Why do patients think that threatening to leave the hospital is going to motivate us to try and stop them? "I got the wrong lunch and I'm going to pack up and leave if you don't fix it," one of my patients said this afternoon. You want to leave because you got the wrong lunch? What do I care? It just means less work for me. You're not doing me any favors by being in the hospital. You should want to get better. You're not a child. I feel like half the patients in the hospital act like five year olds. "I'm not getting that test," another patient insisted. "Sir, we can't figure out what's wrong with you without the test." "Well I'm not getting it, and that's final." "That's your choice, but if you want to get better, you need to think about letting us do that test so that we can find out what's wrong and help you." "Well you need to find another way to figure that out." I don't gain anything by giving invasive tests. I don't even get paid for it. We're just trying to help. Why do the patients have to make it so difficult?
I have a schizophrenic patient who refuses to talk to doctors. At least he has an actual mental illness to excuse the behavior. He'll talk to nurses, physical therapists, the guy who cleans the floor... but not to doctors. I didn't know this at first, and went in with my white coat, introduced myself... and he said nothing. Wouldn't even look me in the eye. I thought perhaps he was deaf, or completely zonked out by some medication. Then a tech comes in and he's suddenly chatting away, friendly as can be. He let me relay my messages through her. "Can you ask the patient how he is feeling?" And she would ask him, and he would tell her, and she would tell me. I sent a med student in without her coat, told her to pretend to be a nursing student, and gave her the questions we needed him to answer. That worked, for now, but I'm not sure he'll keep buying the act.