Tag: communication

Communication

March, 2015

Throughout my career communication has been extremely important.  This weekend, I made an epiphany that floored me and was so natural I could not believe it.  I owe gratitude to my grand daughters.

I was to see this 4 year old girl that was sick with a fever, cough, congestion and general not-feeling-well-grumpiness.  Mom had brought her into the ER and she had her favorite blanket with her for comfort.  Mom was sitting on the stretcher with the girl bundled in her arms in a typical protective manner.  She had blond hair, but beyond that I couldn’t tell a whole lot else about her as I walked in the room.

I have to approach this encounter with tenderness and the understanding that this is a scared patient and a comforting protective Mom.  I mean, it was about 2 am and normally she would have been asleep in her own warm bed at home, right?  Mom had brought her to this brightly lit, big, noisy room with a lot of strange people running around with serious looks on their faces.  There is a lot of big furniture and machines that look like a Transformer movie with beeping, shrill sounds, noisy conversations and even yelling.  All of a sudden, there are about 5 more people in the room that is only about 10 x 12 feet and a lot of things that she doesn’t understand are being moved around or attended to by these people in a purposeful manner.  She was certain she was the purpose.

She had her head tucked down and her long blond hair hung across her face, almost as good as a blanket to hide under.  At the same time, all of these people were talking to Mom, moving things around, reaching to pull her clothes  off and sticking things at or on her.

If you hadn’t experienced this several times in your life, it would be scary to anybody.  When I opened the door and entered the room, I knew exactly what I was facing.  I would talk to Mom a bit and as I did she would squirm and whine little vocalizations meant to express to Mom that she was uncomfortable here and wanted to leave.  Then, I’d somehow maneuver Mom and her to a physical position that would allow me to examine her in the least threatening manner.  Least threatening but not so coddling that I could not accurately and completely examine her to enable me to come to an accurate diagnosis. She would cry and reach for Mom and twist away from me, essentially making any examination impossible.  Maybe she would even throw a full blown temper tantrum as if I was the devil here to take her away.  We would wrestle and I would direct Mom or the nurse(s) to use leverage techniques and hold her in position.  After this kind of torture session ended she would crawl up into Mom’s arms and immediately be calm.  She’d understand that the battle was over and no harm being done and no pain inflicted, would cease crying and fighting immediately.  She would stay there the remainder of the time, quiet so as not to be noticed.

But that didn’t happen.  Oh, I completed my exam and was successful in obtaining everything I needed, but under calm cooperative conditions.  It doesn’t always happen this way, but thanks to my grand daughters, it did this time.

See, I recognized the theme on her favorite blanket the minute I opened the door.  I could see her eying me with fear and suspicion through slightly parted strands of hair, I being one more of the enemy to keep an eye on, she thought.

I smiled, relaxed and kinda hunched my shoulders and shrunk down a little and said,  “Have you seen Frozen?”

Ice melted.  Her head came up smiling and she nodded her head.

I said,  “Do you like Princesses?  I see you have a Princes blanket.”

She kind of scooted away from Mom and said, “Yes.”

The rest was like cutting butter with a hot knife after that.

Now, that is communication.

From your grumpy Uncle/Brother Dave.

Weary

Communication is Important, For the Record

7/2017

Communication is important in the effective practice of medicine.  Ergo the medical record.  It is a way for one physician to inform other physicians and staff what is being done for this patient by a physician.  One area of importance in the medical record is the “Problem List”.  This is where one can go to look for all the active problems that are being addressed by all of the different physicians treating a patient.  It sort of weeds out all of the old stuff, the fake stuff and the errors and such.

But alas, social media has arrived to the EMR (electronic medical record).

One of my patients, tonight, had 3 listings for a severe medical problem that had a direct impact on what I did or didn’t do.  Listed below in exact representation from the EMR are the following:

1. liver transplant
2. Liver Transplant
3. Unspecified organ or tissue transplant

This may seem confusing and complicated to those not highly trained in the medical profession.

1.  “liver transplant” implies that the patient has had a complete failure of his natural liver and a liver from another individual was transplanted into his body, in a casual voice.

2.  “Liver Transplant” implies that the patient has had a complete failure of his natural liver and a liver from another individual was transplanted into his body, in a firmer, louder voice, but not shouting.  (That would be LIVER TRANSPLANT)

3.  “Unspecified organ or tissue transplant” is a little more complicated. It could mean that the surgeon doing the transplant was totally clueless as to what he was harvesting from the donor and where it was going in the recipient, like in the book Catch Me If You Can, about the Doctor/Airline Pilot impersonator. Or, it could mean that the surgery was done in Colorado or California and that the surgeon was a die-hard Cheech and Chong fan, striving to carry on the principals espoused in Up In Smoke (1978).

To think that the U.S. Congress mandates that we use this efficient, productive and safe method of physician-to-physician communication boggles the mind.

Delusions in the pursuit of absurdity from your grumpy Uncle/Brother Dave.

Weary.