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    Saturday, January 15, 2005

    Rashomon: The different spins or recollections that patients sometimes put on our encounters never ceases to amaze me. Sometimes, a patient will tell the nurse that they've come in because they "still have" back pain, or leg pain, or a cough, or whatever's bothering them. But their chart shows no prior complaints of any sort similar to it. They'll swear they told me about it, as if that had been the main reason of their last visit, but I know I would have documented it if they brought it up in any way that needed to be addressed. Sometimes, it turns out they mentioned it only to the receptionist, or to the nurse at the last visit. Sometimes - and this has happened more than once - it was their previous physician they're remembering.

    Once, a mother told me that she "didn't like that other woman doctor" in our office. Which I found puzzling, because I was the only woman doctor in that office - ever. I asked her if that wasn't me she meant, but she was adamant that it was another woman. While she went on about how much she despised her, I looked through her daughter's chart. Sure enough, I was that despicable woman. I just nodded my head and said, "Oh, yes. That doctor." We got along just fine in every encounter after that. Nary a whiff of conflict. Although, I'm still not sure what I did, or when, to make her hate me.

    Today, I had a patient whose memory was, perhaps, more intentionally selective. I made rounds on an elderly woman who sprained her ankle last night. The emergency room physician didn't feel he could send her home because she has no reliable help at home. Not that she lives alone. She has a grown son. He's just neither reliable nor helpful. I was hoping to send her home today, but she told me that it was just too difficult to walk, that she feared that she would fall at home, that she needed assistance just to walk a few feet. She'd feel better if she could have at least another day in the hospital. I relented. I wasn't sure the home services she needed could be arranged on a weekend, anyway. But, as I stood outside her door, documenting our visit, I heard her talking on the phone to her son. She wanted to go home today, but I told her we needed to watch her for a day or two longer. I guess what she really wanted was a break from her son.

    UPDATE: A reader wonders if the confused mother might have had Capgras syndrome. It's more likely she just forgot the details of me.

    posted by Sydney on 1/15/2005 11:09:00 PM 0 comments


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