Monday, December 28, 2015

Learning From Your Patients

Some of my best learning moments as a clinician came when a patient left me.  They liked me enough, and respected my trying to meet their needs, to let me know personally why they were leaving me.  Early on, one patient listed my faults (which were many!), including not washing my hands before I examined their child.  Another one, later on, told me I was ineffective in dealing with her troublesome child, and had me read "The Difficult Child" by Henry Turecki, which is a great book that I have recommended to all my patients ever since.  It was painful, but I learned.
And then there was the patient I had with repeated bouts of acute abdominal pain.  I had them come into the office, against their will since they thought I should be able to do it over the phone for free.  I looked at the kid, I thought about it, I walked around the room, and I said, "Does he chew sugarless gum?" 

"Why, yes, he does!" they said. 

"It could be the sorbitol," I said. 

They cut out the sugarless gum and no more stomach aches!  One of my best diagnoses.  I had been studiously reading my newsletters in pediatrics, and it paid off.
The next thing I heard from them was a notice requesting that their records be transferred to a doctor nearer their house.  So I called them up to ask why they were transferring.  They said something about the distance.
I said, "What about that diagnosis that cured the abdominal pain?"
They said, "We expect that!"
What a world.  
Budd Shenkin


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