Don't Call Me Bob

First history taking workshop ever.

I smoothed the creases from my clothes, made sure the hem of my pants wasn't tucked into my socks and straightened my shirt out.  Carefully taking it off the hanger and sliding it on, the pièce de résistance, my white coat.  I stood there feeling a little bit in awe of myself.  I had waited so long, it felt like my entire life for this moment to finally put on that coat in a serious capacity.  

It was the first clinical skills workshop of the year.  This was the first time I would put to use the tedious amount of instruction we had received in clinical skills plenary sessions about how to interact with a patient, what to ask, how to ask it, when to ask, how to diagnose, how to rule out one disease versus another.  I was pumped.  It was gonna be my first day of doctoring.

What I encountered could not have been further from what I had imagined.  We were all herded into a room where we proceeded to split into groups and each group was to interview two mock patients.  So here we are sitting in a large multi-purpose room in the college sitting around a "mock" patient (these were people who did suffer from the medical conditions they were describing to us but had been nice enough to subject themselves to the utter clueless-ness of M1s) who we were supposed to interview as if in a clinic setting.  There were six of us so we went around the circle (like it was a second grade sharing time) and each asked questions until we had exhausted our totally inadequate list of what information we needed to elicit from the patient. 

I went home from that experience feeling so much less like a doctor than I wanted, essentially nothing like a doctor.  That was when I realized how many eons away I was, we all were, from even being comfortable enough with ourselves in a conversation with a patient to be of any use clinically. 

One thing that struck me from that day, that I will never forget is something one of our patients shared with us.  He was an older gentleman who shared with us that for years and years he had harbored some slight resentment for his primary care physician because the young chipper doc had affectionately called him "Bob" from the very first visit.  The doctor didn't realize what a colossal misstep it had been not to ask the patient what he preferred to be called, although the patient had approached the situation with a 'grin and bear it' attitude and eventually came to like the physician there always remained that initial feeling of discontent.

It seems like such a small thing, just tell him not to call you Bob, but it isn't.  As physicians we often are in situations where the power is shifted tremendously on our side and away from the patient.  For that reason I believe it is of utmost importance to cultivate a relationship that gives the patient a loud enough voice even if the only thing they want to say is "Please, call me Robert"