We have been trained in medical school to talk to our patients when taking their histories - not to their family members or friends - whenever possible.
I ask 3 year olds where it hurts, 99 year olds with dementia what is bothering them. Even if your family member is a doctor or x-ray technician, I'd rather hear your story from you. Other people don't mean to, but they end up flavoring your story with their own interpretation of the situation. This can change how I think about your illness which does you no favours. It took me a while to develop any sort of strategy for dealing with friends and families who insist on talking for the patient. I tell them I appreciate their concern but that I really need to hear the information directly from the patient.
Ideally we have translators that are not related to the patient interpret languages we don't understand to avoid this kind of pre-interpretation. When interviewing patients through translation it can be difficult to watch the patient not the translator when the translator is speaking, and to speak directly to the patient. The first few times it feels awkward but eventually it does begin to come more easily.
Twice now I've had patient family members come up to talk to me but I haven't recognized them because I was more focused on my patient than them. I'm very proud of this fact.
Now switch to my friend Wanda who had been living in France. One Sunday morning she woke up feeling funky but not terrible. During brunch she became quite pale and dizzy. Her heart was racing and her husband kindly described her as looking like sh...
They went looking for a doc who took patients on Sunday. The closest was a few blocks away and on the third floor of an apartment building. He was located in the third circle from downtown, definitely should be respectable. His office smelt of cigar smoke, his breath of whiskey. Not surprisingly, Wanda was concerned and wanted to leave, but her husband knew she was sick and made her stay.
When this doc found out that Wanda did not speak French well, he ignored her completely and spoke only with her husband. "does she feel this?" etc. Absolutely awful. Then he grabbed a rocks glass off his shelf, looked in it, and handed it to Nick to have Wanda go pee in it.
After being handed the glass, the doctor stirred the chem strip in the glass, giving Wanda and Nick the impression he was using a swizzle stick and may take a sip at any moment.
Even though this doc made the correct diagnosis and cleared up Wanda's pyelonephritis, he gave the couple the impression that he was not a good physician.
By the way, the reason those family members wanted to talk to me was to tell me that my patient had really enjoyed the care they got and appreciated my advice. I'm hoping that this is something I can internalize and continue to do when my life as a doc gets busier and the temptation to talk to the 65year old daughter of the 85 year old tangential patient gets stronger and stronger.
(sorry if the details aren't perfect Wanda, I'm not used to telling true stories on here!)
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