to treatment plan
Doctor: Can you tell me more about your family history, ma'am? How is your father doing?
Patient: Well, doctor, my father passed away from leukemia a while back. 
Doctor: I'm so sorry to hear that. What about your mother? How is she doing? 
Patient: She died too. She had kidney and heart failure.
Doctor: I'm sorry, ma'am. 
Patient: Oh, it's okay doctor, thank you. 
Doctor: Do you have any siblings? 
Patient: Yes, I have two brothers and five sisters. 
Doctor: That's a big family, do they have any conditions that you know about?
Patient: One of my sisters has breast cancer. 
Doctor: Okay, thank you. Do you have any children? 
Patient: Yeah, I have two sons and a daughter. 
Doctor: That's great. Do you have any other conditions I should know about? 
Patient: Well, in addition to all of that, there's some high cholesterol, um, depression, and a nervous condition.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: father passed away from leukemia, mother passed away from kidney and heart failure, sister has breast cancer, family history includes cancer, hypertension, nervous condition, kidney disease, high cholesterol, and depression
Plan of Action: N/A
Doctor: Anyone sick at home? 
Patient: No, fortunately. Everyone else is feeling fine.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Hi there! What brings you in today? 
Patient: I have not been feeling well. I am tired and feel weak. 
Doctor: Have you had any other symptoms? 
Patient: I noticed after I went to the bathroom this morning, that my urine was dark. 
Doctor: Have you been staying hydrated? 
Patient: Yes. 
Doctor: Lets get a urine sample. I will have the nurse come in with a sample cup. 
Patient: Okay.

Clinical note:
Symptoms: tiredness, weakness, dark urine
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Good afternoon, sir. 
Patient: Good afternoon, doctor. 
Doctor: You're forty four, correct? 
Patient: Yes sir. 
Doctor: Great, what seems to be the problem today, sir? 
Patient: Well, doctor, I've had lower back pain for a while now. 
Doctor: Does the pain go into your legs? 
Patient: Yeah, I have pain in my right thigh too. 
Doctor: Is there an injury associated with this pain? 
Patient: Yes, I had an incident back in nineteen ninety four. 
Doctor: Do you have any paperwork or medical records from the initial injury? 
Patient: No sir, I don't have those today. 
Doctor: What do you do for a living, sir? 
Patient: Right now, I work at Taco Bell. I have a workers comp claim open.
Doctor: Your pain came back while working there, correct? 
Patient: Yes, that's correct. 
Doctor: Do you remember when your last appointment here was? 
Patient: Um, yes, it was on April twelfth two thousand five. 
Doctor: With ten being the worst pain imaginable, what was your pain out of ten at your last visit? 
Patient: Um, I'd say it was an eight out of ten. 
Doctor: Have you taken any medicine for this? 
Patient: Um, I had a Medrol Dosepak prescribed at my last visit. 
Doctor: How did your pain respond to the Dosepak? 
Patient: It took it down to about a four or five out of ten. 
Doctor: Can you point to me where the pain is, sir? 
Patient: Yes, it's right here. 
Doctor: This band right here? 
Patient: Yeah, that's the spot. 
Doctor: Okay, this is between your L four and sacrum. How would you describe your right leg pain?
Patient: I'd say it's intermittent and minimal now, it's not always there. 
Doctor: Have you ever had back surgery? 
Patient: Um, yes, I've had two laminectomies, one in nineteen ninety and the other was in ninety four. Wait, I also had a discectomy some time in between. 
Doctor: Do you know where the focus was?
Patient: It was at L four L 5. 
Doctor: Have you had any imaging done on the lower back? 
Patient: Yes, I had an M R I on October eighteenth two thousand four. I have the report right here. 
Doctor: Okay, this shows multi level degenerative changes, with facet involvement at L two L three, L three L four, and L five S1, with no neural impingement, which is good. 
Patient: What does that mean, doctor? 
Doctor: In summary, you have a significant amount of arthritis in the back. 
Patient: Oh yeah, I had an M R myelogram as well, here's the report. 
Doctor: Okay, this shows severe spinal stenosis at L three L four, but it may have been artifact. 
Patient: What does that mean? 
Doctor: This finding may be a misinterpretation.

