June 10, 2010

A Return to Empathy

We worked with standardized patients yesterday on psychiatric illnesses - we were assigned one partner in our class and had to enter three rooms of patients with different "diagnoses". Here's how it works: we get our schedule of rooms (ours was, room 2, then room 3, then room 1), go up to the door of the first room, read the "chart" posted on the door, which has vital signs and a brief explanation of who the person is and why they've come in - similar to what you see in real doctors offices.

Our three cases were:
(1) a patient suffering from a depressive episode of bipolar disorder
(2) a patients suffering from mania that precipitated from treatment with an antidepressant for his long-standing depression
(3) a patient suffering from pain who was also addicted to her pain medication, who showed up randomly and demanded more medication.

Our third case was the toughest - the patient with substance abuse who the instant we walked into the room said "you're not my doctor. does that mean I can't get my pills?" we started a little bit shaky and it just spiraled downhill, with her getting defensive about everything we said, with us continuing to say "okay, we're trying to help, we just need to get through these questions..."

Finally we took a "time-out" - which we're allowed to take in select exercises, and talked with the psychiatrist attending. His advice was for us to
Regroup to a Place of Empathy

by saying something like:

We are so sorry to hear that you're in pain, it sounds pretty terrible. You've been on these medications for a while; we don't see any reason why you would not be able to get refills on them today. How does your pain interfere with your life? Maybe we can figure out some other ways to help with your pain..."

It was incredible the difference when we tried that - it felt like we were on the same team with her instead of mid-battle. I just liked that phrase a lot -

regroup to a place of empathy...


“If you just learn a single trick, Scout, you'll get along a lot better with all kinds of folks. You never really understand a person until you consider things from his point of view...until you climb inside of his skin and walk around in it.”

-Atticus Finch (from to Kill a Mockingbird)

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