* * Anonymous Doc

Saturday, August 29, 2009

"Sir, you have to wear your oxygen"

"Just my oxygen?" says the 61-year-old man, and gives me a wink.

Uh, excuse me?

How about not being creepy to the person who's trying to help you?

I don't understand why some patients think it's fine to scream at us, to insult us, to ignore us, to act like they're the high-status person in this relationship. They're not. Without us, they're not getting better. We're the ones with the knowledge and training to help them. We're not their servants. I don't just mean the doctors-- it's even more ridiculous when it comes to how some of these people treat the nurses. Yes, you're sick, but that doesn't absolve you from the obligation to act like a civilized human being, and not to try and get the nurse to touch your penis when she's checking your hernia wound (that happened last night too-- with three other people in the room, the patient grabs the nurse's hand and is like, "no, feel a little bit to the left." Gross.).


  1. But isn't the customer always right?

  2. I've really been enjoying your entries, but "high-status person in this relationship?

    I feel compelled to remind you that if it weren't for those low-status patients, you wouldn't have a damn job. That attitude is the main reason people hate doctors and the medical system so much. Just because you have "M.D." after your name doesn't make you anything more than a high-rent hireling for the patients in your hospital. You would do well to remember that your status is "employed," and nothing more.

  3. I also should have mentioned - yes, that guy was totally creepy, and WAY out of line.

    Despite the fact that one can get very cranky when sick or in pain, that's still no justification for abuse of anyone.

    But it also doesn't justify you thinking of patients as some sort of supplicants who should look up to you. It's a partnership. They need you. And you also sure as hell need them, unless you want to flip burgers.

  4. Perhaps you are reading too much into it. Strictly speaking, saying that the patient is not the high status person does not imply that he is the high status person. It may be the case that neither is the high status person. Nor does his defense of doctors training and skill imply that he believes doctors to be superior, he may merely be asserting that they are not supplicants.

    To read more than that into his statement says more about your own prejudices than his. It's clear from previous posts that he works in an environment with a strict hierarchy where he is routinely treated like a servant. So perhaps he is especially sensitive to being treated that way by patients.

  5. I think it's really easy for "frequent fliers" to lose track of what is and isn't appropriate. Give the man a break, yeah he's creepy, but he's probably had a shitty life recently and needs something to break the dull routine of sitting in a room with a moaning roommate all day while nurses come in at all hours to stick him in the few remaining veins he has open, followed by rechecking the q2 vitals and stool collection that you ordered.

    And if cracking inappropriately perverted jokes makes his day, then let him do it. Just give him a gentle reminder when he crosses the line.

  6. Since I haven’t met the specific patients you’re talking about, I’ll take your word that the only thing wrong with them is a bad case of the stupids. Creepy people get sick, too.

    But sometimes the weirdest things are symptoms. Graveyard humor could mean “I feel like I am going to croak and I don’t want to face it.” Or it might mean “I had thought I was going to die but I feel much better now.” As a parallel, vomit is inappropriate in most places, too, but I wouldn’t call someone who did it uncivilized. Maybe you should discuss this with a senior (i.e. elderly) doctor, specifically about how to tell whether this kind of behavior might be symptom?

  7. You might want to read: http://blogs.acponline.org/acpinternist/2009/08/pinpointing-transition-from-human-to.html

    Could this be the root cause of your complaints?

  8. while i find this blog an incredibly interesting view into the life of a resident, i must agree with jayson that the remark about patients acting "like they're the high-status person in this relationship" rubbed me the wrong way.

    i agree that anonymous's argument has merit, but i disagree with the proposition he/she puts forth based on the following: the remark implies that there is indeed a high-status person in the relationship. were there not, it would be sufficient to say something along the lines of, "acting like they are better than me," or, "acting like i am their servant."

    the words strongly imply the existence of a status-based relationship, particularly when juxtaposed against the next two sentences ("they're not. without us...")

    anony doc, i agree with your conclusions that patients should not treat you as a servant or imbecile, but i truly believe that both you and they would be better served if you did not believe what this paragraph implies that you believe.

    you may have the literal power of life and death over your patients; they may indeed be the supplicants; but concluding your high status from these circumstances is a lot of self back patting.

    people almost never know what is best for themselves. that is a given. so it should come as no surprise that they will resist all the unwanted ills and pains of a hospital. people act out at you, blame you, insult you -- but they are scared and have no outlet. you are the face of the ills (unfairly, of course) - the walking talking embodiement of their sickness. it's natural for them to lash out, as hurtful and stressful as it is for you.

    i liken it to being the older brother/sister. as a kid, my parents always said that i had to act more grown up than my little brother, because he didn't understand. i thought it unfair that i had to bear the burden of understanding and restraint, but it was the truth - he was a little kid who didn't know better. i did my best to teach him without losing my temper (sometimes failing), but i could never lash out myself. and when i couldn't make him understand, i still had to do the right thing, as galling as it was to me at the time.

    and i was born into that situation. you chose to be a doctor, and from your thoughtful outlook on things, probably a good one. you are the bearer of reason. it's easier said than done, but you can't take that kind of thing personally. people will not always understand what they don't understand, but if you resent them for it, it will be to the detriment of you both.

    lastly, i don't want to come off as preachy. i am merely articulating things from the other point of view as best i can in response to the preface of your big paragraph ("i don't understand why..."). while this response is unsolicited, i am trying to be as respectful as possible.

    i look forward to future posts,