Episode 208: Cough Basics (Pidjin English)

Written by Ebenezer Dadzie

You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.

Episode 201: Cough – Revised Version (Host + 1 Resident; Resident speaks Nigerian Pidgin, Host speaks regular English)

[Play intro music, start loud, then lower volume under speech, fade out later]

HOST 1:
[Introduction]

Today we're tackling one of the most common complaints in clinic: the cough. Joining me is one of our amazing residents. Doctor, please introduce yourself.

RESIDENT:
Na Dr. Resident from Rio Bravo. I dey here to gist about cough wey dey disturb plenty patients for area.

Segment 1 – Cough Basics

HOST 2:
Let’s start simple. When a coughing patient walks into the exam room, what is the first step?

RESIDENT:
First tin na history. You gats ask whether na dry cough or cough wey dey bring sputum, whether e just start or don tey. Whether person get exposure, dust, new medicine—history dey open many doors pass Google.

HOST 1:
Exactly. And as we know, acute coughs are usually viral, but chronic coughs lasting more than eight weeks can point to asthma, GERD, ACE inhibitor side effects, or more.

Segment 2 – Valley Fever

HOST 2:
And since we’re here in Kern County, we have to mention Valley Fever. We see thousands of cases every year, many of them presenting with cough.

RESIDENT:
True. Valley Fever fit look like pneumonia, bronchitis, or even TB. Patient go come with cough, tiredness, sometimes rash. If person dey work for outside or dey around dusty area, you suppose reason am.

Segment 3 – Workup and Treatment

HOST 1:
So let’s talk evaluation. When you have a cough here in California’s Central Valley, what is your approach?

RESIDENT:
Start from basic: chest X-ray, CBC, ask good history. If e no improve, add Valley Fever blood test. If cough get phlegm, you fit send sputum. If weight dey drop or sweats dey night, you reason TB or cancer. Treatment depend on severity. Mild one fit resolve, but if no be small, na antifungals—like fluconazole—and you go monitor liver enzymes well.

Segment 4 – Humor Break

HOST 2:
Alright—quick humor break. Got any memorable cough stories?

RESIDENT:
One man tell me say “doctor, my neighbor ghost na cause my cough.” We check-am finish, na allergy. Ghost no dey push fungus, sha!

[Both laugh]

Segment 5 – Takeaways

HOST 1:
Before we wrap up, give listeners top key points on cough.

RESIDENT:
One—ask better history. Cough dey tell story.
Two—if person dey Bakersfield, reason Valley Fever, e fit sneak.
Three—no dey give antibiotics anyhow. Virus and fungus no go respond like bacteria.

Trivia Time

HOST 2:
Trivia question: In adults who don’t smoke and aren’t on ACE inhibitors, what is the most common cause of chronic cough?

A) Asthma
B) GERD
C) Chronic bronchitis
D) Postnasal drip (Upper airway cough syndrome)

RESIDENT:
I go choose D—postnasal drip. Na e dey cause that tickle wey no dey go.

HOST 1:
And that’s correct—postnasal drip is the number one cause of chronic cough. Nicely done! You win bragging rights and a cough drop.

HOST 2:
Thank you for joining us today on Rio Bravo QWeek. To all our listeners—stay curious, keep learning, and if someone sounds like a barking seal in the waiting room, you know it might be more than a cold.

HOST & RESIDENT (together):
¡Hasta luego!

[Music fades in, rises, then fades out after 10 seconds]

References:

Irwin, R. S., & Baumann, M. H. (2018). Chronic cough due to upper airway cough syndrome (UACS): ACCP evidence-based clinical practice guidelines. Chest, 129(1_suppl), 63S–71S. https://doi.org/10.1378/chest.129.1_suppl.63S
(Guideline on postnasal drip/upper airway cough syndrome as a leading cause of chronic cough)
Dicpinigaitis, P. V. (2022). Evaluation and management of chronic cough. New England Journal of Medicine, 386(16), 1532–1541. https://doi.org/10.1056/NEJMra2115321
(Comprehensive review on causes, diagnostic strategies, and treatment of chronic cough)
Centers for Disease Control and Prevention. (2023). Coccidioidomycosis (Valley fever) statistics. U.S. Department of Health and Human Services. https://www.cdc.gov/fungal/diseases/coccidioidomycosis/statistics.html
(Official CDC data and epidemiology of Valley Fever in the U.S., including high incidence in Kern County)
California Department of Public Health. (2022). Coccidioidomycosis in California Provisional Monthly Report. https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Coccidioidomycosis.aspx
(State-level surveillance data showing high incidence rates in Bakersfield and Kern County)
Prasad, K. T., & LoSavio, P. S. (2023). Approach to the adult with chronic cough. In UpToDate (L. M. Leung, Ed.). Retrieved June 20, 2025, from https://www.uptodate.com
(Evidence-based resource for differential diagnosis and workup of cough in primary care)
Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.