tag:blogger.com,1999:blog-5628616877664827988.post4109672801516079045..comments2024-02-17T14:50:54.001-05:00Comments on Notes of an Anesthesioboist: "C'mon, Dear" (or, How Many Buttons II/Revenge of the Buttons/Buttons Redux/Son of Buttons)T.http://www.blogger.com/profile/09208990104460795917noreply@blogger.comBlogger23125tag:blogger.com,1999:blog-5628616877664827988.post-64863626033038024512008-10-16T22:29:00.000-04:002008-10-16T22:29:00.000-04:00Anna - not sure about that one. Perhaps unintenti...Anna - not sure about that one. Perhaps unintentional, or perhaps, avoiding the possibility of offending? <BR/><BR/>You're so right - there is indeed that infantilizing tendency, albeit well-meant, I think, by most. I'm glad the NY Times brought it up. It certainly made me re-examine my own habits and try to do better.gelci72https://www.blogger.com/profile/01868356563355386773noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-21756054800404297712008-10-16T17:35:00.000-04:002008-10-16T17:35:00.000-04:00When my mother was hospitalized recently, she was ...When my mother was hospitalized recently, she was constantly referred to as "young lady" and, occasionally, "gorgeous" or "sweetheart." (And we don't even live in the South!)<BR/><BR/>I'm quite sure that the doctors and staff weren't trying to be demeaning, but it grated on our whole family just the same.<BR/><BR/>I think as a society we often infantilize older people, especially women. Would you call a 35-year-old male patient "young man"? Patients are often powerless anyway, and it seems like these terms of endearment reinforce - even subconsciously - that the staff is all-knowing and powerful, and the patient is the one who's condescended to and has to just submit to it all.<BR/><BR/>On a scale of 1 to 10, I guess the name-calling falls near the lower end. But it's something that bothers me just the same.<BR/><BR/>Re your not-so-charming gentleman: You know, most normal people in this situation would have apologized and/or backed off once they were aware that you didn't appreciate the condescension. The fact that he wouldn't leave it alone suggests that he really did see it as a power thing. Continuing to needle you about it is, IMHO, rude and sexist and inappropriate. I think you had every right to call him on it.<BR/><BR/>I deal with physicians fairly often in my own (health care communication-related) line of work, and I'm not really comfortable calling them anything other than "Dr." Many of the younger ones often leave off their title when they introduce themselves to me, so my impression is they're not particularly obsessive about being called by their title. But I still feel I should be respectful. I would only use the physician's first name if he/she asked me to do so. ("Oh, don't call me Dr. Schweitzer, it makes me feel so old. Just call me Al.")<BR/><BR/>I have noticed that my doctor doesn't use my name at all. No first name, no Ms. XYZ, just... nothing. So what's up with that?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-51628676413360300732008-10-15T21:01:00.000-04:002008-10-15T21:01:00.000-04:00LOL! :)LOL! :)T.https://www.blogger.com/profile/09208990104460795917noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-8254610827074080582008-10-15T17:38:00.000-04:002008-10-15T17:38:00.000-04:00Um, that's "Sir Mister Doctor Anon" to you, please...Um, that's "Sir Mister Doctor Anon" to you, please. <BR/>:)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-35782180747437641452008-10-13T16:23:00.000-04:002008-10-13T16:23:00.000-04:00That is true, Anon - rarely do I ever anesthetize ...That is true, Anon - rarely do I ever anesthetize a friend or a friend-of-a-friend!<BR/><BR/>In those rare instances, of COURSE they call me T. rather than Dr. T., as per our usual customs. :)T.https://www.blogger.com/profile/09208990104460795917noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-75004122646976892272008-10-13T14:20:00.000-04:002008-10-13T14:20:00.000-04:00I think a lot of people equate a sense of being en...I think a lot of people equate a sense of being entitled to respect/deference with power issues. People perceive a power dynamic in play whenever you get into hierarchy/social status. I don't think it makes you power-hungry to want to benefit from all of your hard work and success. "Deference" is more of an English social value than an American one. Just go to a town board meeting in any American town to see what I mean!<BR/><BR/>Americans are a crazy bunch. Some Americans will defer to the MD and some will say an MD and $1.25 will buy you a cup of coffee. Most will probably call you whatever you want to be called as long as they get good care.<BR/><BR/>Also, maybe you have a different relationship to patients as an anesthesiologist than some of your colleagues in other specialties do. It's not unheard of for doctors to be friends with longtime patients.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-46549580813230979602008-10-13T13:33:00.000-04:002008-10-13T13:33:00.000-04:00I am reminded that two comments ago I should have ...I am reminded that two comments ago I should have written "As I said" instead of "Like I said," technically. <BR/><BR/>Kim - I can be obsessive compulsive about grammar errors too, even informal/conversational writing, especially because I tend to point the grammar finger at others myself. :)T.https://www.blogger.com/profile/09208990104460795917noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-61783034510260798272008-10-13T12:56:00.000-04:002008-10-13T12:56:00.000-04:00PJ - you just reminded me: I do call everyone her...PJ - you just reminded me: I do call everyone here on this blog by his or her first name, as they do me, because in this forum I guess we are all sort of blog-pals, and I am certainly NO ONE's doctor.