johnpalmer (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
johnpalmer) wrote2025-04-10 11:41 am
johnpalmer) wrote2025-04-10 11:41 am
Letter to doctor's office - thoughts welcome.
(Return Address, inside address, etc., skipped)
Re: “YELLOW CARD” encounter with your provider, Biggus Arseholius, and John Palmer
(refs prior doctor, who I call "Dr. Prior")
To whom it may concern:
Mr. John Palmer has a severe speech impediment, especially under stress. Twice now, your caregivers have pressured Mr. Palmer to the point that he has been obviously flustered and upset. The first time was Dr. Prior, telling Mr. Palmer to “stop fighting him,” when Mr. Palmer was trying, in good faith, and as calmly as he could, to answer Dr. Prior's questions, prior to a medical procedure. Getting a PTSD patient frustrated and upset before a medical procedure is a bad medical outcome, and obviously, scolding is an unacceptable response to a good faith effort to answer.
In the most recent incident, a far worse breach of patient trust occurred. Biggus Arseholius had pestered John until he was upset and flustered, and then, accused him – the patient, John Palmer – of being “aggressive” merely because of the frustration that he, Areseholious, had caused! This is what resulted in Mr. Palmer’s inability to respond to the harassment verbally, which necessitates the use of a non-verbal signal – the yellow card referenced above.
It is natural for caregivers to have problems with patients who are both a genius – and normally appear gifted with eloquence – who also have pain, cognitive impairment, and concomitant speech impediments. That said: those “problems” are what medical training calls “challenges” and, they are on the side of the caregiver, not the patient. Disabled patients are entitled to good care too, and while the patient (yes, me) must also help, the caregiver must be the “adult in the room” who handles things, like a frustrated patient, in a mature, and responsible manner – not an unjustly accusatory one.
To both upset a patient, and then call the patient aggressive, is an extraordinary breach of trust, and a wholly unacceptable patient outcome. Your clinicians need to do better. Due to my speech impediment, I can’t calmly explain why I am upset. Merely answering Arseholius's questions was extremely difficult! Instead, I use a well recognized, non-verbal signal: one that says “what just happened should not happen in any caregiving scenario” – just like a yellow card means something happened that shouldn’t on the soccer field (or, in other sports).
I can provide your clinicians with some advice.
First, if this patient is having problem answering your question, pause, and ask the question a different way – this gives him another mental pathway, through which he might be able to answer more easily.
Second, if this patient is simply trying to provide too much information, pause the conversation, explain the specific piece of information you need, and then, either let him know he’s given you what you wanted, or, if need be, allow him to continue. Just as with a stutterer, John sometimes feels a need to finish an interrupted sentence – so even if you have all the information you need, it is polite to ask him to continue, if there’s more he needs to say.
Thirdly, become aware of signs that you, the caregiver, are causing unnecessarily difficulties for the patient. Active listening and observation allow any observer to see that a patient is having internal, non-obvious difficulties – signs of frustration with everyday tasks are usually easy to spot! The person having difficulty is used to minor issues – e.g., I know I have a hard time speaking sometimes! – but a trained observer can spot incipient frustration. Put another way: a caregiver, who is watching for problems, can, and will, spot problems, like a speech impediment, before the person with the speech impediment becomes severely frustrated.
Obviously, Mr. Palmer can’t return to this clinic until he is assured that no further accusations will be leveled against him for behavior that is fully within clinical expectations, entirely innocent of wrongdoing or wrongful motive, and not remotely criminal. I must be assured that I can be a patient, sometimes even a difficult patient, without being accused of wrongdoing, nor of a desire to do wrong.
Re: “YELLOW CARD” encounter with your provider, Biggus Arseholius, and John Palmer
(refs prior doctor, who I call "Dr. Prior")
To whom it may concern:
Mr. John Palmer has a severe speech impediment, especially under stress. Twice now, your caregivers have pressured Mr. Palmer to the point that he has been obviously flustered and upset. The first time was Dr. Prior, telling Mr. Palmer to “stop fighting him,” when Mr. Palmer was trying, in good faith, and as calmly as he could, to answer Dr. Prior's questions, prior to a medical procedure. Getting a PTSD patient frustrated and upset before a medical procedure is a bad medical outcome, and obviously, scolding is an unacceptable response to a good faith effort to answer.
