On morning pre-rounds during my Methodist rotation, I was rushing to see all the patients in anticipation of the bolus of admissions that would be coming in soon. I spotted the gray and yellow cart near my patient’s door and opened the cart door while simultaneously trying to fit my handoff into a scrub pocket. I was about to knock on the door with my gown and gloves on, but my flimsy gown was falling so I ended up opening the door with my leg as I was retying it around my neck. The nurse down the hall briefly looked at me and smiled as if I was doing a whimsical dance. “And we don’t knock on doors anymore?” said Mr. W in his resounding voice and skeptical tone. Frozen in the doorway, my hand was still clinging to the doorknob as I straightened my back and offered a sincere apology. No reply from Mr. W except an annoyed gaze as he put his cereal spoon down. I let go of the doorknob and approached him. I asked him how he was feeling now but he looked away and gave no response. “What about your shortness of breath? Is it better now?” I asked. He finally responded, “Just wait until you see me walk down the hallway then you’ll see how short of breath I get.” I asked him if he had gotten a chance to walk the hallways yet and he hadn’t. He then asked me to leave his room and I obeyed.
Iqbal, MD, Rabia
"An Encounter with “the Difficult Patient”,"
The Medicine Forum: Vol. 22, Article 22.
Available at: https://jdc.jefferson.edu/tmf/vol22/iss1/22