to wonder why consultants comment on people's personalities?

[EverythingYouDoIsaBalloon]

Not a TAAT but I just read a post on a different thread that mentioned someone experiencing this, and it reminded me that I've heard about it several times over the past couple of years.

In 2023 I fractured my shoulder and as it wasn't a straightforward fracture I was referred to a consultant, who wrote in one of this reports that I was a 'very pleasant lady'. While that was nice to read, it baffled me a little as I didn't see the relevance.

Then a friend of DH's said a consultant had referred to him as a 'pleasant gentleman'. (Different part of the country, no chance it was the same person.)

Then another friend said she'd been referred to as a 'lovely lady' when seen for stomach problems.

Don't get me wrong, compliments are always nice. I just find it a bit strange in a health context. 🤔 I've wondered whether it's some sort of code for 'cooperative patient' or something along those lines, but then I can be a bit of a cynic at times.

Has anyone else experienced this, or does anyone know why it's done?

I thought it was code for 'has googled everything' 😅

Ditto with my oh who got similar description. He won’t put up with the nhs crap and being fobbed off. He’s 7 years since cancer diagnosis and the sheer incompetence he’s suffered is unbelievable. Even down to getting blood test appointments the day after his chemo course due to start rather than the week before, and his chemo drugs never being ready, being phoned to ask where he is for appointments he hadn’t made and knew nothing about. He’d be dead if he wasn’t on top of it all himself. He even checks the labels on his infusion bags in the treatment room as when he started they gave him the wrong dosage. Likewise his monthly bag of drugs - barely ever right, sometimes something missing, and sometimes doses have changed and not what was agreed with haematologist. They all know him well in the oncology department and we’ve no doubt they regard him as a patient from hell, but he’s always calm and respectful, just very assertive and not afraid to challenge their cock ups which are far too frequent!

More like means a doormat they can walk over!

My children both have complex health needs. As a mother I have been on the sharp end of healthcare workers’ commentary more times than I wish to remember. Sometimes because I am questioning their approach or advocating for my child’s particular needs, sometimes because I am exhausted and fearful. Sometimes because I have felt discharge would be dangerous (and it was).

In my experience it is the nurses rather than doctors who poor out personal judgment onto the page. I have 600 pages of ward notes upstairs from one hospital stay - at least 50 per cent of this is details of what I was doing and saying, most of it wildly inaccurate. I can only presume this comes from nurses who wanted to cover their own backs on a ward with a particularly toxic culture.

This hospital - Derriford Hospital in Plymouth - is well known by SEND parents as being a hostile environment. The nurses, not so much the doctors.

Both myself and one of my children have C-PTSD partially caused by our experiences in that hospital.

Will we complain? Not again. NHS complaints process is, in my experience, not worth the extreme stress and personal effort.

That's terrible! Sorry you have to put up with this.

Ha ! I did wonder this, was surprised I was 'lovely lady' in a letter after my shoulder fracture...

Nail on the head, sadly. They like to play God and really don't like patients who are well informed and ask pertinent/relevant questions, nor challenge poor treatment.

But the doctor hasn't seen your kids' medical notes - so they are simply documenting that the information is from you and hasn't been checked by the Dr. People give inaccurate information all the time - a person confidently told me they'd had a stroke last month but the letters show that the final diagnosis was something different - I explained that twice but they didn't understand (or didn't/couldn't hear) - ditto people reporting a relative's diagnosis is often inaccurate. It's helpful to be clear in letters as to what's definite and what's second hand information.

I got "educated and articulate" in mine by an endocrinologist!

Defo code. My child's paed referred DC once to specialist and the letter stated that they had met DC in clinic together with DC's 'mother who has a very strong and detailed understanding of DC's difficulties'. I always wondered if that translates into 'Outchy is a bit of a know-it-all and very persistent'.

You see I'd read that comment as 'this child has a very competent and involved primary caregiver, you can rely on anything she tells you'.

I was described as 'pleasant' in a few medical letters and was also confused by it, so I asked my doctor... She sheepishly explained that it was code for me being overweight. I guess different terms mean different things. I preferred it when I just thought they were saying that I was nice!

That can't be right! I have been referred to as pleasant when I was young and not remotely overweight

My Dad was described as “pleasant” when he weighted about seven stone (he was very unwell). He also wasn’t all that pleasant to the people in hospital (he was in a lot of pain).

I've been called pleasant and I've never been overweight in my life.

My NHS gynae-oncologist writes his outpatient clinic follow-up letters directly to me, summarising what we have discussed, reiterating the results of any scans and investigations carried out last time I saw him, what treatment plan we have agreed going forward, in how many months he will review me again etc. A copy of his paper letters to me are emailed to my GP and to any other consultants involved in my care. This is a much better system than:

"Dear Dr Gloucester,

"I reviewed this 70 year old lady in my clinic today. The endometrial biopsy I performed four weeks ago showed xxxxxxx and we have agreed that xxxxxxxxx etc"

"Funny looking kid? Why would you need to tell anyone that you think someone's child is funny looking? And who are you to decide that?!"

The SNOMED CT Terminology system which is used to allocate codes to medical diagnoses for patient medical records, insurance and data collection purposes used to include the term "Funny looking kid (FLK)" under the medical code for "Abnormal facies".

Abnormal facies are distinctive facial expressions or appearances associated with specific medical conditions. They may be caused by a number of conditions, including genetic disorders, birth defects or steroid use and might warrant further investigation if the child does not already have a diagnosis of a condition that alters the appearance of the face.

I’m a ward MH nurse and so I have to write enormous quantities of notes on what, usually really quite mentally unwell, people have been doing during the day. Somewhat paradoxically, it’s actually easier to write about someone who is obviously poorly (paranoid, dishevelled etc) than it is to write about someone getting better. I find myself using “bright and cheerful” or “well engaged” quite a lot but it’s hard.
In general, when it comes to these kinds of descriptions from HCPs I think it’s important to remember that we’re judging mood and behaviour rather than personality. You can’t judge someone’s personality from one meeting-there’s patients who I’ve been caring for for months whose personality I’m only just really understanding-and this is doubly so when someone is ill.

DC's 'mother who has a very strong and detailed understanding of DC's difficulties.

See this sort of thing, along with describing parents as articulate, can be intended to be a bit sneery and can be code for pain in the arse. (Interestingly I've seen it more as a description of mothers than fathers).

But if it was me advocating for my sick child, you bet I'd have plenty to say. So I'd totally own it and be proud of the description. Even if it wasn't meant as a compliment.

Exactly. There were probably a few choice words written about me when my dad was in his final illness. But if I hadn't researched and (that thing some clinicians hate) informed myself about what was happening to him, I'm convinced he'd have died a lot sooner.