Patient's home after a sleepless night:
Another night of fits and starts — the pain in my back woke me every time I turned in bed. I am finally getting in to see my doctor — it took three weeks — and now the pain is interfering with everything I do, from getting out to bed, to driving, to work, to spending time with my family. My wife and I are arguing more — I don't seem to have much patience these days. And I am snapping at my kids. People at work notice that I am irritable too — my boss called me out on it the other day.
This is a common scenario — we need to recognize that often patients are compromised, to some degree, before even stepping foot into our office.
The doctor's office — take one:
I arrive at the doctor's office for my appointment and there is a line of patients at the front desk. My back is killing me and it hurts to stand. I can feel my anger starting to rise. It's finally my turn and the receptionist greets me, but then answers the phone. "Listen, I've been waiting for over 10 minutes and now you take a call ahead of me," I say with an angry tone. But she's busy dealing with the call and gives me an irritated look. "I'll be with you in a moment. Please just be patient." (Patience is the last thing I feel). When she finally finishes the call, she gives me a meek apology and I am sent to the waiting room.
There are now numerous factors that add to the distress of the patient — pain, having to wait, being put "on hold," and not being seen on time. All this creates a threatened state in the brain, making it very difficult to self-regulate, thus the impatience and the angry tone in his communication. The patient is likely to be more inwardly focused on his own needs and level of distress, making it extremely difficult to focus on how he might be impacting others (like the office staff).
Finally, it's my turn to be seen. I am taken back to an exam room and the assistant lets me know the doctor "will be right in." Fifteen minutes pass — still no doctor. Don't they realize how much pain I am in! At 10:30 a.m. the doctor finally comes into the room. I blurt out that I have been waiting almost an hour since I arrived at the office. "I am sorry," he says, sounding defensive, "but it has been a really busy morning. I was delayed earlier at the hospital seeing patients." He listens to my complaints, does an exam, then suggests that I get some physical therapy and prescribes me some pain medication. The visit is over in 10 minutes and I am rushed out the door. I don't really understand what is wrong with my back, but I am relieved to get some medicine for the pain. I have such a busy schedule I don't think I can fit in physical therapy. The doctor told me I should come back if my pain does not improve over the next three weeks. So I will wait and see if the pills work. I am feeling a little hopeless and wonder if my back will ever get better.