Your Patients.

                 A woman swimming in a moonlit sea; cue the ominous “Daaa dum.” Or a glass of water rhythmically vibrating to a massive tread. Or a little girl turning from a static-filled TV -- “They’re heeeereee.”

                 Hollywood knows all sorts of ways to convey anticipated dread, but they don’t know Mrs. Holfstedder. Or some of our other patients.

                 Gulp!

                 Some of our patients fill us with anxiety. They are evasive and omissive. Or hostile and argumentative. Sometimes they are just plain loony. And, sometimes, they can be litigious.

                 Like lion trainers, we learn survivor skills. We come into the examination room with the chair up and the whip cracking. We don’t turn our backs on them, even for a second, lest we become Purina lion-chow.

                 In medical school, weren’t you taught to never allow a patient to come between you and the door? And this wasn’t just for duty on the lock-up ward.

                 To safeguard ourselves, we de-humanize our patients. We turn them into “product,” endlessly flowing down the examination-room assembly line. And it works well.

                 After all, we’re so damn happy, right?

                 Who are these people we poke and prod? Who are these people who come and see us with their pains, worries, and concerns?

                 Well, for one, they are our customers. They pay the bills that keep our lights on and our stethoscopes and K-Y cold. We exist to serve them by the best means possible. Wasn’t there an oath about that?

                 And they’re the reason we’re here. In choosing our profession, we were granted entry into patients’ lives, and even their bodies, by virtue of our white coat. They are our honor and responsibility.

                 Further, they are our window on the world.

                 My brother, who works in an office, tells me that people will kill for a cubicle near a window. And yet we have a window to humanity in each of our examination rooms. Every day, every fifteen minutes, we get to meet another person, all with their own sets of views, dreams, and outlooks.

                 It’s our choice – we can either open the blinds, look out of this new window, and see the wonder. Or we can get out the Windex and simply clean it, never looking outside. Nothing needs to change but our perception.

THE EXERCISE:

                 We’ve looked at how you deal with your family, your colleagues, and your staff. Now it’s time to take those things we’ve learned and apply them to our patients.

                 Below are three checkboxes. They represent Gratitude, Fun, and Personalization. You’ve done exercises on these already.

                 Tomorrow, as you work through your patients, you must apply what you have learned to them. You may not complete this exercise with a single patient; each one can only fulfill a single attribute. Further, don’t rely on performing these with patients you already like – nothing is gained in that. Rather, pick new patients (or, if you are a sportsman, antagonistic patients).

                 Tomorrow night, while you check off your boxes, think about how the day went. In treating patients like humans, did it improve your own attitude? Did it make the day downright enjoyable, or at least more bearable?

GRATITUDE: I have complemented a patient on his efforts to change, for caring for themselves, for waiting, or for not biting my head off.

FUN: I have told a joke to a patient, laughed at one of their jokes, or even included them in some office prank. . 

PERSONALIZATION: I have inquired about a patient’s life, such as an interest they exhibit or a book they are carrying. I have learned something about them.

                 We can’t guarantee that patients will respond humanely in return. They might still be rude, disrespectful, and abrasive. The world is full of angry people.

                 Still, it’s a start. Didn’t you enter medicine to make a difference in the lives of people, not just fix them? Or would you rather continue with the assembly-line approach?

Patricia Raymond MD FACP FACG is a Virginia gastroenterologist who takes the personnel hemorrhage in medicine seriously, and herself lightly. Formerly fried by compassion fatigue, and a frankly cranky caregiver, Dr.Raymond writes and speaks on helping physicians and nurses to play nicely in the sandbox of medicine.

Her books, “Don’t Jettison Medicine” and the cult comedy anthology “Colonoscopy: It’ll Crack u Up” are available at www.RxForSanity.com, or you can hear her on streaming audio each Friday from 12-1 EST as she hosts NPR’s Housecalls challenging patients to step up and accept responsibility for their own health.

Contact her at PLRaymond@RxForSanity.com.

Get more on booking Dr. Raymond’s presentations for your hospital  at  Rx For Sanity

Pre and Post Colonoscopy Humor can be found at the quirky Colonoscopy: It’ll Crack u Up

Listen and call in to live streaming audio as Dr. Raymond teaches the public to accept responsibility for their own health Fridays 12-1 EST on NPR’s Housecalls with Dr. Pat Raymond

Dr Raymond’s patient-centered gastro practice