“I’d love to have an opinion on that, but it seems the politicians are going to do what they want no matter what we doctors think. Your blood pressure was fine when the nurse took it, but let me just recheck it, and listen to your heart and lungs.”
The silver-haired matron began chattering away again as Dr. Diogenes pumped up the blood pressure bulb. He put his finger to his lips, begging for silence, but it only shushed her for a moment. By the time she left with her new prescription in hand, the doctor realized he’d learned everything about her except her state of health. Indeed, it wasn’t until her next visit, a month later, when she revealed, “We were so busy talking last time, doctor, that I forgot to tell you I’ve been having this nagging cough ever since I’ve been on this medication.”
“I wish you’d have told me sooner,” he admonished, but feeling a little guilty he hadn’t uncovered this fact at the previous visit. The medication, a so-called ACE inhibitor, was doing an excellent job of lowering her blood pressure, but causing her cough. Fortunately, in this case the side effect was merely an annoyance, and the delay in reporting it to her physician resulted in no serious harm. Lucky for both of them!
Small talk can make a big difference in business settings. It can establish a sense of rapport and put people at ease, or provide a transition into weightier matters. Certainly in the setting of a physician’s office, small talk can serve those functions, but in what is often a very limited amount of time, it can also distract from the matter at hand. While your physician should be friendly and be your ally, that’s different from being social friends. In some small towns, a doctor may be social friends with many of his patients, but he still needs to keep his office a place of business.
Do expect that your doctor will be friendly and may inquire into matters other than your health.
Don’t expect a large part of your visit to be taken up with social matters even if you’re a friend as well as a patient. Call each other later at home!
The Silent Type
Forty-three-year-old Hagob Nararan hadn’t been in to see his physician for several years, not since she removed a badly ingrown toenail from his right foot. Understandably, Dr. Debra Peters’ first question to her patient was “What brings you back after all this time?”
“Just a check-up,” he muttered.
Now Dr. Peters knew that someone who doesn’t come in for several years is not the type of person to seek regular check-ups without having a problem, so she persevered by asking, “Are you sure that you’re not having any particular health problems you need checked.?”
“No,” he said, and continued to answer in monosyllables as she ran down her usual checklist of questions.
Soon, she’d finished both the history and physical exam and concluded, “Everything seems to be normal. It would be a good idea to do a cholesterol test on you though, as a screening measure.”
“Okay.”
“I’ll write the order and then you can return anytime you’d like after you’ve been fasting for twelve hours, and we’ll draw the blood. You can call two days after that for the result.”
“Okay.”
As she turned to leave him, he asked, “Will the blood test check for everything?”
“Well, no, it’s just a cholesterol level. There are hundreds of different blood tests.”
“Oh.”
“Is there something you’re worried about that you’d like checked?”
“No. Well, yes. What about HIV?”
After much beating around the bush, Dr. Peters was able to ascertain that Mr. Nararan was worried about an encounter he had with a female prostitute while away on a business trip a few months ago. Although a widower, he was still tormented by the thought that he had dishonored his late wife by having sex with a hooker–and felt sure he’d be punished by catching HIV.
When the results came back negative in a few days, Mr. Nararan smiled and became effusive in his relief. “Thank you, thank you. Dr. Peters, you have made me so happy. I will be sure to see you whenever I have a problem.”
“Next time,” advised Dr. Peters, “just tell me what’s on your mind.”
Doctors aren’t mind readers; they base their diagnoses on the things their patients tell them. The less information they have, the more difficult it is to arrive at a correct diagnosis. Doctors will generally keep probing until they feel they have enough information. Of course, too much extraneous information can be bad, too. For example, in response to the question “When did you start having abdominal pain?” one could hear the following responses:
“A while ago.” (Too little info.)
“It started two weeks ago while I was just sitting on the couch reading.” (About right.)
“It started at 8:15 p.m. last Thursday while I was reading this new murder mystery, Black Ice, by Duane Patterson. He’s my favorite author.” (Too much!)
Some information, such as sexual concerns, may be difficult for you to talk about, but remember: your physician is your confidante. Besides, you won’t shock her–there’s probably nothing you can tell her that she hasn’t heard before (or at least read about in medical school).
Do tell the doctor the real reason you’re there.
Don’t just answer “yes” or “no” to all your doctor’s questions.
Do volunteer information that you think might be helpful.
Don’t keep secrets from your doctor when they relate to your problem.
Do expect confidentiality to be respected.
The Pierced Patient
Gillian Landers couldn’t wait to get away to college–or perhaps more accurately, away from the parents who controlled every aspect of her life. Two hundred miles and three hours away from her small town, she was free now–free to party, to play–and get pierced. She’d been wanting to get her belly-button pierced ever since she saw a model in Elle with a gold-and-emerald ring in her mid-section. Her mother had let her get her earlobes pierced, of course, but that was nothing special, and both her parents had thrown a fit when she said she wanted her belly-button done.
It didn’t hurt much when the guy at “The Nifty Needle” did it–he was a pro who did his work as easily and as casually as a seamstress darning a sock. But two days later it began to be painful, and pus was oozing from the puncture site. By the time she sheepishly made her way to the doctor’s office in another two days, there was also redness and swelling for an inch all the way around the ring.
“I’ll put you on an antibiotic, but that ring’s going to have to come out, at least until this is all healed,” advised Dr. Lois Gavin. “Otherwise, it acts as a hiding place for the bacteria.”
Gillian burst into tears. “I should have listened to my mother. She told me it would get infected.” Composing herself, she continued, “I don’t want this to happen again. Would you do the piercing for me next time, doctor?”
“No,” she said, “I don’t do piercing.”
“Why not?”
“Because it’s really a