The importance of listening

I prefer being the doctor, not the patient. After all I spent 8 years of my life learning to be a doctor, have practiced 2 years as a doctor and so it makes sense that's the role I know best. Having had 4 surgeries the past year though, I've learned a bit about being a patient.



This last surgery reminded me of the importance of listening to the patient's story. Taking the patient's history is one of the first skills acquired in medical school: you learn to ask open ended questions, focused questions, system specific questions, and learn to direct your questions based on what the patient is telling you. The patient's story should begin your differential diagnosis and in many times will make the diagnosis. Physical exam and testing should confirm what you already believe to be true. Granted there are times when things are unclear and we tend to blaim the patient as a "poor historian," but perhaps we're just not asking the right questions.



I left Crescent Lake certain of my diagnosis because of my history; I had not had a pregnancy test, ultrasound or exam. However, when seen by the doctor I felt I was convincing him that this was even a plausible diagnosis and should be considered on the differential. Maybe I was a "poor historian" from the pain I was in--but even that pain level points to a ruptured ectopic. As he started to talk about anovulatory cycles, thyroid dsyfunction and stress I finally fessed up that I was an Ob/Gyn and certain of my diagnosis. (Also, if some one shows-up in your office wearing yoga pants and a polar fleece when its 90 outside and hasn't showered for 3-4 days you better think something is seriously wrong!) While I still accepted his care plan and the right diagnosis was made I mostly wanted to know that I had been heard. That the testing was done because he believed me rather than to try to prove me wrong.

I'm finding that true with grieving as well. Sometimes the story just needs to be heard. So thank you to those that have offerred and willingly listened; it helps.