Saturday, December 18, 2010

The Doctor Who Said Yes

It's a great skill, talking to patients. As with all great skills, the best doctors - or other healthcare professionals - make it look very easy.

To the patient, it should seem like a friendly, though focused, chat. The doctor is - hopefully - information-gathering, possibly diagnosing, and eventually coming to a shared management plan that the patient understands and agrees to.

Near the beginning of the consultation the doctor needs to find out lots of information from the patient. To show they're taking it in, doctors show "active listening" such as nodding, or repeating back what the patient has said in different words.

"It started about three weeks ago," says the patient.

"So, it began towards the end of November?" says the doctor.

That kind of thing.

But it's very easy for doctors (or nurses, or any other healthcare professionals) to get into a habit of saying one thing in reply, whatever the patient says to them.

"So I climbed up the stepladder,"


"and then I balanced on the top,"


"but then I wobbled and crashed to the ground."


There was a nursing student I was working with recently who was a man with a very deep voice. Whatever I said, he immediately said "Okay" but the O bit was a deep, slow rumble from the depths of the Earth. "Ooooooooooooookay".

As it was a roleplay about mental health issues, and as I was baring my soul rather (or the soul of the woman I was playing, anyway), it got VERY tedious after about the seventeenth time.

The example I usually give as to why it's not a good idea to just keep saying the same thing without thinking, is of once when I had a student who said "Brilliant" to everything I said. I was telling her the story of what was going on, finishing with - "and then my mother died."

"Brilliant" said the student, cheerily.

This week I came across The Doctor Who Said Yes.

At some point he had got into the habit of saying "Yes" to anything the patient said. And it wasn't just a quiet, acknowledging kind of "Yes". It was the kind of Yes you say when your team has just beaten their worst rivals by six goals to nil.


Now, this was a practice exam, and I was playing a patient who was asking the doctor to do something illegal - I can't tell you what, but it was the doctor's job to tell me clearly and firmly that it was illegal and he couldn't do it.

But, with The Doctor Who Said Yes, the conversation went a bit like this. And for the purposes of this blog post, I will call the illegal thing The Illegal Thing. Hope that's clear!

"So, would you be able to do this Illegal Thing for me, doctor?"


"Ah, that's great. Could you do it before Christmas?"


"Because it's really important to me. You're definitely willing to do it?"


I just knew he wasnt' listening to what he was saying so I tried a different tack.

"So, that's agreed then. So how are we going to set about it?"

"YESSS - - - no, sorry, what did you say? Oh, no, I'm afraid I can't do it, that would be completely illegal."

"But you've just agreed to it three times."

"Oh no I didn't!"

Well, it being panto season and all that, I was very tempted to go down the "Oh yes you did!" route but I left it to the examiner to explain it to him, in the hope that he won't do it again.

Ohhh, I do love this work. It's never less than fascinating.


Blogger Silverback said...


7:44 pm  
Anonymous Gareth said...


7:53 pm  

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