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Miscellaneous thoughts and ramblings
Monday, June 06, 2005
I Really Appreciated This Visit
Judy Fischer*, a woman in her 60s, met me three months ago at the suggestion of her cardiologist. She had seen a long string of internists and found them unsatisfactory for various reasons. From speaking to her cardiologists, I learned she was emotionally needy and difficult to please – the stereotypical difficult patient. Our first visit three months ago went without incident.

She returned today. She’s been caring for her daughter while her daughter is treated for ovarian cancer. She’s an anxious wreck and it’s making her asthma and her menopausal hot flushes worse. She’s been trying to diet and exercise, but hasn’t lost any weight yet, probably because her anxiety is making her overeat. I adjusted her asthma medications and suggested a short term tiny dose of estrogen to get rid of the hot flushes, but mostly I just let her vent, and I agreed with her that all of these physical symptoms are the understandable consequence of the terrible stress she’s under.

At the end of the visit, when I shook her hand, she said “I really appreciated this visit.” After I stepped out of the examining room I peeked at my watch. We had spent 20 minutes together, exactly as much as was scheduled.

It’s too early to pat myself on the back and think that I’ve forged a successful relationship. In another three months I may inadvertently upset her and she may switch doctors again. Still, I’m surprised how much worse she was advertised than she is in person. Maybe she just needed someone who took the time to let her talk. Maybe she just needed 20 minutes.

* I’ve changed her name and the details of her medical problems.
My previous reflections on doctoring:

If I could be a doctor...
If I could be an astronaut...
Gawsh, You’re Awful Purdy!
Going Around
What Is It?
The Secret To Longevity
Thank You, Doctor
Senior Sadness
The doctoring styles of yesteryear are somewhat tough to find in this day and age. Everyone is checking the clock, booking and overbooking, nodding but not necessarily listening closely to a patient's ailments.
I'm lucky to have a young doctor who is "Old World" and I'm lucky to know a young doctor who is "Old World" -- you do take the cake.
Keep the good work, take two happy pills and let's do a follow-up, say...in about ten days' time!
Torontopearl: Thanks. Your follow-up plan sounds reasonable.
It's amazing what you can accomplish by just shutting up and listening.
a lot of truth to this post, i think with these kinds of patients it's best to respond and not react, as you did very well. best of luck.
very cool site by the way, if it weren't just my lunch hour i'd peruse the other posts for a while, i'll link to ya so i can come back.
Psychotoddler: Yup. Sometimes they feel better even if we don't have an answer for them.

Dr. Charles: Welcome! I'm glad you visited, and I look forward to seeing you back. Thanks for your kind words.

For our eleventeen regular readers: Dr. Charles is a physician blogger recently featured in an LA Times article. I just discovered his blog a couple of days ago.
God bless you! I'm sending my mother-in-law right over!
Mirty: Um... Thanks. Let me know her name, so I can double my fees for her. ;-)
Oh, I never have an answer for them. I've just figured out how to turn a deficiency into a feature.
Bean - can you link to Dr. C's article?
Psychotoddler: Genius. From "he really doesn't help me" to "he really listens to me"!

Ralphie: Dr. Charles' blog is here. The LA Times article about him and other blogging doctors is here. I gotta yell at my PR people for not getting me into that article!
Looking at asthma info online today while my son coughs I came across this post. Does anyone know a good asthma site to help?

I was looking at your posts about cancer liver and found a good article about the same cancer liver info too...

God luck with it : )
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