Since I’ve started working with #epatients through Intake.Me, I’ve been reminded of a post I read in Scientific American about the “good patient” a few months ago. A “good patient,” as medical student Shara Yurkiewicz writes, is one that covers their emotional cracks:
When we told the patient and his family that the mass in his lung was highly concerning for cancer, he didn’t say anything. His daughter asked about his symptoms. His son-in-law asked when and how he could get a definitive diagnosis. His wife asked when he could go home. Finally, he spoke.
“I’m sorry for being so much trouble.” The tone was casually apologetic, the way I’d address someone after bumping into him on the T. That was the first and last thing he said during the meeting.
In the days after, he stayed cheerily aloof. When we read him the consent form before we stuck a needle in his chest to drain over a liter of fluid compressing his lung, he interrupted with a flick of the wrist. ”Do what you need to do, Doctor.” The fluid came out, slightly bloody. ”It looks precious,” he said as he gazed at the jar. ”I can use it in my garden and plant orange trees on top.”
On the final day of his hospital stay, he invited the entire rounding team over to his house for dinner. A few minutes after we left the room, he took a walk wheeling his new oxygen tank next to him and waved goodbye to us.
He was a good patient.
Shara goes on to explain how the medical team finds themselves reserving their time and energy for these “good” patients and avoiding the patients that are more demanding and require more counseling. Part of this, she reasons, is because of the considerable time and energy we must use to focus on more “difficult” cases. The new cancer diagnoses make it difficult for the team to sympathize with the woman with irritable bowel syndrome moaning in the room next door. In other words, it is not that health care providers don’t care, but that they must triage their limited time and emotional resources.
But where does that leave patients?For the health care provider, a patient may be the third, tenth or seventeenth person on their list, but for the patient, that is their pain, their disease, their hospitalization, and their life. Shara suggests that maybe it is the good patients that get better medical attention because they do not frazzle the team or make them reschedule their morning discussions to avoid confrontation. Yet as Shara points out later in the piece, perhaps some communication is lost in that process.
How does the empowered patient bridge that gap in communication?
Join us for further discussion of this tomorrow (Friday) at 1pm EST / 10am PST for #patientchat!
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