Clinical note:
Symptoms: lower back pain, pain in right thigh, intermittent and minimal right leg pain
Diagnosis: multi-level degenerative changes with facet involvement at L2-L3, L3-L4, and L5-S1, history of two laminectomies and a discectomy at L4-L5
History of Patient: experienced pain recurrence while working at Taco Bell, previously treated with Medrol Dosepak, MRI on 10/18/04 showed no neural impingement but multi-level degenerative changes, MR myelogram showed severe stenosis at L3-L4 possibly artifact
Plan of Action: N/A
Doctor: Did you have an allergic reactions to any medication? 
Patient: Nope. 
Doctor: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: no known drug allergies
Plan of Action: N/A
Doctor: Hello, how are you?
Patient: I am doing well. Just here for a follow up visit. 
Doctor: Are there any changes from the last visit in your social history or medical history?
Patient: No. Whatever you wrote last time should be correct. I was here just three months ago. I was here December third of two thousand and three.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: reviewed and unchanged from the dictation on 12/03/2003
Plan of Action: N/A
Doctor: Do you take any meds?
Patient: No.
Doctor: Are you sure?
Patient: Yes.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Did you have any surgeries in the past?
Patient: No.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Welcome to the clinic. 
Patient: Thank you. 
Doctor: I would like to start with your medical history. Do you have any medical problems or conditions? 
Patient: I don't have any medical conditions other then the one I was sent to you for. 
Doctor: Yes. Doctor Hanine sent over your recent blood test results and chart notes. Did he discuss those results with you? 
Patient: Yes, he did. He said I have multiple myeloma. And that the blood work levels are how he found it. 
Doctor: Yes. The I G G levels show that the subtype is multiple myeloma. 
Patient: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: IgG subtype multiple myeloma
History of Patient: N/A
Plan of Action: N/A
Doctor: So, how are feeling? 
Doctor: You came here last time with C V A right?
Patient: Yeah, I am recovering well. You asked me to follow-up for high sugar.
Doctor: Oh yeah, you have diabetes mellitus. Did you happen to get a blood test done before this visit?
Patient: Yes, I did here is the report.

Clinical note:
Symptoms: N/A
Diagnosis: diabetes mellitus, status post cerebrovascular accident (CVA)
History of Patient: N/A
Plan of Action: N/A
Doctor: What is your family medical history? 
Patient: I don't know of any family health problems.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: noncontributory family medical history
Plan of Action: N/A
Doctor: What brings you here today?
Patient: I have a queasy tummy and the feeling that I am about to throw up all the time.
Doctor: Anything else? 
Patient: I'm actually throwing up a lot.

Clinical note:
Symptoms: queasy tummy, feeling of about to throw up all the time, vomiting a lot
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Do you smoke? 
Patient: Yeah, here and there. 
Doctor: On average, how many cigarettes would you say you smoke? 
Patient: Probably three or four if I had to guess. 
Doctor: Any medical problems that run in the family? 
Patient: Yeah, my brother had a heart attack when he was pretty young. 
Doctor: How old was he? 
Patient: Fifty two. 
Doctor: Oh wow, how's he doing? 
Patient: Good, he has to see a heart doctor at least once a year. 
Doctor: Does anyone else in your family have heart problems? 
Patient: Um my dad has some heart issues. He's also a type one diabetic.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: family history of heart attack in brother at age 52 (smoker), father has type I diabetes and heart disease
Plan of Action: N/A
Doctor: Hello, miss. How are you doing?
Patient: I am fine. I just have a few questions about diet and exercise. I want to get my health in order. 
Doctor: Okay, great. That's something we can handle today. Can you tell me about your familial history? This will help me see any possible ailments that we should watch out for. 
Patient: Yes. So let's start with my mom. She died of congestive heart failure. 
Doctor: How about your father? Your paperwork says both parents are deceased. 
Patient: Yes, unfortunately. My dad died from myocardial infarction at fifty six years old. Not sure how old my mom was. 
Doctor: Your family seems to have a history of ischemic cardiac disease. How are your siblings? The paperwork says you have brothers. 
Patient: Yes. Two are alive and one has passed. He died from lymphoma. One brother has had two angioplasties and the other brother just has asthma.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: family history of congestive heart failure (mother), myocardial infarction (father), ischemic cardiac disease, lymphoma (deceased brother), living brother with angioplasties x 2 and another brother with asthma
Plan of Action: N/A
Doctor: Smoke or drink? 
Patient: No and no.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor:  Are you allergic to anything?
Patient: No, I am not.
Doctor: How about food allergies.
Patient: No, I am fine.
Doctor: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Do you have any food allergies?
Patient: Nope.
Doctor: Any drug allergies? 
Patient: No.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Do you smoke? 
Patient: Yeah, I smoke weed every now and again. It helps with my anxiety. 
Doctor: How about cigarettes? 
Patient: No, not the least bit interested in cigs. 
Doctor: Good to keep it that way.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: patient smokes marijuana, does not smoke cigarettes
Plan of Action: N/A
Doctor: Hello! Who do we have here today?
Guest_family: Hello, this is our son, A B C. 
Doctor: How old is he? What is the issue?
Guest_family: He is two. He is continuously complaining of pain in his belly and back. He is active otherwise. 
Doctor: Did you notice any change in his toilet habits or routine?
Guest_family: No.
Doctor: Any fever or chills or any other issue?
Guest_family: No, we did not notice any such issues, he has been active and was acting very normal otherwise.
Doctor: Any change in his eating habits?
Guest_family: No, he has been eating and drinking as usual. He was acting normally but we did notice a foul odor coming from his nose. He was on antibiotics after removal of that piece of cotton from his right side of nose in our previous visit here. 
Doctor: How is his nose now?
Guest_family: He got better but now we can notice that odor from his nose again.
Guest_family: His mother started him on the antibiotics again, whatever was remaining, we think something is still there. 
Doctor: Okay, Is there anything else like runny nose or any pain in his ear or bad throat? How about cough or congestion? Or any other issues you have noticed?
Guest_family: No, nothing of those instead he has been active and eating and drinking normally, no other issue. 
Doctor: Is he complaining of any pain or discomfort on bowel movements? Is there any increase in the frequency of urination?
Guest_family: Well, we can't say it for sure as he still wears diapers but we have not noticed anything abnormal.

