Thursday, December 12, 2013

It's good to be grown up

One thing I really hated about med school and residency was when you were stuck in a patient's room while the attending decided to get all chatty with them about things unrelated to medicine. For example, I got stuck standing there for a twenty minute conversation between an attending and a patient about Valentine's Day presents their husbands gave them. And you're just trapped.

When I was an intern, I was rounding on a Sunday one day and I got trapped in a really irritating situation. The attending started talking to an elderly patient's family. This led into a big nostalgia fest. I swear to God, I heard every story about this woman. I now know her favorite music, her favorite TV shows, her favorite color. And we'd had a meeting with the family practically every day and her elderly sister loved telling these stories. I'm a somewhat patient person, but for Christ's sake it was Sunday and the room was 2,000 frickin degrees and I just wanted to finish up my work and go home. I still had a lot to do.

The worst part was the attending was eating it up! He was chatting with them and not making any move to leave during breaks in the conversation. If the family ran out of things to say, the attending would be like, "So who was her favorite movie star?" I was like, "You've got to be kidding me, let me out of here!!!"

As I stood there, I prayed to god that my pager would go off, because I knew that would be my only means of escape. I kept looking at it, wondering if I could do something to it to even make it SOUND like it had gone off. Finally, I fiddled with it, it beeped softly, and I exclaimed, "Oops, I gotta go!" And I ran out.

I got some of my work done outside, wrote orders, finished notes, and signed out to cross cover. Then I came back to the room and the attending was STILL talking to the family. I quickly slipped away.

I paged the attending when I was ready to leave. I said, "I'm sorry I left but it was really hot in that room and I had work to do."

He said, "It's okay. They just seemed like they wanted someone to talk to."

And then I felt like a huge jerk. But then again, I still don't think my standing in that room made much of a difference.


  1. As you probably understand now, patients pick up on this not atypical vibe and it's why they (and their families) can be uninterested, dismissive and borderline rude to interns and residents when they try to do their jobs.

    1. Being rude to your care providers is likely to result in exactly the opposite result than the one you desire.

    2. @Anon1: If not having time to chat about non-medical issues for 20+ minutes with each patient constitutes dismissiveness to my patients then they should seek care elsewhere. I care deeply for my patients' well being and give whatever time is needed to deliver the best care I can. We chat a bit here and there, often much longer if they've had a major life event or about mental health-related issues (although that is not my specialty, this does impact how well they heal). But to waste even 2 hours a day on frivolous chatting (that's only 6 minutes extra per patient!) takes away from my ability to deliver appropriate care to everyone. I already stay past dinner, what more do you want? In the old days listening to a patient for an hour was considered therapy, but insurance won't pay for that anymore. I am not an appropriate replacement for that.

      You sound like you're in the "I hate doctors" camp. Hope you find an independently wealthy doctor or one with a wide open schedule who has time to listen to you talk about whatever your heart desires. Going to be harder to find that as insurance co.s further decrease physician reimbursement and medicare/CMS increases documentation requirements. Right now is not a great time to be either a patient or a doctor.

  2. So, he thought the patient just wanted someone to talk to? I think HE wanted someone to talk to. Having had long experience as both a nurse and a patient, I can assure you that a little light conversation that extends beyond symptomology and pathophysiology is a welcome break and makes everyone feel more human. A lengthy conversation, however, makes the patient feel responsible for entertaining the caregiver. TCG

  3. Now we just program our pager numbers into our cell phones...

  4. Equally as bad is when the attending leaves you alone in the room in the middle of when you're observing something, and you have to awkwardly stand there in the room with the patient and the family waiting for the attending to come back, and you're not sure if you should leave or wait in the room with the patient.