Section 3  The effective clinical encounter
Once, when I was a resident, a delicate-looking young man came to my office for his first visit. "I have post-polio syndrome," he said meekly, as though this were an illness that demanded a great deal of respect. I had never heard of it. He handed me a letter--a summary of his prior medical care, which detailed his symptoms and the tests he had had. They were tests I didn't recognize, the names of which collapse in one's mouth trying to pronounce them, such as gamma-hydroxy-butyrate levels and carboxy-aldolase titres. "Hmmm, hmm," I murmured as I read, my teeth chattering slightly in panic, wondering what I should do.
In our training days, we could call on teachers to help us, so I went out of the examining room and fetched the supervising physician assigned to us. "What is going on with this guy?" I demanded. She came into the room with me after glancing at the patient's letter I'd shown her.
"So," she said, shaking the young man's hand, "I imagine you have a stack of books about post-polio syndrome next to your bed."
"Yes, I do," he replied, astonished.
"You must feel weak-." He nodded.
"Exhausted--hardly able to do anything," He became teary.
"And all this causes you a tremendous, an almost paralyzing anxiety." Her voice becoming deep and soothing, almost hypnotic. The patient had been sitting stiffly in the corner; now his shoulders slackened, his jaw muscles relaxed. He looked at her like a child who's been calmed after a terrible fright.
"Yes, tremendous," he acknowledged, and it was as though he were referring to the relief he suddenly felt.
In this section we will examine how the health care professional can use
personal skills and behaviors to improve the relationship with patients. |
