Facilitator notes

Facilitator, please role-play Bill, John’s partner, and allow the student/team to collect a focused history. The key elements are reported here, provide generic information when there is no applicable answer below.

After the role-play, provide the History handout to the player.

John Perkins, 54 years old, non-Aboriginal or Torres Strait Islander. History provided by partner, Bill.

Opening line: “I don’t know what’s wrong with him, doctor. It all started two days ago.”

John started complaining of a dull pain in his stomach the day before yesterday, from the late morning. When describing it, he gestured around his belly button. He said it was coming and going, but he couldn’t bear it, so came home from work early and went to bed. You saw he took some Panadol from the cabinet, as you found the pack on the bathroom sink.

John didn’t sleep well in the night between that day and yesterday. You know he didn’t eat much dinner, complained he was nauseous, and took more Panadol without relief.

Yesterday, John stayed at home again. You don’t know how much Panadol he had, as you were at work. In the evening, you noticed he was acting weirdly: wandering around the house, arguing with the television. You think he dozed off on the couch.

This morning, you found him on the bathroom floor. He seems to be in pain, seems to be unconscious at times, and is unable to make a sentence. You dragged him to the car and drove here. You think his eyes and skin look a bit yellow. If asked, you mention that John has been bruising a lot lately.

Past medical history

John was told he has hypertension ten years ago. He is meant to take 4mg Perindopril twice a day, but doesn’t really. Has not seen a doctor since. No allergies.

John’s sister, now 49, has foetal alcohol spectrum disorder, with speech and language delays. John has been estranged from his parents since young adulthood.

Lifestyle and social history

John is a little overweight, mostly in his belly. He eats takeout often, usually skips lunch but eats big dinners. He often has trouble opening his bowels as he doesn’t eat enough vegetables.

John drinks half a bottle of whisky every day, or 5-6 long-neck beers, and has done so since you’ve known him. He works in construction, managing building sites. He doesn’t smoke, nor use recreational drugs. You’ve been together for 12 years, living together for 10 in a nice cottage you own in a quiet neighbourhood.