Mr. A sat in the exam room holding a grimy fistful of papers about ticks, tick bites, and the multitude of horrific things that can result from them. I caught the letterhead of S.T.O.P. (Stop Ticks On People, I kid you not) and tried hard not to laugh as I pictured S.T.O.P. rallies and protests in
Dr. Good* – “So, what brings you in today, Mr. A?”
Mr. A – “Well I just haven’t been feeling right since these bitesYou** see there are five different types of ticks. Many people only know about the deer tick and the dog tick, but…”
Like a seasoned politician, Mr. A moved flawlessly from his answer to his speech, in this case a dissertation about all things tick-bite. I settled in, expecting that once he got this speech off his chest, Dr. Good would resume the detective work. But Dr. Good had other plans.
Before Mr. A could get to the comma after “dog tick” Dr. Good was peppering him with questions. Where are the bites? Do you have a rash? When did they happen? I don’t see the rash. Tell me about this fever. Where are the bites? Did you see the ticks? Do you have a rash? Tell me about this fever. Where are the bites?
Dr. Good had decided that he was in charge of this interview, and he was beginning to flex his will power. This specifically entailed interrupting Mr. A’s every answer with a new question. Just as Mr. A would start to say “Well, there were some bites here, and maybe on my legs…” Dr. Good was studying his arm, already asking about a rash. Mr. A was still on bites when Dr. Good was asking about fever. Mr. A was doing a poor job of following the questions Dr. Good was firing off let alone answering them. It seemed Dr. Good wasn’t even following his own questions; he asked about the same things so often I had to bite my tongue to keep from blurting out Mr. A’s answers for him.
I was watching a skit on precisely how NOT to interview a patient. By Act 3, Mr. A had been “broken”. He submissively answered all of Dr. Good’s questions in as few words as possible, and Dr. Good whisked out of the room to record his victory under Progress Notes. As he shook my hand and thanked us both for all our help, Mr. A was visibly stunned by the whole event and looked unsure of what he had done wrong.
We’re continuously taught to let patients tell us their own stories about their illness, to listen carefully to them, and to pull the “facts” out as they arrive rather than forcing them out. Everything I know about Doctorin’ tells me that Dr. Good was a bad doc there. Dr. Good isn’t a bad doc though…well, at least he wasn’t at any other time. In fact, he was the perfect doc to everyone else we saw that day. The more interviews I witness, the more I see doctors shape-shift to match their patients, pulling out different personalities every 15 minutes. The stars apparently aligned against Mr. A that day, and he saw a very mean shaped doctor.
*Not his/her name. I decided to start creating characters for my stories. Mr. A will likely be followed by Mrs. B, etc. Dr. Good, Dr. Bad, and Dr. Ugly – maybe not Dr. Ugly, cuz that’s mean – will also come out to play.
**I’ve adopted the no-space sentence as a way of conveying a pause-less segue. Its much easier to communicate by voice than on paper. In this case, slam sentence 2 (You) into sentence 1(bites) by refusing to take a breath and pronouncing the two words as one…bitesYou
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