I started this past Monday energetic. It is my split day. I love split days. I work in the hospital in the morning, my private clinic in the afternoon, and still get to go home at 5 pm. Some afternoons I have health professions education rounds. The latter has lately been my preferred indulgence; or escape. The variety is intoxicating but can be overwhelming. I teeter-totter between wanting routine and wanting unpredictability. I think everyone does.
It is nice when public transit is on time. When I was a child, I used to sit for an hour with amazement at how slow time is passing, and now that I am 35, every minute is eternally precious. Some tell me I am too young to think that. In retrospect, you’re never too young to think that. I often sit on the street car in the morning and wonder to myself if this is the day this trip takes 40 min or is it the 20 min day. I hate unreliability. I like consistency. Let me re-frame. I hate avoidable unreliability. It was my lucky day, the green lights were all synchronized, and we didn’t have to line up at union station behind 2 other street cars either. I hate unreliability. May be it is inevitable when so many rely on you.
I arrived at the hospital 20 min early. It even seemed as though the revolving door was waiting for me for efficient passage. The smell of coffee greets you at the door. Two administrative colleagues are waiting in line for coffee. I am greeted with not one, but two smiles and a “can I grab you a coffee?” I respond with alacrity. I run in to meet my first patient; a new patient. It is not my usual large operatory. It is a small one. The cozy one on a given day, the claustrophobic one on another. I wonder which it will be today, but, subliminally, I know I can deal with either.
We help the patient into the chair. They looked young. They were young. They were tense, I can sense it. I can hear the resistance in their voice. “I have already written down what you’re asking me” they said. “I understand, but that’s your record, and this is my exam” I thought. “well, I still have to review it for accuracy” I said. I did not communicate I realize. In fact, I think I began with “I don’t think you did”. They did in fact, but I missed the clandestine entry. To be honest, I never rely on their record, so I do my own anyway. Regardless, I should have said “okay, let me have a look”. Funny thing, it was the first time anyone had ever contested my routine. The patient was triggered. They became anxious, defensive, almost hostile. They didn’t want to be there. It took a lot of courage for them to be there. I can sense it. Their past was the culprit and it shaped their reaction. While I thought their outburst was not justifiable, I realized later I was wrong. For a moment, I ignored their mental health needs, even though they authentically expressed it to me. I remained calm, slowly adjusting my tone and attitude. Danielle Ofri tells us most patients are interrupted within 12 seconds and on average need only 92 seconds to share their story. Effectively, all I did was, just listen. They calmed down. They let me examine them even after exclaiming earlier their refusal. They told me I had great bedside manners. I really had them to thank for it.
(Photo: Dentistry during World War II viewed at the AGO)