Another day at work

Running late for the morning research seminar, I have twenty minutes to see the new patient on the floor. Time enough, I think, as I walk in the door.

'Hi, I'm Dr. P, I'll be taking care of you while you're here on our unit.'

She asks for my credentials. I hand her my ID card.

'So, you're a resident.' She might have said vermin.

Uh oh. 'You'll be meeting a senior attending physician later. May I ask you a few questions?'

'Let me tell you something first. You are supposed to be a professional, but your behavior is not. You need to make better eye contact like I am making with you. You also need to stop jerking your head.'

So much for 'empathic' nodding. She goes on for the next five minutes, hard to interrupt.

I already have a diagnosis. Which is good, because she'd rather see a more professional doctor. Later, she tries to incite other patients to a non-compliance strike. Fortunately, her abrasive manner pushes them away. She plays the piano all day long and sings in the hallways. We spend a lot of time calming down other patients.

My attending offers to transfer her to another resident's care, but I can't let this one go. I go back the next day.

'You can be my doctor. I come from a good family. I can see that you are a genius, too. Amen.'

We bargain over medicines. She refuses the sedative she takes at home but agrees to take the mood stabilizer. I couldn't care less about the sedative; the battle is won.

Three days later, she's still grandiose and demanding. But its getting better.

[printed with permission, identifying details changed]

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About purplesque

Psychiatrist, cook, bookworm, photographer. Not necessarily in that order.
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17 Responses to Another day at work

  1. Patience with a patient. You are a genius. Amen.((hugs)) — just because.

  2. Just re-read the comment I left– it "reads" a little flippant– I didn't mean it that way — you really are patient and compassionate– what a job! — what responsibulity – I wonder how many people realize what that takes. I certainly can't imagine doing it. [this is where the hug goes]

  3. Purplesque says:

    Hey..it didn't feel flippant at all. I firmly believe in my genius. lol.I was just sitting here, eating icecream and feeling hugged. Thank you.

  4. *whew* that's good.Hooray for ice cream/frozen yogurt!I just had a big mug of Turkey Hill Chocolate Cherry Cordial Fat-Free Frozen Yogurt ……so fine! (I hope that link works)

  5. Purplesque says:

    Yes, the link works!! That sounds Yum..I'm a sucker for old fashioned vanilla. Kroger sells a bag of 100 calorie cups. They're probably completely synthetic and bad for me, but they taste good on Friday night. 🙂

  6. Karen Lynn says:

    oh yummm Turkey Hill…what I wouldn't give for a Turkey Hill Diet Lime iced tea right now. where about in pa do you live robbie? I'm from lancaster county, lititz to be exact.

  7. Karen Lynn says:

    I would hate your job gf. My feelings were hurt for you just reading this! **(((hugs))))****

  8. Purplesque says:

    Thank you for the hugs..:)I can't deny my feelings were hurt a little, but that was before I realized what was going on. Now its just funny.

  9. Karen Lynn says:

    I so very much admire you :))

  10. Purplesque says:

    Hey, you're the hero, remember? Quit projecting on to me! 🙂

  11. Well done! I know for sure you're a very patient and compassionate therapist. No one can refuse your food. Just offer her a piece of your pizza and she will come begging next time. 🙂 Seriously, it's very refreshing to find someone like you in your profession who actually cares about the patients even when they are being difficult. God bless you!

  12. is it sad that i have patients who treat me like that and they don't even have psychiatric problems? none that are diagnosed anyways. i'm thinking of one guy in particular who absolutely refused to have a resident (me) putting in his IV, and obnoxiously demanding that an attending do it. the others just get scared when they see me, introducing myself at a resident, at a particularly anxious moment in their life (pre-op). i guess i just don't fit the picture of what they expect to feel a comfortable with (an older, tall, distinguished looking man, perhaps?).re your comment– i guess i'm trying to write every day so that i can record my experiences as a young physician– an experience that i will never have again. i'm afraid that if i don't capture it now i will forget all the nuances and little details. i'd be interested to know how you view your blog– what purpose does it serve for you?

  13. Purplesque says:

    Lol..now why did I not think of bribing her with food? Seriously, though, its hard to get angry at my patients..they have real problems, and between them and me, they're the ones who have a justification for anger. A lot of physicians do care. With time and experience and just..life, I guess, all of us become jaded. Maybe its a survival strategy..I don't know. I get into trouble for being too compassionate at times..its all about finding a balance.

  14. Purplesque says:

    You're right..being in the hospital is such an anxiety provoking situation; it tends to bring out all the hidden personality disorders. Its no fun treating a full blown psychodermatosis (my attending's name for personality disorder) patient, especially for a busy med/surg/anesthesia team. We get such consults — Consult psych re: mean patient. Consult psych re: patient smoking in bathroom. WTF? How you look like definitely plays a big role, I get flak sometimes for being young, female And brown. Thankfully I don't have much of an accent.I find the idea of chronicling your experiences as a physician very interesting. This blog started out more as a personal dialog with people I like, but keeps on taking different avatars. I use it more as a means of communication than a chronicle, but would like it to be more inclusive of everything in my life.

  15. Scott says:

    This is a good post, but mostly I just want to thank you for saying "I couldn't care less" instead of "I could care less." I'm not used to seeing it used correctly. 🙂

  16. Purplesque says:

    Lol…enjoy it while you can. I have learnt the Queen's English in school, but now its rapidly going down the drain while Americanisms take over.

  17. Emjay says:

    Don't let those Americanisms take over your good English!! Good luck with that patient!

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