220: Child's Play

In response to the regular survey that most of our patient's receive, a patient said that she felt like she had been treated like a child. As a brief written note, I couldn't tell whether this comment came out of anger, frustration, humiliation or resignation, but it sure wasn't a compliment. Too much time had elapsed between the encounter and the feedback, and I could't remember the specifics of the visit; I just had to leave it as an unknown.

Unknown until last week when I experienced a very unsatisfactory exchange with my (now ex-) dermatologist. I was at first annoyed, then frustrated, then unhappy but I couldn't pin down exactly what it was that bothered me until after a couple of days I connected the two. I felt treated like a child.

If a 4-5 year old came to me with a scratched arm or broken toy (or more likely, a crashed iPad ap), I would exaggerate my concern and sympathy wanting to make sure that I would be heard through the tears.  "Oh that's just terrible," I might say, or "you must feel really upset; let me make it better"  A knowing parent might want to add a reality check: the scratch is minor, the toy fixable, the pad just has to be rebooted. But I think (wrongly?) my relationship with the child would suffer if I reacted that same way as I would to a friend.

The dermatologist brought her chair close to me, tilted her head just so, maintained steady eye contact, and expressed much concern even though I hadn't really complained--I just came in for a refill. Her manner would have been lauded at a doctor-patient communication workshop. But it didn't work for me any more than my condescending manner worked for my patient a few months ago.