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 was just referred to as 'lady' in my latest consultant letter - no descriptives. What does that suggest?!

This is interesting. I live abroad and all my medical notes are available online for me and health professionals to access.
They never put anything on the notes that could be used to decode my personality.
So it's usually something like (female, 32) presents with.... so on.

I usually get pleasant but one time I had remarks made on some very old SH scars (more than 25 year old scars so very flat and white). That made me very unhappy. It was completely irrelevant to the matter I was in for. I'd love to know why they wrote that because it's made me paranoid for life about making sure they're covered up whenever I see a doctor.

I was also in resus a couple of years back and couldn't hide them because they asked me to take all my clothes off. One of them shouted about the scars across the room to another, which again made me very unhappy and confirmed that I must keep them hidden wherever possible. I was in no fit state to challenge it at the time, but it wasn't cool. I could understand if they looked recent or fresh, but it should be obvious to anyone that they're from a very long time ago, especially a medical professional.

I should add that not one person has asked me directly about them so I can explain that they are from 1998.

It's so the next person that has to deal with the patient will know how to deal with them. Anxious is code for PITA; lovely means amenable and will listen to you; gentleman means full of himself; pleasant is probably code for docile.

Strange, I read that as the mother is a pain in the arse as she thinks she knows best 😀

The notes from one of my consultations stated that I 'was dreading the prospect' of needing a shoulder replacement. I'd never said any such thing, merely pulled a little face (understandably, I'd have thought!) when told that there might be no avoiding it. It would have been far more accurate if he'd written that I 'appeared anxious', which I was - when I read the 'dreading' comment I was concerned that it might be taken as a refusal of surgery even if I needed it, which wasn't what I was saying at all. (Happily I didn't end up needing it.)

They probably refer to me as that bad tempered old cow because I never put up with any shit from consultants.

Eek, this is exactly the kind of thing I meant in my earlier post. Good job you challenged/sought a second opinion!

Oh, I'm not wound up as such, and I can see your point, but I can also see potential problems with this practice, given the subjectivity of some of the wording...

It is just a way of saying you're compliant as a patient. I don't know what the "they are a difficult fucker" version is though.

I had a midwife who called me "undo-operative" in my notes as we fell out so badly during my DD's birth.

Her manner was so cold and unpleasant, I wanted to complain about her but never got round to it.

I did complain about the terrible stitches I got from a surgeon after DD's birth and they sorted it out after DD's birth.

A woman did it the second time at my request #justsaying...

That's terrible. 😯If they think it's relevant surely they should ask you about it - but given the age of the scars it should have been obvious they didn't point to anything ongoing.

Fist birth was ds's

Re: those who wonder why we include comments on the pt’s appearance - this is standard practice in most spheres of health care, esp MH (in which I work).
Pt’s presentation and appearance all form part of the assessment of their welfare/needs/presentation and issues with this can signify self-neglect / low mood when combined with demeanour, voice, eye contact, and what the pt is self-reporting.

It’s not a value judgement tho.

Apparently my husband is “ a delightful gentleman!” News to me! Joking!

Honestly? I understand that it means “clean, doesn’t smell, speaks in coherent sentences, isn’t drunk / on drugs and isn’t aggressive”. My Dad used to be described as a “pleasant gentleman” in his doctors’ notes - he often wasn’t, he could be a crabby old git (and was in a lot of pain).

I was lovely, now delightful-is that a promotion or demotion? 😍

I'd also add that if I make comments about your job/pets/where you live/family it is generally for my benefit so I can remember who on earth you are next time I see you.

It's much easier to recall 'Susan who wants to be able to ride motorbikes again' than 'Susan who is complaining of a bad back'.

I got called wilful
He did also say I would have a great recovery if I was going to be so "bloody stubborn"
He was right!

As other posters have said, it's just code to say what you're like to deal with. I rather love these descriptions and various other things consultants write in their letters and notes. When told I had cancer, the oncoplastic surgeon wrote: 'DoubleC was shocked by the news but took it well.' Translation, I had laughed (out of shock) then burst into tears.

The same consultant referred to me as 'an expert patient' which is a bit of a double edge sword inasmuch as it has two meanings. One is that the patient has been through it all before and is throughly well-versed with the procedure, the other is that they think they know it all. Thankfully, I was very much in the former camp as it was with reference to a second mastectomy when I had already had one. I was rather paranoid about it so asked the consultant. She laughed when she explained and said she meant it in a kind way and that I knew what I would be dealing with both in terms of the surgery and the recovery. She very much enjoyed having me as a patient. However, oncology did not.

My oncologists have always referred to me as 'well-read' and 'forthright' which is highly accurate as I refused steroids during chemo and various other treatments, as well as questioning them at length about all manner of things.

The comment on your clothing is often part of a general assessment of wellbeing. For example someone appearing unkempt, unwashed or dressed inappropriately for the weather (for example no coat in the snow) may highlight failure of coping mechanisms. This might be due to mobility issues, frailty, cognitive impairment/ mental health problems such as depression or grief or lack of social support. It’s not a personal judgement but part of assessing a person.

Why is it only used in medical notes though? Other customer based industries don't do this (or do they?) It's a little demeaning I think.

I remember years ago seeing a medical report for a legal case describing a woman as a 'well mannered unmarried secretary', my colleague was furious I remember. It's kind of funny too though.

Thank you. Yeah, it makes me feel really uncomfortable and I don't understand what they're trying to imply.

I feel like I won't be taken seriously if they're on show so I've sat in appointments in the middle of summer sweating like a pig because I don't dare risk the judgement.

Vets do it too. My dog's record is full of "A very friendly character" and "Model patient who enjoyed lots of fuss and treats." Unfortunately one vet decided to quote me without the context (they were trying to prescribe something that I thought was not going to contribute to my cat's quality of life. A concern that, 3 years and many stressful vet trips, needles, pills and other tests and one dead cat later, I must say I feel was 100% justified. I should have listened to myself and not have let them pursue that line.) They quoted me as "O does not want to pursue dx because "she is an old cat so not worth doing X tests" which was an accurate quote but very much missing in context and made me look like I couldn't be arsed to do right by my cat because she was old. Unfortunately for them, it was precisely because I COULD be arsed with understanding my pet's health status and advocating for her best interests that I requested a copy of her notes and saw the note for myself. I'm still annoyed about that and whish I'd have said something, along with pointing the many pages after that comment that proved that I was very much the opposite of not arsed.

Strange, I read that as the mother is a pain in the arse as she thinks she knows best 😀

It possibly was the first time it was written like that, but my pushiness and reading saved my daughters life (her condition is rare so I don't expect everyone we meet to know it in detail) so it's definitely the latter now 😂