Figure. Photo by: Anson Liaw
I have a patient that, most days, I'd like to throttle.
It starts with how she enters the office: always unannounced and with utter disregard for other patients in the waiting room. For her, appointments are unheard of; she arrives regally, demanding to be seen right away. I've given up telling her to book appointments. There isn't any point. I haven't given up telling her to behave in the waiting room; I feel protective of my other patients, who are serially insulted about their age, weight, size, skin colour, clothes, coughs and shoes. This problem patient insists on knowing other people's business (a sinister-sweet “What're you here for, dear?” can switch in a second to “What's your deal, fatass?”) and, on one memorable occasion, she told all who would listen that the reason I was behind schedule was that I like to fondle my patients.
I deal with this shocking behaviour on a regular basis.
In the examining room, things aren't any better. I'm told, “You're too slow with everyone else but you rush with me,” “Your office is a wreck and you ought to renovate,” “You have a bunch of boors for patients out in the waiting room, do you like being Dr. Boor ha ha?” and “Why can't you ever fix my yeast infection?”
Any question I ask in history-taking is, to her, an admission of ignorance, incompetence or guilt; whatever I say is used against me. Once I had the naiveté to ask if her discharge had a fishy odour. Her reply? “Whad'ya mean, does it smell fishy? I bet you'd like to find out, you pervert.”
This sort of thing has become so routine that I now have a chaperone in the room at all times with this patient. I just can't trust her. And I have adopted a few other routines whenever she drops in unannounced, beginning with rushing her to the front of the queue. Not an entirely fair procedure, but the least disruptive to office harmony. I also limit her to fifteen minutes per visit, a strict rule. I had no choice in this. At one point she was a clinic-wrecker, derailing a whole morning or afternoon schedule with allegations of ineptness mixed with prolonged paeans to the gynecological and a dash of self-harm behaviours thrown in. Now she knows that I'll get up while she's mid-sentence — I've been forced to be this unsubtle — and move on to the next patient without looking back.
When I first tried this, she refused to leave the room until I finished listening to her. I refused to go back in, and instead continued to see patients in my other examining room, deciding to wait her out. And she did go, cursing the whole way out the door, threatening to call the College about how bad a doctor I was. But she didn't do that, of course. She came back a few days later with postcoital headaches, at which point I told her that if she ever threatened me again I would cease to be her doctor.
In some way, she's probably the most ill of all my patients, and as she ages things will only grow more complicated. Indeed, as time passes her behaviour becomes more outrageous. But I can think of no other ways to cope with this patient, other than to fire her — something I've never done before. But then I think, Where would she go?
This is the strange relationship we've developed: I somehow think I'm essential to her care. Yes, I suppose she'd just find another doctor to terrorize. So why do I feel a small pang of regret at the thought of not seeing her any more?
— Dr. Ursus
