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Need to spread the bad mood?

Posted Oct 30 2008 3:22pm
"No, I won't tell you anything, because you guys are here to tell me stuff."
"But, ma'm, we can't tell you anything if we don't know what's wrong with you."
"Well, you don't know anything anyway, you're just students!"
"Of course we are, that's why we're here. To learn. And we would appreciate it if you could help us by talking to us."
"But there's nothing to talk about."
"You're in a hospital, of course there's stuff to talk about. What kind of problems do you have?"
"Ooohhh..... I have x and y and w and everything hurts and there's q and I cough."
"Aha.... and regarding your cough, has it been going on for long?"
"Oh yes, I cough every time I have a cold."
"Aha. And you say you vomited badly enough to be admitted to a hospital. Did you eat anything that might cause it?"
"Now how am I supposed to remember that?"
And so forth...

I can understand patients don't feel well. I can understand some of them are annoyed by visiting students. I can understand we're being a pain in the behind with our endless questions and touching and poking.

But there is such a thing as saying 'no'. When your doctor asks you whether you are willing to see some students, answer truthfully. He won't bite you. The students won't come marching in defiantly, demanding to do a digital rectal exam in retaliation. You won't get worse treatment. Nothing bad will happen. You will only benefit from not having to see a bunch of people trying really hard to learn how to be good doctors someday. And we'll benefit from getting a different patient, one that gives as good a history as she can, one that cooperates as much as he can during his physical exam. A patient we can learn from. A patient that doesn't make us regret our decision to become doctors before we've even gotten there.

I know I won't always get nice and friendly and pleasant patients. But those patients will be people who have no choice but to see me, the only person who can at this moment give them an answer and help them. Possibly also the person that has had a really long hard day and isn't smiling from ear to ear. And they'll be scared and insecure and in pain. Of course we won't always find each other good company.

But presenting cases are different. They are being treated. They are feeling better, and often have no symptoms at all. They are not in any danger and they know it. They are not dependant on me. They can always say no when asked "Are you willing to talk to some students?".

So if they choose to see me anyway, I expect to be treated decently. I'm not responsible for their disease. I'm not responsible for their treatment. I'm not responsible for their doctor's behaviour. I am only responsible for acting appropriately while trying to do my job. Learning.

If that's a problem, say so immediately. I'll go see another patient. One who appreciates another exam. One who understands the need for practice. One who's not convinced everyone is trying to be mean to him. And who knows... my rather more enthusiastic exam might even reveal something that's important to this new patient and his doctor. It's happened before.
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