<BR/><BR/>But you also reminded me: all the nurses, paramedics, scrub techs, other docs, housekeeping staff, etc. all address me by my first name, at my insistence. I am NOT their doctor; we are colleagues and friends. (Though sometimes they still call me Dr. T anyway, then I try to keep encouraging the friendlier form of address amongst ourselves...)<BR/><BR/>I have to say I smiled at your story of having admonished the intern. I think we've all put our feet in our mouths like that, either as interns or later in our careers, and we do deserve to get called on our tactlessness, whether we're clueless docs, nurses, paramedics, or whatever! You did her a favor... :)T.https://www.blogger.com/profile/09208990104460795917noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-24867740851294584842008-10-13T12:30:00.000-04:002008-10-13T12:30:00.000-04:00I confess to being on both sides of this issue, my...I confess to being on both sides of this issue, myself.<BR/><BR/>As a paramedic and later an organ donation coordinator, I always address patients and families as Mr./Ms., correcting that only at their insistence (rare). I generally the physicians and surgeons with whom I've worked extensively by their first names, and less familiar ones (and those taking care of me) as Dr. Soandso.<BR/><BR/>The one exception was when I was in the ED with a pulmonary embolus (a complication of a tibial plateau fracture). The ICU resident and intern who came to admit me happily informed me (not knowing what I do for a living) that such a condition "is usually diagnosed on autopsy!" Already a little stressed out (and, in fairness, still a little hopped up on pain meds) I growled back "Listen, sweetheart...<I>I</I> know that. But your next patient isn't going to take it quite as well, so you might want to consider your bedside manner a little, ya think?"<BR/><BR/>Don't know if it stuck or not, but I felt better, and I never saw her again.PJ Geraghtyhttps://www.blogger.com/profile/15883503105104340655noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-34648778466694949252008-10-13T11:41:00.000-04:002008-10-13T11:41:00.000-04:00Perhaps coming from a culture in which respect and...Perhaps coming from a culture in which respect and deference are expressed linguistically, I have never gotten used to the more informal American habits of people calling each other by their first names without agreement.<BR/><BR/>I prefer being addressed as doctor by people who are coming to me for that professional capacity. I don't know why everyone keeps mentioning power as if doctors are these power-hungry arrogant people all the time. It's a PROFESSIONAL title. We all went through more years of grueling study, labor, and academic pain than most, and I think the title is EARNED and should be respected.<BR/><BR/>Perhaps there will come a day when patients will no longer ASSUME when they see my face that I am a student or a nurse. After all, they never assume that about my male colleagues or insist on calling THEM by their first names. When that unlikely day comes, I may revise my preference for a more formal form of address in PROFESSIONAL situations. Nothing to do with power - just respect. Like I said, I and most of my colleagues usually continue to call my patients "Mr." or "Mrs." so-and-so. I think people who are not BUDDIES have a habit of being entirely too familiar with each other in this country.<BR/><BR/>BTW, that said, most of the time when nervous patients are trying to remember what the heck my name was as I'm applying monitors on them before an anesthetic, and they've given me permission to use their first names, I usually repeat, "I'm Dr. T, but feel free to call me T. (I give them my first name) - it's easier to remember."T.https://www.blogger.com/profile/09208990104460795917noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-63378542295427149932008-10-13T11:19:00.000-04:002008-10-13T11:19:00.000-04:00I am conflicted about the use of "Doctor" as a for...I am conflicted about the use of "Doctor" as a form of address. As a patient I sometimes address my doctors as "Doctor" and sometimes by their first names. In my experience, some doctors insist upon the honorific for power reasons, while others do it to reinforce the professional nature of the relationship. <BR/><BR/>I don't think it makes you a not-nice person to assert yourself in a strong, direct way. Aren't the majority of med students females now? Times are changing and today's children are used to seeing female doctors. Just a generational thing, I think. I wonder if on a different day you would have just laughed this incident off.