Agree with above medical student’s assessment.
The satisfying addendum by attendings to a well written assessment and plan.
I stood there and did my best to explain what we felt was going on, our impression of the possible causes, and our investigations around them, some of which simply could not be done tonight.
The family was not satisfied. “We want answers. Now.” From there came the questions. “Why must it happen later? Why is this test being done? Why will you not take our complaints seriously?”
I reassured everyone that we were checking every avenue, that there was a method and reason behind the tests and explained as plainly and thoroughly as I could. More importantly, I tried to address their concerns up front and with honesty.
Nothing could appease my audience. I could feel the growing dissatisfaction in their tone, the tension that my presence brought to an obviously well meaning and concerned family.
However, standing there, the focus of every pair of eyes in the room, I began to feel the churning of my stomach, the pounding nudge in my chest, and the burning flush of my face. I had become an enemy in the room, an obstacle between the vocal family who wished to be heard and heard by none other but the doctor himself. It was time I excused myself.
I returned quickly to my attending and explained the situation: I had attempted my best to alleviate their anxiety and answer their questions but I had failed. I needed help.
When he arrived, even then the discussion presented challenges. It took a lot of work to come to an agreement and understanding.
The communication channel is open both ways. The solution to defusing a situation like this is always to make people feel that they have been acknowledged, that their concerns have been understood, that they are not an afterthought in this already complicated system of care. Even with that in mind, the discussion can be challenging. It really takes a lot of patience, perseverance, and thick skin to build up the rapport needed in difficult situations.
Perhaps with time and experience, I can find a way to finally manage this myself. For now: please do not shoot the messenger.
Were you ever involved in a confrontation? How did you deal with it?
Invest in building your network. It will pay dividends in the future.
Five doctors - a general practitioner, a paediatrician, an internist, a surgeon, and a pathologist - decided to take a weekend trip and go duck hunting.
Soon after they were in their duck blind, a bird flew over and the general practitioner said, “I think that is a duck,” and so he took aim and slowly squeezed the trigger…but then he lowered his rifle and said, “I better get a second opinion.” “Back of the line,” said the group.
Another bird flew overhead and the paediatrician said, “I think this one is a duck too,” and he took aim…only to lower his rifle and say “but that duck might be a mother have baby ducks somewhere.” “Back of the line,” said the group.
A third bird flew overhead and the internist shouted, “That looked like a duck, etiologically classified as Animalia, Chordata, Aves, Anseriformes, Anatidae, based on the size, I am judging it to be a male, with an estimated weight of…” Before he could finish his thorough assessment or raise his rifle, the bird was gone. “We do not need to hear all that gibberish. Leave it to me,” said the surgeon.
Then a fourth bird flew overhead and the surgeon immediately raised his rifle and with no hesitation shot the bird out of the sky. He then turned to the pathologist standing next to him and said, “now go find out if that was a duck.”