Wednesday, May 29, 2013

To all medical personnel

Dragon to all medical personnel:

Yes, it's true, I am a difficult patient.

There are reasons for that, however. Let's begin with the truth that my medical situation is unusual, even exceptional, with a lot of very atypical factors involved, making me an exceptional patient. Therefore my treatment requires customized knowledge of my situation, rather than the answers you keep suggesting that work for ninety percent of patients, but not for me.

Yes, I'm a difficult patient. But that's because I never feel like you actually listen to what I tell you, so we spend all of our visits together with me reminding you why what you've just ordered has already been tried and didn't work. If I seem frustrated at my lack of progress, that's largely why.

Yes, I'm a difficult patient. That's because my father was a doctor and I've been around medicine my entire life. I'm a lot more informed than your average patient, I know how to go do my own medical research, I speak the jargon pretty well for a layman, and I know enough Greek and Latin to be able to translate the jargon back into English when I encounter an unfamiliar phrase. Also, I was trained in science, and I'm probably just as smart as you are, intellectually. So when you talk down to me, you're wasting time for both of us. If I get frustrated at my lack of progress, it's partly because you waste most of our visits together going over what I already know, rather than helping me figure out how to move forward.

So, here's a little bit of advice when dealing with an atypical, difficult patient, like me: Listen to your patient. He knows what is going on, and he can report his symptoms to you very clinically and accurately, if you let him. Fucking take the time necessary to educate yourself about your client's unusual constellation of problems, so that together you can figure out what to do next, instead of constantly going over the same ground. Your patient is under a tremendous burden of stress surrounding his situation, and if you're not actually going to be helpful you are in fact making things worse. And finally, don't blame the patient. He really has tried everything that's been suggested to him, and really, truly, most of it really did do more harm than good.

Your difficult patient does want to work with you to move forward. He has in fact explained all of this to you before, has in truth been asking for your help all along. You just haven't been listening.

Is it any wonder, therefore, that your patient appears to be acting like a difficult patient? Is it any wonder that he is frustrated and impatient and annoyed with you? If you will just kindly fucking catch up to him, all is forgiven, and can we please get on with it.

That is all.

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Blogger Jim Murdoch said...

My wife could’ve written this, Art, so you’re not alone here and it’s obviously not a problem unique to the United States. She sees a number of specialists and regularly comes back with similar stories. To counter that I’ve often been impressed by just how much my own doctors have remembered about me considering how infrequently they see me and how many other patients they have to attend to; I wouldn’t want to do their job. When I was at my worst a few years back I used to write down what I wanted to say to my doctor and reduce it to a single A4 page, the kind of thing he could read in a couple of minutes because I simply couldn’t be relied upon to remember how I’d been. You might try something similar. I’m not suggesting you hand them a sheet of paper although in my experience doctors don’t like to have their valuable time wasted and actually appreciate when a patient meets them half way. What you have to accept is that you are atypical and the doctor will need reminded of that every time you see them. They expect patients to be vague and unhelpful and ignorant. What you need is a little spiel—something that lasts maybe sixty seconds—that you can rattle off in response to their opening, “So how have you been?” You’re not difficult; you’re exceptional. As soon as you say, “I don’t mean to be difficult, doctor, but…” you’ve branded yourself. So don’t say stuff like that. Maybe all you need say is, “Before we start, doctor, maybe I could take a minute to bring you up to speed on my current situation.” Of course when you say, “Could I take a minute,” take a minute, not five.

5:24 AM  

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