The patient who just wanted to be heard

I was two months into my first year of medical school when I first experienced it.

“Room 214… oh yes, she’s really painful. She will probably speak your ear from you and come up with a new self-diagnosis for which she would like a full workup. She always does. “

Nervously I laughed at it. I grew up in a household where doctors are highly valued – they are geniuses, healers and heroes without robes. I also grew up in a household where I am the first (permanent) doctor to ever come out of it. I have never known a doctor up close. The closest I had ever been to a doctor before medical school was with my family doctor, whom I only saw for an annual physique and the other two times a year where sinusitis would get the best out of me.

So naturally, when I got into medical school and saw so many successful doctors before me who were tasked with teaching and training me for the next four years of my medical career, I was completely overwhelmed. It was like meeting your heroes for the first time.

All your life you see them from afar on the pedestal you put them on. And when the blessed day comes when you finally meet them, you will be shocked when they are not united with the perfect image of those you had in your mind.

The thing is, all people are capable of getting annoyed at other people, right?

We have probably all been annoyed with many people before to count on one hand at all. So why is it that when a doctor, another human being, shows the slightest bit of irritation towards another individual, that my gaping and bushy-tailed first-year medical student himself became so horrified?

I could not believe that a trusted doctor would make such a comment about a patient who came into his office with the guard down.

I suppressed the comments he made about the patient, grabbed my notebook and stethoscope, knocked on the door of room 214, and went in for an inviting “Come in!”

A well-developed, well-nourished woman without acute distress waited on the study bed, looking thoughtfully down at her swaying feet that hung from the side.

After a 10-minute discussion about what brought her in, I learned about her anxiety about a possible underlying genetic heart disease she was suspicious of. Her uncle and her grandfather had both experienced heart attacks within the past three months, and she was petrified at the thought of “being the next one.”

Tears welled up in her eyes as she thought of her family. I grabbed her hand, understood the fear of insecurity and saw those you love fall victim to life-changing events.

One of the first lectures I have ever received at the medical school touched on the fact that a large part of patient satisfaction comes from the quality of communication with the provider, and it stuck with me. In fact, sometimes people will come into the office just to talk to someone, be heard and be comforted. I understand that as a patient.

As a budding doctor, I also understand the stress that comes with the rigorous 15- to 30-minute blocks we get to talk to, examine, and treat a patient.

I understand that what appears to be an easy visit for a single major complaint of a stuffy nose can quickly turn into ordering an ECG after learning that the patient had also fainted the night before.

We enjoy neither the 15-minute visits more nor less than our patients who had to take time off work and drive for 30 minutes, only to have time to talk about one or two of their many concerns.

If we could have it our way, I’m sure many providers also wish they could dedicate an hour’s blocks to all their patients so both parties could go home with peace of mind.

When I put myself in my place of meeting, I understand the frustration that can come with being 30 minutes behind schedule and going into an exam room that is likely to bring you further back with the reprocessing that the patient may request.

The lunch will be sacrificed just to keep writing patient notes and continue to see patients in an attempt to prevent them from getting angry because they are seen too late. As providers, our basic needs are often replaced to take care of our patients’ needs.

Yet I also understand the fear of a patient who is in the dark regarding their health.

I thanked the patient for letting me take a medical history and do a physical examination of her and informed her that I would be back in the room shortly with the attending physician before I left.

“So how was she?” asked my attendant with a smile.

My participation was not a villain – he was just tired and overworked. My patient was not a villain – she was just terrified and wanted someone credible to unpack it with.

Having eight minutes left in the time block to see her did not help anyone. The system is not perfect, but I knew at the time that I had to give my participation a useful presentation to give him an accurate picture of the patient’s situation, while I spoke for her and her rightful anxiety and fear and explained him the latest trauma she experienced.

Fast forward to my internal medicine rotation as a third-year medical student, I was again assigned a patient that many providers considered difficult.

As she approached her room, her screams in the hospital hallway got louder as she called for a nurse. I set the pace, worried it might be an emergency.

As I entered her room, her screams stopped, interrupted by a smile covered by part of her nasogastric probe.

She was ok physically. Yet she longed emotionally for connection in a time of insecurity and loneliness. I understood. I pulled a chair up by her bed and kept her company until it was time to sign up for rounds.

Saba Daneshpooy is a medical student.

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