To wonder why doctors always refer to a patient as pleasant

[Beatinghearts]

I find it strange these nothing particularly pleasant about me. I’m polite but not overly so.

Tangentially, I love the fact that there's a disease called pseudopseudohypoparathyroidism. Two pseudos.

I was the wrong side of 40 when the surgeon wrote that

Wrong side? So you were under 40 at the time, and perhaps did seem like a slip of a girl

@SophieGiroux

I never get why they have to include the family background on children's notes saying "lives with mum, dad and 13 year old brother." What's that all about? Why is it so relevant that it needs putting in the doctors letter?!?

It often is relevant.

A child’s understanding of their illness and our understanding of how it affects them is strongly correlated to who is at home with them. It’s an attempt to try and put the child at the centre of their care and understand their world.

Contrast your child’s home life with
“Lives with foster parents who have only known him a few weeks” “lives with his paternal aunt and her family, his parents are presumed to still be in Syria” “Lives with his mum and his four siblings aged 1,2,3 and 5” “lives with his mum and dad and his terminally ill sister 7 and his uncle also lives in the family home”

They all throw up multiple potential consent, safeguarding, lack of support and mental health issues.

@SophieGiroux it is absolutely relevant and standard when dealing with children to document the child’s close family and living situation. Absolutely vital. Professionals need to know who the child lives with and anyone who has access to said child. For both medical and safeguarding reasons.

There have been far too many cases where a lack of professional curiosity or assumptions made about the home environment have had absolutely dire consequences. Medics should ask, and document, at every appointment.

You've had a very very sheltered life if you don't think a child's family background and living situation is important to their contact with health professionals and their health .

@LeaveHomeNow

A consultant asked where I was from and when I asked how it was relevant, he said he was just being polite. Sure enough, letter arrived "pleasant patient, originally from x". I assumed it was to help him recall me at a later point, if it was required.

Obviously, I've no idea where you're from or why you're seeing consultant, but it may help them rule in / out any long dormant tropical diseases that may be causing symptoms now. Rare, but I imagine it can happen. Also I suppose may alert to any cultural sensitivities..

Or perhaps, he was just curious?

When I was a councillor I used to get "This pleasant lady is a city councillor" (think that meant be careful if you make a mistake she'll complain robustly)

A pleasant person could underplay their symptoms. Also its helpful to know, if you present on another day as highly agitated that would be significant.

I once had ‘this pleasant and conservatively-dressed lady’

@speakout

I am " casually dressed but clean".

Not sure what that means.

This is often used for mental health assessments. So while wearing work out gear is currently in fashion, if you hadn't washed for a week it would suggest lethargy or something similar.

I once got 'this wonderful lady, slightly deconditioned....' (in other words, overweight and unfit - to be fair it was after years of cancer treatment and he was right!)

Where you come from originally could be highly significant, in many circumstances. Could be relevent genetically, culturally, related to diseases you might have been exposed to in childhood etc etc

@Natsku

Slightly disappointed they don't write things like that here in Finland, just the medical stuff (though its often noted that 'patient is stressed' in my notes) but for some reason with my children they always write down that they speak English at home, not sure of the medical relevance of that.

My snarled a Finn. His MIL, who speaks fluent English, was taken seriously ill on a visit to the UK. One day the doctor was anxious he could wake her when she needed to go for tests. A nurse suggested getting DIL to talk in Finnish and hey presto, she responded. That could be the reason they note the language used at home.

That could be it.

DD used to see a very old school, but lovely, orthopaedic consultant who used to write a multitude of things like this. The funniest thing though, was that he used to start dictating his letters whilst you were still in the room eg, getting DD dressed and back into her wheelchair. I often wondered what he would have dictated if I wasn't 'pleasant' and DD wasn't 'well cared for'.

@bigbluebus one of the consultants I worked for did this - I thought it was a really good idea! Saves times, confirms the action plan and makes sure the patient is happy with what’s going in the letter. I think they mostly did it because they were really forgetful ....😂

Took Ds to A&E as a toddler and they described him as 'happy'. Maybe he wasn't in enough distress or maybe no signs of abuse?

@Aweebawbee my God that’s in poor taste.

[quote Vursayles]@Aweebawbee my God that’s in poor taste.[/quote]
It wasn't a joke. I genuinely wondered why they would describe a toddler in A&E as 'happy'. Didn't seem very happy to me.

I've only had "pleasant" in the past.
I wonder what my notes say now though.
I broke down after day surgery (for something notoriously painful) and because a mistake had been made they were trying to discharge me with no pain medication.
Luckily it was whilst my obs were being recorded so my heart rate and blood pressure shot up. I refused to leave until I had pain medication so they probably wrote something rude about me as they were late going home.

They don't always!

My fave was 'you referred this interesting gentleman...' 😂

My most recent letter from the gynaecologist said more about my partner than the actual appointment. He asked why after 2 children my partner wasn’t getting a vasectomy and I replied because he doesn’t have biological children which he wrote in the letter. Very odd.

I remember reading a case (may be an urban legend) of a consultant giving evidence at a trial and being called on by the advocate to explain to the court an acronym he'd written in his medical notes:

Patient TTFO

Obviously able to think on his feet, he replied, "Patient told to take fluids orally."

😀😀😀

Aweebawbee

Vursayles
@Aweebawbee my God that’s in poor taste.
It wasn't a joke. I genuinely wondered why they would describe a toddler in A&E as 'happy'. Didn't seem very happy to me.

Many apologies Bawbee I thought you were being sarky. My mistake for misinterpreting.

@RancidOldHag, I wasn't under 40 at the time. The wrong side of 40 means I was over 40