In the most recent incident, a far worse breach of patient trust occurred. Biggus Arseholius had pestered John until he was upset and flustered, and then, accused him – the patient, John Palmer – of being “aggressive” merely because of the frustration that he, Areseholious, had caused! This is what resulted in Mr. Palmer’s inability to respond to the harassment verbally, which necessitates the use of a non-verbal signal – the yellow card referenced above.
It is natural for caregivers to have problems with patients who are both a genius – and normally appear gifted with eloquence – who also have pain, cognitive impairment, and concomitant speech impediments. That said: those “problems” are what medical training calls “challenges” and, they are on the side of the caregiver, not the patient. Disabled patients are entitled to good care too, and while the patient (yes, me) must also help, the caregiver must be the “adult in the room” who handles things, like a frustrated patient, in a mature, and responsible manner – not an unjustly accusatory one.
To both upset a patient, and then call the patient aggressive, is an extraordinary breach of trust, and a wholly unacceptable patient outcome. Your clinicians need to do better. Due to my speech impediment, I can’t calmly explain why I am upset. Merely answering Arseholius's questions was extremely difficult! Instead, I use a well recognized, non-verbal signal: one that says “what just happened should not happen in any caregiving scenario” – just like a yellow card means something happened that shouldn’t on the soccer field (or, in other sports).
I can provide your clinicians with some advice.
First, if this patient is having problem answering your question, pause, and ask the question a different way – this gives him another mental pathway, through which he might be able to answer more easily.
Second, if this patient is simply trying to provide too much information, pause the conversation, explain the specific piece of information you need, and then, either let him know he’s given you what you wanted, or, if need be, allow him to continue. Just as with a stutterer, John sometimes feels a need to finish an interrupted sentence – so even if you have all the information you need, it is polite to ask him to continue, if there’s more he needs to say.
Thirdly, become aware of signs that you, the caregiver, are causing unnecessarily difficulties for the patient. Active listening and observation allow any observer to see that a patient is having internal, non-obvious difficulties – signs of frustration with everyday tasks are usually easy to spot! The person having difficulty is used to minor issues – e.g., I know I have a hard time speaking sometimes! – but a trained observer can spot incipient frustration. Put another way: a caregiver, who is watching for problems, can, and will, spot problems, like a speech impediment, before the person with the speech impediment becomes severely frustrated.
Obviously, Mr. Palmer can’t return to this clinic until he is assured that no further accusations will be leveled against him for behavior that is fully within clinical expectations, entirely innocent of wrongdoing or wrongful motive, and not remotely criminal. I must be assured that I can be a patient, sometimes even a difficult patient, without being accused of wrongdoing, nor of a desire to do wrong.
no subject
"In order to return to your practice, I also need you to recognize what went wrong last time. I was doing my best to communicate, and your clinician appeared angry and accused me of being aggressive."
Put the explanations of why you need these things after saying what you need. It's more important that they make those changes, than that they understand why you need them.
I'd write this in the first person, using I/me/my, rather than the third-person "Mr. Palmer," because if the letter says "Mr. Palmer" repeatedly, they will probably think they're hearing from a caregiver/personal assistant, rather than the patient.
It's well known that, Unfortunately, many people will stop reading partway through a letter, email message, or newspaper story. You can't say everything you want to tell them in one paragraph, so try to write a letter that won't be misleading if they only read the first paragraph or two.
I would also drop the word "genius"--some people react badly to someone claiming to be a genius, whether or not it's true. Something like "intelligent patients who sometimes suffer from cognitive impairments, which can trigger a speech impediment" is also true, and more likely to get the results you need.
no subject
Oh, I'm never sending the letter or going back.
My wife was embarrassed that once I was accused of aggression, I dropped a yellow card and left, rather than using my words - remember, frustrated and louder already! - which would have worsened the situation.
I know they'll never admit they were wrong. But until they do, I'm unjustly labeled as aggressive. There is no going back!
no subject
Oh... one embarrassing note.
I can't complain of emotional abuse in the first person. Hence,the writing in second.
I just can't do it, not yet. Ptsd thing, I assume. But, it is a "thing" I guess.
no subject