I have a difficult patient.
Ok, I have many difficult patients. Attendings like to give me the difficult patients. I'm not sure why, but I have a few theories. 1) I'm nice but firm. 2) I'm a girl. 3) I don't complain about it. I'm not sure which of those theories factors most into the equation, but the end result is that I have a lot of difficult patients.
The positive side to my patient panel is that I occasionally make a break-through with a patient. Almost always, my patients at least start to prefer seeing me as opposed to the other fellows (we don't always get to see our own patients, due to scheduling conflicts). So, even if they hate me, they hate me less than they hate the others! Ah, the simple victories.
I have a patient - Mr. S. Mr. S is HIV+ and in an electric wheelchair. I'm not sure why he's in a wheelchair, because he can walk. I haven't dug deep enough in his chart to figure out why he has chronic leg pain. Maybe from HIV neuropathy. Maybe from HIV-associated bone destruction of his hips. I'm not sure.
Mr. S is difficult because he has a lot of psychiatric issues as well as his chronic pain. He gets a lot of narcotics to deal with the pain. He also takes a lot of anti-depressants and other psych meds. As a results, he can be drowsy and not a great historian. He's also a little whiney and demands a lot of attention.
Mr. S has outfitted his wheelchair with solar panels. I had never asked him about the panels, because he was never my patient. Until now. About 3 months ago, he got moved to my patient panel (see the above 3 reasons as to why). So, half way through our appointment, I asked him, "Are those solar panels?"
Long story short, he went into how they work, what they do, etc. Smart guy. They don't power his wheelchair. Oh, no. They power his sound system. Yes. Yes, I said sound system. Mr. S always rolls with music. He has a receiver and speakers that are rigged to an MP3 player. You can always hear when he's arrived to clinic. This week, he entered to Green Day and waited with Jimi Hendrix. He always turns the music off when he comes into the see the MD, though.
Next, I asked him what kind of music he likes. He said all kinds, and he explained that his current MP3 player got run over by his wheelchair, but still seemed to work. Mr. S actually got run over by a car a few days prior, but he still seemed to work, too. Fractured ankle, but doing ok.
He pushed play, and Tupac filled the room, singing about California Love. My favorite. So, I did the rest of his physical exam with Tupac jammin'. At that point I came to a conclusion:
All patients should come with a soundtrack.