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.

@Georgyporky

I had a copy of a doctor's report, that said something like "Mrs. G presented at the interview, casually dressed."

My clothing was completely irrelevant, & it was a very expensive trouser suit!

Did the medical report have to make comment on your mental state? The required first part of a mental state is the patients appearance and the second is their behaviour....possibly not irrelevant but part of the report

At least in our age group, we're unlikely to be described as 'pleasantly confused'. I've seen that used for elderly people - it seems to be code for 'appears to have some degree of dementia, but isn't aggressive with it'.

My mother in her later years was described several times by doctors as 'delightful'. That seemed to mean 'older than time, but still seems to have her wits about her, and is polite into the bargain'.

Not exactly the same thing, but my mother also told me that in the 70s a consultant once put in a letter to her GP that, as she came originally from a Mediterranean country, she probably drank too much alcohol and should try to reduce her drinking. Actually my mother almost never drank alcohol, as she was extremely sensitive to its effects, and would get an immediate hangover if she drank half a glass of wine.

@Pluto46

"This gentleman is mildly demented", said of my lovely Dad, during the early stages of Alzheimers

IMO this could have been better phrased as “this (lovely) gentleman has mild dementia” but again not an insult, Alzheimer’s is a dementing condition and in the early stages it often is mild.

Just checked my own clinic letters out of curiosity and sure enough, “this pleasant lady” is in there! No mention of “young” anymore which is a bit sad but I’ll accept that two babies have wreaked their havoc 😂

In all seriousness, if someone is offended or feels it inappropriate that a clinician has made a personal or unnecessary comment, they could tell the doctor next time they’re in, or leave a message with the secretary stating as such. I’m sure the clinician would much rather be told and be able to fix the issue than get a complaint about it, or unknowingly make one of their patients unhappy by doing it. Easier said than done I know, but better that than to stew and mistrust your doctor as a result of something that may just be a force of habit when dictating a letter.

A friend got 'pleasant but appeared somewhat anxious' at an appointment where she was told she had cancer, and they thought it may have spread to multiple organs.
Covid times, so on her own.
She felt 'somewhat anxious' was rather underselling her emotions, and that the 'but' was a bit unnecessary.

So happy to have found this thread as I've been wondering about this for years! In all my letters relating to childbirth I was "anxious/distressed" etc but for everything else I've always had "delightful/charming lady". The "young" description seems to have dropped off in the past couple of years

But on a serious note, the whole thing basically confirms my worst fears about consultants: that they're overwhelmingly arrogant and loathe anyone who dares to question them, express any form of negative emotion, etc. I also found a massive difference in the way they spoke to me when I moved from a very low-status job to a much higher one. Ugh.

As I said upthread, clothing and appearance can be an important part of the assessment (and if it is a mental state assessment or has any relation to possible mental state factors, then it is essential for this to be commented on).

In my assessments, "casually dressed" is usually a good/positive thing in relation to someone's state of mental health. It implies a sense of normality. Over-formal or elaborate dress to see the doctor (unless you have just come from work or something), or alternatively dishevellment, could both have important meanings.

@WinstonsWeirdVole it is very sad that you have had experiences that have made you feel like that about consultants, and so strongly, from the way you word it. We are not all like that by any means.

@user1497207191 totally agree with you about being informed. I always make sure that my background reading is proper sources (research papers, policy documents etc) rather than Dr Google so that if I want to ask a question, I can reference a particular paper or policy. It means I can get actual answers to my questions rather than just generic fobbing off. I've got a medical condition which, although very common, seems not to be well understood by many GP's (in my experience anyway). When I was diagnosed , the doctor said 'do you know anything about PCOS? No? Well, just Google it'.

It's brilliant that your DH has been able to push for things that he knows will work for him and that the consultant will listen to him. It's always best to be as informed as possible and it sounds like your DH is managing his condition the absolute best way.

Yes, pleasant lady, I've had.

A gynaecologist once described my vulva as unremarkable, which made me irrationally miffed . I had just given birth and I think he meant nothing wrong with it, but it made me chuckle in faux outrage. Ahem, I wasn't well at the time in my defence.

Mildly demented is a specific clinical term for a symptom (of various illnesses incuding Alzheimers), it does not imply any judgement.

Unremarkable sounds not nice in the usual world, but in medical terminology it's a really good thing!

@LuckyMcDucky

Yes, pleasant lady, I've had.

A gynaecologist once described my vulva as unremarkable, which made me irrationally miffed . I had just given birth and I think he meant nothing wrong with it, but it made me chuckle in faux outrage. Ahem, I wasn't well at the time in my defence.

Your vulva and my cervix.

@theDudesmummy

Unremarkable sounds not nice in the usual world, but in medical terminology it's a really good thing!

Hehe yes, I did know that really. Just made a funny anecdote!

It’s better than what they used to write before patients had access to their records. I used to work in medical records and sometimes had to put old records into new files if they were worn out etc. They used to write horrible things like scruffy, downtrodden, poor appearance. Or worse extremely attractive, womanly figure!

I would definitely say that if anyone sees a descriptive in a letter that they are unhappy with/unsure about, they should speak up. It will probably cause the doctor to reflect on what may well be unconscious habits.

If the descrption is in fact appropriate/necessary (as I have mentioned in mental state examations, for example, certain things take on specific meaning) then the doctor could at least discusss wth you why this is so, which would hopefully lead to a better theraputic relationship and understanding.

I got one from the dentist to the orthodontist...

‘Made referral to reassure mum.’

No you didn’t. I didn’t think there was anything wrong with DD’s teeth and was surprised you made a referral.

And don’t mum me. I hate being mummed.

@hellywelly3 oh God yes. I have to, becuse of a part of my work, soend many hours each week going through old, sometimes very old, medical records, and Social Services records, clearly written with not thought that the patient/client would ever see them. Some of them are amazing.

Very young teenage girls being described as "attractive", "flirtatious" etc (sometimes by people who were actually sexually abusing them at the time). Comments on attractiveness of women and their clothing (with no possible relevence to anything being investiagted or assessed at the time). Complaints about people being unco-operative or inappropriate, when they were clearly just asking questions. Casual sexism, racism and cultural assumptions everywhere. Value judgments all over the place. Can be hard reading at times.

Sorry about multiple typos there. Typing with a broken wrist and way too fast.

Your vulva and my cervix.

High five sparking on our equally unremarkable nethers

@LuckyMcDucky

Your vulva and my cervix.

High five sparking on our equally unremarkable nethers

I was told recently my cervix was like a teenager's (it's just because DS came out through the sunroof, as my DH puts it).

Hahaha I always get delightful

I find it so peculiar 🤣

I got 'jolly' once. I am quite jolly though - good job ha

I once got described as challenging by a midwife in my notes . I mean she wasn't wrong. Ds2 was in NICU I had just come round after a horrific birth , a blood transfer with three bags (i think i could have been seeing double) of various things being dripped into me. Then insisted I was getting out of bed to see my baby and there wasn't a damn thing they could do to stop me.

Sensible midwife eventually stood back and said "Go on then. If you can get out of bed you can go" I didn't even manage to sit fully upright! I was clutching onto the photo she had given me of DS sobbing and insisting I could do it.

She was lovely and I apologised profusely once the meds and hormones calmed down .

Yeah , Challenging was a fair word to use.