Wednesday, March 05, 2014

Silent.

I had my first clinic this morning. Or I was supposed to, anyway. The office didn't actually open up my schedule because our secretary was worried I would end up with a full clinic and knows I am still getting a handle on how to use our EMR. I did see a few patients to help out some of the other docs and had one of the more unsettling interactions I've ever had with a patient.

She came in for a routine follow up for her blood pressure - she was higher than her goal at her last visit, so her doctor had started a few medication. This was a visit to recheck how that medicine was doing, as well as keep an eye on her diabetes. As I was talking about how her blood pressure was better than last time, but still a smidge higher than where I would like it, she began to tell me about how stressful her waiting room experience was today.

Apparently, a mom was waiting with her child, who was crying. I told her I understood how stressful a crying baby can be.

"No, no, no. There was something wrong with this baby. This baby obviously had some kind of mental defect, and was making this terrible noise. That poor mother."

"Hmm," I said, trying to move the conversation along.

"Sometimes, I think a pillow to the face might be the best solution. That kid was straight out of a Stephen King novel. Or Carrie. Or a Horror film. That poor, poor mother."

I really had no idea what to say. I was completely horrified that someone could even say such a thing. I guess I shouldn't be too surprised - this is not exactly a new idea. But to have someone say it directly to me - and mean it - was almost more than I could handle.  I thought about the many beautiful moms I know who have equally beautiful children with special needs, children whose right to life was being insulted right in front of me. I thought about my aunt, who has spent her entire career working hard to teach and love children like this. I thought about a good friend who has done the same - and is currently teaching a group of high school students with severe disabilities who I'm sure all love her because she takes them bowling every single week.

And I said nothing except "I'm sorry you were stressed. We'll recheck your blood pressure in a few months."

I honestly have no idea what I should have said. As a Christian physician, what should my response be? I feel like I would push back if I heard someone say this in a context when I'm not their physician (but maybe this conversation is proof that I would rather just avoid conflict.).  At that point, all I could think of was how much I wanted to finish the visit and get her to stop talking. But she just. wouldn't. stop. She kept talking and talking about how stressed it made her - to have to listen to this crying child. I would mention something else - why she needs an aspirin, what to do in an emergency, if she had her eyes checked, and she would answer me and then again get back to talk about the child in the waiting room.

As I was leaving clinic a few minutes later, I was sorry that I didn't find some way to affirm the beauty in all who are created in God's image without lecturing or condemning. Anyone out there with things you would have said? Any doctors want to chime in on how you react to patients who are saying things that are inappropriate?

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