am usually a humble person. Possibly because, as a smartass friend once told me,
I have so much to be humble about. Yet I feel compelled to boast about one of my
few impressive attributes, which is that I have always been an expert at coming
up with good come-backs to unexpected responses from patients.
The only problem is that I usually don't
think up these clever retorts until about two hours later. For example, I always
found it effective to explain exam procedures to a patient as I performed them.
Thus I once told a college professor patient during keratometry testing, "This instrument
measures the curvature of the cornea of your eye and is accurate within 1/200,000
of an inch."
that much accuracy is not necessary," replied the professor, clearly convinced that
I was giving him a "snow" job. But I came up with the perfect answer:
"Perhaps. But I'd rather err
on the side of too much accuracy rather than too little." Again, though, it was
two hours later that this answer came to me, long after the professor had departed
my office forever.
Think before speaking
During my years in practice, I discovered that
there were also many other ways of miscommunicating with patients. One of them was
caused by my dreadful tendency to let my mouth get in gear before my brain does.
"I'm really tired," my first morning
appointment, a very comely young lady, told me one day. "I had to work the night
shift last night and I'm going home to bed as soon as you finish my examination."
I had had a rough week, and the thought
of being able to just forget the rest of the day's appointments and to also go home
to bed sounded mighty appealing. So, again, putting mouth in gear ahead of brain,
I unfortunately replied:
"Gee, I sure wish I could join you!"
My stuttering attempts at explanation,
after I realized what I had said, did not seem to make much headway, and I'm afraid
she was certain a dirty old man was examining her.
Another type of miscommunication is failing to
make your message sufficiently clear. For example:
The metal strips the federal government
uses to band birds are inscribed: "Notify Fish and Wild Life Service, Wash., D.C."
They used to read, "Washington Biological Survey," now abbreviated to "Wash. Biol.
This was changed, the story goes, after
a farmer shot a crow and disgustedly wrote the government: "Dear Sirs, I shot one
of your pet crows the other day and followed the instructions attached to it. I
washed it, biled it and surved it. It was turrible! You should stop trying to fool
people with things like this."
Lastly, in addition to patients at times misunderstanding
you, there's also the problem of making sure you understand them.
"One of my patients presented for her
annual exam," Dr. Sheldon Kreda of Lauderhill, Fla., explained to me via e-mail.
"She had just had cataract surgery at a relatively young age, and her figure was
extremely well endowed. A short while into the exam she flung open her arms and
said, 'How are my implants?'
"It took me a moment to realize she
was speaking of her IOLs rather than her chest," Dr. Kreda writes. "I told her they
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