THE LAST WORD
My Favorite Patient of the Day
Defiant, defensive and depressed, he was the highlight of my day.
Fam Pract Manag. 2011 May-June;18(3):44.
Simple moments in our professional lives can often turn into life-long memories, giving us the utmost satisfaction and reminding us that our work is not in vain. I experienced one such beautiful moment in my residency practice this morning. It involved a 15-year-old boy (let's call him Casey) who has depression, attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder and many other diagnoses. His mother had been struggling to keep him out of trouble at school, and she tried to get him counseling but was unsuccessful because of insurance limitations.
So I met with Casey and decided to do some baseline counseling myself. After all, someone had to do it. He had seemed so sad the last time I saw him and had said he hated “everything and everyone.” That comment had left me worried about him for days. I decided to bring him back to make sure he was doing all right. He came in today with his mother.
During the session, he told me that he was enrolled in an emotional support class at school. He did not think it was a useful class. The other day the teacher was explaining different emotions using drawings of faces – happy faces, sad faces, angry faces and so on. Casey felt it was a waste of time, started fidgeting (he has ADHD, after all) and ultimately got into trouble for distracting the class. He was sent to in-school suspension for the day. When I asked him whether he felt bad about it, he said, “No, I helped everyone in that class. They were bored too!”
I almost chuckled when he said this. I commended him for being honest but explained that he has to be respectful to people around him. What his class was discussing could have been helpful to him, I said, explaining that when we understand our emotions and why we have them, that gives us the power to change the way we react to our emotions.
“But I already know them,” Casey replied.
I decided to test him. I asked if he could guess what my emotional state was. “Am I sad? Angry?” I asked him. “You say that you know how to read people's emotions, so tell me, what do you think my emotion is at this time?”
Casey looked into my eyes and without hesitating said, “Caring.” He paused for a very brief moment and then continued, “That's what I think your emotion is.”
My intern and I exchanged surprised yet happy glances. This young patient, who normally responded with defiance and defensiveness, had just paid me a compliment! It gave me a glimmer of hope for his future, and it reminded me that our patients – even the most troubled ones – really do recognize when we care.
Casey's visit was the highlight of my day, one of those moments to be treasured forever. Although these moments are rare and unexpected, they are worth more to me than anything of material value in this world.
WE WANT TO HEAR FROM YOU
The opinions expressed here do not necessarily represent those of FPM or our publisher, the American Academy of Family Physicians. We encourage you to share your views. Send comments to email@example.com, or add your comments below.
Copyright © 2011 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact firstname.lastname@example.org for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions
More in FPM
Related Topic Searches
MOST RECENT ISSUE
Access the latest issue
of FPM journal
The Adolescent Health Consortium Project has clarified clinical preventive service recommendations for adolescents and young adults.
Here's how to succeed in the four performance categories of the Merit-based Incentive Payment System.