The Real Patient Encounter
- Jaraad Dattadeen
In the simulation lab where we trained as medical students, all we had to do was grab a tissue and hand it to the patient. Then, like magic, they would thank us. As if that's all it takes to suddenly make things better!
We also learned to say empathic things like “I know this tough,” “I’m here for you” and “What’s wrong?” And in the simulation lab they worked like magic, too.
But now I'm with a real patient, and I tried all these things, and they just didn’t cut it. She seems so disconnected and isolated.
When I put myself in her shoes, I begin to understand why.
Here she is in the Emergency Department where all these strangers are popping in and popping out. Doctors come in, ask a few questions, write it down and then leave. Nurses come in, give her a couple pills and then leave. Nurse’s aides come in, clean her, help her get dressed, check her vitals and then leave. Case managers and social workers come in, ask about her insurance and what not and then leave.
I'm guessing she didn't make a connection with anyone. How could she? No one is focused on her. Everyone is just fixated on doing what needs to be done. Then we wonder why we miss important details, or why patients lie, or even why they refuse to take their meds or get lab tests done.
So there she was, feeling distant and afraid and alone. And I'm not connecting with her, either.
So, I take a step back and sit facing her on the opposite bed. I give her a few minutes, and then a really basic idea comes to mind. I ask her if she lived in New York for all her life. To my amazement, she responded. I then asked where she was originally from, and again she responded. In fact, she was very willing to speak about these things.Within seconds we were exchanging words about our countries and she realized that my country was close to hers. Suddenly, the place didn’t feel so lonely to her anymore.
Just like that, I could see her fears and anxiety wash away.
Brooklyn, New York