Sometimes Patients Make You Feel Bad

At the hospital, I meet many new patients every day.  Sometimes, I introduce myself as "J" and other times, I'm "Dr. Llo."  There's not clear rhyme or reason to when I pick which title, but I tend to use "J" with the very young, the very old, people who look like they might be fun to get a drink with were we meeting under different circumstances, and always with patients who are themselves physicians.  In contrast, I make sure to use "Dr. Llo" with patients who are angry, unruly, or have already called me "Nurse" (these patients are usually talking loudly about inane stuff into their cellphones and say things like 'hey, hang on, my nurse just walked in'...um, yeah, I didn't go to 4 years of medical school, pass three national licensing exams, and give up my twenties to be called "nurse"). 

Tonight, a patient came up from the Emergency Department after breaking his tibia falling off of a ladder.  He was a relatively healthy, middle-aged guy who had been painting his house prior to putting it up for sale.

So, after putting in a few orders for pain medicine and a meal tray, I went to the patient's room.  All new arrivals to the service need to be checked out by a doctor following admission, plus I figured a little TLC would smooth over what I'd heard was a long wait in the ED.

As it so happens, this patient did something sort of boldly obnoxious that had not yet happened to me in my almost-10 months of being a doctor.  And he really, really irritated me in doing it.

You see, I walked in and--based on my split-second assessment of his posture, his age, his mood, etc--decided that I would be "Dr. Llo" in my interactions with him, because he just looked a little bit surly. 

"Hi Mr. SoandSo.  My name is Dr. Llo.  I'm one of the night doctors on Orthopedics" [aside:  I'm covering Ortho this month].

"Who are you?"  he asks.

"I'm Dr. Llo.  I'm one of the night doctors on Orthopedics."

"And what is your first name?"

Obviously, I don't love this question since I'd already decided that I wanted him to call me Dr. Llo, but I answered, hoping my ever-so-slightly reluctant tone of voice would clue him in to the fact that I've not invited him to refer to me by my first name--especially since I was referring to him as 'Mr. SoandSo'.  "My first name is J," I told him.

And then we talk...about his long wait in the ED, the 10 feet of his house he has left to paint, the plan for his operative tibial repair.  And the whole time, he's calling me J, in a way that feels simultaneously aggressive and dismissive.  I was so mad...and what kills me is, if he was just a little less threatening to begin with, I probably would have introduced myself as J in the first place!