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-60432010486731585352008-10-12T16:40:00.000-04:002008-10-12T16:40:00.000-04:00I live in an area where people are called sweetie ...I live in an area where people are called sweetie and dear a lot, no matter what their age or gender. It used to strike me as odd, at the very least, but I don't seem to mind it anymore. <BR/><BR/>I laughed at Bardiac's comment because every time a physician introduces him or herself as "Dr. So-and-so," I'm mightily tempted to respond with, "Nice to meet you. I'm Dr. M." I don't mind calling them "doctor," but I do think it's disrespectful for them to call me by my given name without my permission. <BR/><BR/>Having said that, I may well be a hypocrite since I expect my students to call me "Doctor" or "Professor," but I generally call them by their first names. Most of them are 18 or 19, but some of them are older, and a few are old enough to be my parent or even my grandparent. I currently have a student (older than I am) who signs her emails as "Ms. K," and I do not call her by her first name. I don't know...I think it's a little different from a doctor-patient relationship because I am required to maintain a position of authority in classroom. I consider my physicians to be experts, but not authorities over me. (I don't consider myself to be an authority over them, either, although I know some patients do.) <BR/><BR/>I very rarely get called by my first name in the classroom, but I do regularly get called "Ms. M," or worse, "Miss M." I find it irritating, if for no other reason than that it makes me feel like a kindergarten teacher, but I figured it was just because they were coming out of high school where their teachers' appropriate titles were Mr. and Ms. However, my male colleague recently pointed out that students never call him "Mr. R." He thinks it's reflectlive of an underlying problem with women in positions of authority. I explained that some students who refer to me as Ms. are quite respectful in every other way, but he stands behind his analysis. Tough to say...<BR/><BR/>I think you handled the situation with your patient just fine. You are the expert in that environment, and he was trusting his life to you in a very real way, whether he fully understood that or not. You have every right to be addressed courtesously, especially given that you return the favor.~M~https://www.blogger.com/profile/14432094649246413401noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-87453606424396694682008-10-12T12:48:00.000-04:002008-10-12T12:48:00.000-04:00i had a patient that took to calling me by my firs...i had a patient that took to calling me by my first name. it irritated me no end, but i let it slide.<BR/>he complicated and came close to dying. after all the dust settled i was so glad i just let it slide. in the greater scheme of things it suddenly seemed trivial.Bongihttps://www.blogger.com/profile/12918640034313468627noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-18743055709882899292008-10-12T12:20:00.000-04:002008-10-12T12:20:00.000-04:00Oops. I meant "still calls me Dr. D."I can't type...Oops. I meant "still calls me Dr. D."<BR/><BR/>I can't type today...dr_dreddhttps://www.blogger.com/profile/02412828381611806365noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-12879996340833169922008-10-12T12:19:00.000-04:002008-10-12T12:19:00.000-04:00Hi, Dr. T. I have exactly the same interaction wi...Hi, Dr. T. I have exactly the same interaction with my own internist. (Also a Dr. T) The same was true with my previous internist in another city. Even a GI family friend who has known me since I was 12 since calls me Dr. D.<BR/><BR/>Love your blog!dr_dreddhttps://www.blogger.com/profile/02412828381611806365noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-17338809011910368362008-10-12T08:42:00.000-04:002008-10-12T08:42:00.000-04:00OMDG - *Sigh* Welcome to the female-doctor-assumed...OMDG - *Sigh* Welcome to the female-doctor-assumed-to-be-a-nurse club. And I did smile seeing the next part of your comment...<BR/><BR/>Kathleen and Catarinolas - thanks! Lots to think about...<BR/><BR/>Bardiac - you're absolutely spot-on to point out the power differential in any medical interaction. <BR/><BR/>I can only comment on my own experiences and observations. I never address patients by their first names without asking for permission first (but then, I usually never address people by their first names without explicit or implicit acquiescence anyway, because my parents brought me up to ask first). Moreover, most of my colleagues consistently address patients as "Mr." or "Mrs." so-and-so too. Maybe we're all "old fashioned" that way, and still believe in common courtesy? <BR/><BR/>There is a practical reason why I DO ask for aforementioned permission, though. When someone is coming out of anesthesia, it's been my experience that they respond more readily when called by their first name than by the more formal "Mr." or "Mrs." so-and-so. Those responses can be very important for the safety of the wake-up. So I always make sure to try to ask ahead of time if it's ok if I use patients' first names. <BR/><BR/>My own primary care physician always called me "Dr. T," until I asked her to please just call me T. But I feel I should continue call her "Dr. Y." She's my DOCTOR, not my pal.T.https://www.blogger.com/profile/09208990104460795917noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-64887046779561000352008-10-12T06:23:00.000-04:002008-10-12T06:23:00.000-04:00once again, your post helps me to think how I inte...once again, your post helps me to think how I interact with my patients.<BR/>quite frequently, when the induction agent is being administered, I'm using affectionate terms (in my opinion) with my patients, in an attempt to reassure them, not having the faintest idea that this may have a counterproductive action...<BR/>thank you anesthesiahumanizer! :)<BR/><BR/>I'd like to share with you the passage that I've been meditating about (Deut 30:11-16)<BR/><BR/>"The Offer of Life or Death <BR/> 11 Now what I am commanding you today is not too difficult for you or beyond your reach. 