STOP LYING TO ME!

No, it is not a heart-telling of an innocent girl for her lover – an unfaithful boyfriend. Instead, it is devoted to my patients whom I greatly respect and dedicate my time to. It turned out to be a heart-breaker when the truth finally was revealed: they did not tell the truth.

As a doctor, I always want my patients enormously benefit from my health service. To make it in such favor, indeed, there has to be a genuine relationship between doctor and patient, thus we call it trust which works on both ways. Patients (and families) are expected to put their faith on doctors. On the other hand, doctors believe that their patients will honestly tell their real (health) problems as they want to receive the best cure. Otherwise, this relationship will fail to demonstrate solutions. Not even close. It will rather build a new form of conflicts between them.

Supposedly, patient interview regarding to their symptoms plays a central role in clinical setting. In fact, it has to be prioritized among other diagnosing tools, such as physical examination and laboratory test, given its cheapest and easiest method to capture what is going wrong in patients. This technique, furthermore, enables both patient and doctor to utilize trust they’ve built to maintain an equal relationship. By doing so, patients are treated as human being with values and belief abounded to them. So it is not an ordinary provider-client kinship but co-workers in alliance who aspire patients’ well-being instead. At least, it is what my former teachers at med school always said to their students, “ You can figure out most of your patients’ disease by merely undergo a history-taking. That’s the key!”

This thought came across my mind, all in sudden, after two unfortunate events had previously happened in my practice. The first case was a teenager, around 15 of age, unmarried, presented with abdominal pain, massive nausea and vomit, and couldn’t defecate for over a week. Her belly I examined was a little bit bloated. She came along with her mother and relatives. Given all her signs and symptoms, I subsequently ordered for laboratory examination and ”three-way positions” abdominal x-ray due to my high suspicion of obstructive intestine problem. Before long, the x-ray result came first and it told me nothing wrong with her intestine. No obstruction, no abnormal free air or liquid outside of her intestine, everything was just seem fine. Then the laboratory exam result came on my hand, and I could not believe what I saw. Her pregnancy urine rapid test: positive! I can not imagine how can I be so stupid for not giving it an utmost concern. It was surely a hiperemesis gravidarum or also known as severe morning sickness which often occurs in early period of pregnancy.

The second came in just a few weeks later. This time a female, 25 years-old, again, unmarried, came with chief complain of unbearable abdominal disturbance. She was so weak and barely had proper meal frequency and quantity due to her loss of appetite. Have I had an inconvenient experience with my previous typical patient, I asked this young lady further about her menstruation cycle. She convinced me that she had regular periods and never engage in sexual intercourse. Ever! Her parents and relatives (who came along with her) gave me a “Doc, I can not believe you rose that kind of question” and “She’s a virgin!” look on their face, so I just smiled and thanked them for all information they gave. However, I didn’t easily believe in their statement that I suggested the laboratory to undergo a pregnancy rapid test. And you guess what! For the second time my patient was my heartbreaker. She was positively 6-week pregnant! Praise the Lord that I had not given her any harmful medication before her pregnancy status was revealed.

Not to mention how hard it was to eventually break this ‘bad news’ to family and patient in both cases, It imposed great confusion in me why patients often fail to disclose their real health problem to doctors. Do they think that we (health professionals) won’t figure it out or just too innocent to care about it? So what do they really expect from us? The best care and treatment you said but they keep information which markedly affect our interpretation on their health.

I am fully aware that patients have right to keep their secret, whatever it is. On the other hand, doctors have to respect patients whatever their intention is. But it is worth to notice that in order to provide the best care for patients, doctors may rise some sentimental questions. Of course you can conceal the answers as it is your right, but not before you know what it will cost you. In my patients’ case for instance, I may had administered harmful  medication or examination (like x-ray!) to the patients because I hardly knew it was too risky for them.

This experience, nevertheless, has fuelled my motivation even more to gain trust from patients. Perhaps, in the future I have to employ more efficient method in maintaining good rapport with my patients and provide the best circumtances when ask such emotional yet problematic issue which may affect my clinical decision. Yes, even in emergency setting!

Therefore, It is clear, if you think that doctor-patient relationship is a casual one. You are totally wrong. We have the most intimate bond (somewhat complicated) that you’ve ever imagined. We are partner,  indeed, who strive toward the best health outcome in patients.

Right on. So, stop lying to me, Love.

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