When you don’t like your patient

13 Dec

I’m still on the way home, on the second leg of my trip.  I am eavesdropping on the conversation going on in the row in front of me.  13C is coming home from Guyana where he’s been working in mining exploration.  He looks like a young guy, maybe around my age, with a kind of Western or Southern drawl.  He’s describing what he does to 13D and I’m trying to listen for any indication of gross injustices against the environment or local communities.  He’s an outgoing guy and seems really friendly.  He leans over the empty seat beside him and is now chatting with 13A, whose contribution to the largely one-sided conversation is the occasional “ah” or “huh”, “yea…”.  He’s talking about his life working overseas.  He proudly mentions having 4 girlfriends, who don’t know about each other “no, they don’t know about each other”.  He sounds jovial, like someone talking about how fresh the fruits are at the local market or maybe how a dad would talk about his son’s little league team.  I wondered how I would approach this if he were my patient.  Would he tell me about his 4 girlfriends?  How would I respond?  Impassionate, matter-of-fact: “Oh, well do you use protection? Have you been tested for any STDs?  Alright, well we have the facilities here to do that”.  I pictured the movie effect where you have a map with a pin-point on it that just spreads like a black wave, sludgy and oozing across the continent.

I remember one time my mom came home from the office upset.  One of her patients was cheating on his wife who was terminally ill.  His mistress wanted him to promise to be with her.  He was stressed and depressed but didn’t know why.  When my mom asked if he thought perhaps it had to do with his relationship situation, he was surprised and hadn’t considered it.  My mom was boiling the whole hour of therapy, as she was reminded of being cheated on herself so publically by my dad.

As much as Western medicine is about micromanagement and control of biology (at least we like to think that), we’ll eventually end up with patients who we will feel crappy listening to.  I’m thinking of the simulated patient we had who was abused by her husband but didn’t want to admit it.  Doctors are legally mandated to report child abuse and elder abuse but not spousal abuse, and I can’t imagine what it will be like to have to see some women walk back out into trouble despite all the counselling you give.

I guess part of becoming a health professional is always keeping a professional front.  Obviously my mom couldn’t bring her own baggage into the care of her patient.  The trick will be finding the balance between being jaded and being human.

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Whutchu sayin'

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