Clinical note:
Symptoms: continuous pain in belly and back, foul odor from nose
Diagnosis: foreign body in right nose (previously), malodorous nose, no other acute complaints
History of Patient: 2-year-old boy with continuous pain in belly and back, no change in urine or bowels, no fevers or chills, eating and drinking well, previously had foreign body in right nose (piece of cotton), restarted antibiotics for malodorous nose
Plan of Action: N/A
Doctor: Can you tell me about the medications that you are currently using? 
Patient: I am taking Alesse twenty eight. 
Doctor: Do you know its strength? Um, like how many milligrams?
Patient: Oh yes, it is twenty M C G and I take point ten milligrams of it. 
Doctor: When did you start it?
Patient: On seventh August in two thousand and one.
Doctor: Who prescribed it?
Patient: My O B G Y N, Doctor A.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: currently taking Alesse-28, 20 mcg-0.10 mg tablet since 08/07/2001, prescribed by Obstetrician-Gynecologist A
Plan of Action: N/A
Doctor:  What type of surgeries have you had in the past?
Patient: I don't know what surgery they did today. I mean I don't know the name of it.
Doctor: It's okay, I know. It is Lap Band.
Patient: And I have had right side foot surgery done in the past.
Doctor: Okay great.
Patient: Sure.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: Lap-Band surgery done today, previous right foot surgery
Plan of Action: N/A
Doctor: Please, tell me a little more about your son. 
Guest_family: Well, he's twelve years old now, but he was born at about a month and a half early. 
Doctor: Were there any other complications with the pregnancy? 
Guest_family: He was exposed to drugs in the womb while I was pregnant, and he has been diagnosed with autism. 
Doctor: Okay. I see he has previously had an operation on the right knee, can you tell me more about that? 
Guest_family: He previously had a lot of trouble straightening out both of his legs, and since the right was worse than the left he had an operation on the inside part of the back of that leg. 
Doctor: When was this operation? 
Guest_family: It was in February of two thousand seven. 
Doctor: How did he respond to the operation? 
Guest_family: He responded really well, he was walking much better, and even got back to playing sports with the other kids in the neighborhood. 
Doctor: What seems to be the problem today? 
Guest_family: Now, his left knee is getting really bad, it's like how the right knee was. He can't straighten this leg. I think we should do the same operation again on the left knee. 
Doctor: Yes, I think we'll have to do surgery. 
Guest_family: What is the risk of infection with the surgery? 
Doctor: Historically, it's been less than one percent, we use prophylactic antibiotics in order to minimize infection risk. 
Guest_family: Will he be under anesthesia for the procedure?
Doctor: Yes, he will be. He won't feel anything. 
Guest_family: Will this completely solve his problem?
Doctor: I can't guarantee that he won't need additional procedures in the future. The other risks include, bleeding, changes in sensation and motion to the leg, failure to restore normal anatomy, and risk it won't work in general. 
Guest_family: What's the name of this procedure? 
Doctor: It's called a distal medial hamstring release.
Guest_family: This is the same procedure he had in two thousand seven, right? 
Doctor: Yes ma'am, the exact same one.  
Guest_family: Okay, that sounds good, we want to go through with the procedure. 
Doctor: Okay, here is my surgical scheduler's business card, give them a call, and they can walk you through everything.

Clinical note:
Symptoms: trouble straightening left leg, left knee getting worse, left knee flexion contracture
Diagnosis: N/A
History of Patient: born premature, drug exposure in utero, diagnosed with autism, previously had distal medial hamstring release on right knee in February 2007 with significant improvement, now presenting with worsening left knee flexion contracture
Plan of Action: agreed to repeat distal medial hamstring release on left knee, risks discussed including anesthesia, infection, bleeding, changes in sensation and motion of extremity, failure to restore normal anatomy, continued contracture, possible need for other procedures