12 It is not up in heaven, so that you have to ask, "Who will ascend into heaven to get it and proclaim it to us so we may obey it?" 13 Nor is it beyond the sea, so that you have to ask, "Who will cross the sea to get it and proclaim it to us so we may obey it?" 14 No, the word is very near you; it is in your mouth and in your heart so you may obey it. <BR/> 15 See, I set before you today life and prosperity, death and destruction. 16 For I command you today to love the LORD your God, to walk in his ways, and to keep his commands, decrees and laws; then you will live and increase, and the LORD your God will bless you in the land you are entering to possess."<BR/><BR/>today I am thankful that Someone tells me to choose Life and Love... and that they are within my reach!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-2196018757474350892008-10-12T00:28:00.000-04:002008-10-12T00:28:00.000-04:00Sounds like you handled this really well.It seems ...Sounds like you handled this really well.<BR/><BR/>It seems like there's an interesting power differential being played out, no? <BR/><BR/>Do patients feel empowered to ask you not to call them "dear" or to ask you to use their surname?<BR/><BR/>A little example: I needed some travel vaccines, so I had to go to the clinic for travel vaccines rather than the doctor I've seen before. The doctor there introduced himself as "Dr. So and So" and then proceeded to call me by my first name (which is legal, but not what I use by choice, ever). I needed the vaccines, so I didn't say anything, because that's how serious the power differential is, and I didn't want him messing things up for me. (That was the least of his rudeness, but at least stays on topic.)<BR/><BR/>Is there a conscious power play in addressing patients by their first name or as "dear" (which seems the case with the patient you describe). Or is there something else in play? It seems like the choice is sort of insidious because it can be "excused" as mere friendliness, so it's all the harder to work against.Bardiachttps://www.blogger.com/profile/11846065504793800266noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-83949448092037392472008-10-11T14:49:00.000-04:002008-10-11T14:49:00.000-04:00Great post T! I read that NYT article and it did ...Great post T! I read that NYT article and it did make me rethnk how I interact with the elderly. Here in the south, many times those "endearing" nicknames usually have a double meaning... <BR/><BR/>You also don't want to be on the receiving end of "...well bless her heart". 95% of the time, it is not a blessing.Kathleenhttps://www.blogger.com/profile/08564625674866397216noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-29933945967061191132008-10-11T08:12:00.000-04:002008-10-11T08:12:00.000-04:00So true. The other day a patient commented as I e...So true. The other day a patient commented as I entered the OR, "Oh I get ANOTHER NURSE??" I said, "Actually, I'm a medical student," and he gave me a funny look, like I'd been rude to correct him. Well, whatever. I'm *not* actually a nurse, dammit! <BR/><BR/>Also, since you wrote a post on my post about anesthesia a few months back, I thought you might find it interesting that I've been spending a fair amount of time with the anesthesiologists during some of the surgeries where there's no room for me to scrub -- and it's been REALLY interesting. I'm not quite ready to admit I was wrong about your field in public or anything, but I thought you might be amused. Now, you can write a post about the hubris of medical students. ;-)OMDGhttps://www.blogger.com/profile/17937425894428802591noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-27527705713450269902008-10-11T07:58:00.000-04:002008-10-11T07:58:00.000-04:00LOL! I do the same thing. I hate it when I've le...LOL! I do the same thing. I hate it when I've left a typo up.<BR/><BR/>Thank you very much for stopping by. I've been doing a lot of thinking about the language we use and how it not only reflects our thoughts/concepts but also defines our reality for us...maybe it's the English major in me...so this whole incident stayed with me for a long time.<BR/><BR/>On related subject, I LOVED your post on nurses describing themselves as "just" nurses, and how ill-suited a description that is to what real nursing entails. Bravo, and thank you!T.https://www.blogger.com/profile/09208990104460795917noreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-87862629151195664622008-10-11T01:52:00.000-04:002008-10-11T01:52:00.000-04:00Because I am obsessive compulsive and because I do...Because I am obsessive compulsive and because I don't want to look dumb, please note the above word should be "appropriate" and not "appropriated".<BR/><BR/>Thank you. : DAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-5628616877664827988.post-57596639673159845762008-10-11T01:50:00.000-04:002008-10-11T01:50:00.000-04:00Spanish has a similar idea in that the use of the ...Spanish has a similar idea in that the use of the Usted form of any verb , or even the word Usted, is a sign of respect, a formal way of addressing any adult and you can never go wrong with it.<BR/><BR/>It isn't something an adult would use with a child, so it doesn't have the "dearie" or "honey" aspect to it.<BR/><BR/>Frankly, I think you did just fine in this interaction. The patient was being disrespectful and dismissive of your ability, your years of education <I>and</I> the fact that you were female.<BR/><BR/>You set the professional relationship in the proper perspective and you did it in an appropriated fashion.Anonymousnoreply@blogger.com