WARNING: I WILL BE SHAMELESSLY RISKING SPRAINING MY SHOULDER BY PATTING MYSELF ON THE BACK IN THIS POST.
Admittedly this blog is dedicated to idiots and stupidity, and as I've said numerous times my favourite idiot remains me. So having told several stories where I am the goat, I think I've disparaged myself enough to have earned myself a complimentary update.
If you want more idiot stories, you'll have to wait. Probably not very long.
Since finishing my training I have spent very little time around other doctors in clinical situations, so I therefore have no idea how my colleagues speak to patients. I don't know what kind of terminology they use, if they have prepared speeches for certain situations, or how they treat patients in general. I have a fairly well-established bedside manner, and it seems to serve me very well in the vast majority of situations. Though my demeanor rarely changes much, every now and then I have to tailor it for certain types of patient (those who are very difficult, very drunk, very upset, very young, very old, etc). Some people need a bit more care, some need a stern talking-to, others need massive doses of sedatives to shut them up.
Kidding, kidding. Sort of.
Generally speaking, my philosophy is this: If you're nice to me, I'll be nice to you. Because of this ideology, every so often patients tell me (compliment warning) that I make them feel better just by sitting with them for a few minutes, talking with them, and explaining everything in excruciating detail, probably more detail than they want or need.
Apparently this is not the norm for surgeons.
Nathaniel (not his real name©) was the unfortunate driver of a petrol (gasoline) tanker truck. In the wee hours of the morning Nathaniel swerved to avoid another driver, and his truck lost control and flipped on its side. Incidentally, I hate the term "wee hours". "Small hours" is no better. I don't know why it bothers me so much. Non sequitur over. Anyway, sparks began to fly from the now-exposed underside of the truck, and despite debilitating pain in his chest, Nathaniel wisely decided not to be anywhere near his truck when those sparks interacted with the several thousand gallons of highly-explosive fuel he had been hauling, and he ran.
When he was brought to me about 30 minutes later, he was clearly agitated, clutching his chest and having trouble breathing. When I pushed lightly on his chest, he grunted and looked at me as if I were Satan. His chest felt unstable to me, and an X-ray confirmed that he had 4 fractured ribs. Fortunately his lung had not collapsed, he had no bleeding in his chest, and he had no other serious injuries. I explained that his injuries were painful but not life-threatening and that the only treatment was pain medicine and time. That seemed to calm him somewhat.
Over the next several days, I quickly assessed that he would be a patient who required a bit more TLC than my typical patients. My daily rounds with him, which should have taken no more than 3 minutes to press on and listen to his chest, assess his pain, and go over his X-ray, took at least 15 minutes while I sat with him, listened to him describe his pain, and reassured him that he would heal, but it would simply take time.
A few days later his pain had improved to the point where he could walk without difficulty, and he no longer needed IV narcotics. I discharged him, telling him he could continue his recovery at home, though it would be several more weeks until he felt completely better.
As I was sitting in my office about a week later, I got a call from Nathaniel, asking if he could transfer his care to me. Confused, I told him I was already his doctor, so I asked him what he meant. "Well, I really liked the way you cared for me in the hospital. You were so patient with me and you really listened to me, so I want you to be my primary doctor."
I told him that while I don't do primary care, I was truly honoured by the request, and that simple question was one of the best compliments a surgeon could get. I gave him the phone number for an internist whose philosophy is very similar to mine - be direct and honest, and above all else listen to the patient.
To the medical students reading this, I hope you take this vignette to heart and learn a valuable lesson that DadBastard and GrandpaBastard taught me a long time ago. Ultimately all patients want the same thing: to be treated like a human being. What I did isn't difficult, it isn't special, and it isn't unique.
All I did was treat Nathaniel like I treat everyone - with respect.