"this pleasant 44 year old"

[ticandtoc]

I've used private doctors twice over the past 10 years, most recently last week - and on both occasions the doctor has sent a letter to my GP starting with "this delightful 34 year old" and "this pleasant 44 year old". It has always struck me as an odd way for a doctor to describe a patient but a friend told me it's kind of a code between doctors just informing them that the patient isn't a pain in the derriere or.... ? Does that make sense? Anyone know if this is true?

Just curious.

[TortoiseUpATreeAgain]

Please feel free to expand on "I always wear my most expensive jewellery when I have to see a medic" if you think you've been misunderstood, Checkerdy...

[IWillYeah]

I got 'this well presented, professional woman of 36' in a referral for psychotherapy

I was wearing fairly casual jeans/tunic combo, and barely mentioned my job

[Bluestocking]

Interesting thread! I've been described as "pleasant" in MH referral letters, and I assumed (because the MH unit I went to was in a deprived area of Birmingham with some very unfortunate-looking individuals in the waiting room) that this was just a not-very-subtle code for "clearly middle-class, always shows up clean, fully-dressed and without a foil hat, and doesn't pick fights with imaginary assailants".

[Bluestocking]

Rather loving Checkerdy's expensive-jewellery technique - must remember to get my tiara out of the bank vault before I have my next smear .....

[TheCheckerdyHorse]

[Fuzzymum1]

I'm now wishing I'd tried to read (upsidedown) the referral letter my GP wrote to the consultant I saw on thursday. I'd love to know how I was described :D

[squizita]

But Bluestocking my best jewellery IS my tinfoil hat!! What to do..?

[70isaLimitNotaTarget]

deniesx is shorter than says he/she does not have x

Some of my collegues write "denies allergies" and I always imagine a patient saying "No I'm not allergic to penicillin , well ok , a bit, but I don't let it bother me or affect me. I don't give it houseroom"

But "None declared" sounds like the patient hasn't saod "Oh, BTW , I'm allergic to....."

I usually write "None known" (because they might have an allergy they don't know about)

'Tis a minefield

[onlyjoking9329]

I was called a model patient by the nurse.
My consultant held my hand and apologised that he not managed to get me in.
He apologised, and said that I was a very patient patient :-)

[goodasitgets]

I know when my gran was in hospital my parents weren't getting much info. Called in from work to visit her and got bombarded with information when I walked in. Very occasionally ambulance uniform comes in useful

[nooka]

I used to read a lot of medical records as a part of my job (clinical audit) a few years ago, and most of the wording has I suspect little to do with the patient and much more to do with the style of the clinician. I really didn't feel that there was a lot of 'code' more habitual words. Pleasant for example I don't think really implies anything very much, it just sounds better than 'this man' and becomes a habit, so it's only when there is something unusual about the patient that you get variations. Bearing in mind that most clinicians do many initial consult type letters, many of patients that they will never see again and possibly wouldn't really remember in any case. Different in general practice or mental health where it's important to take a more holistic view, but mostly the focus is on the symptoms.

I worked in breast screening/cancer and anyone under about 45 was 'young' simply because the usual caseload tended to be in their 60s and older. It surprised me at first as I was in my 20s, but it did make sense.

Later in my career I worked in quality and we used to arrange for a barrister to come and teach the clinicians about appropriate language in notes, it was really interesting watching him call them out on inaccurate language and irrelevant comments, but in practice I've never seen any of the egregious things that are often referenced (Normal In Norfolk etc) so I suspect that most of them are either myths or long since gone. I was however mightily upset that my maternity notes said I was 'happy' to go to hospital when my home birth went tits up, yes I agreed that was best, but I was also in tears! That sort of lazy language is not helpful.

[herecomesthsun]

An element of this is about pitching the discussion at the level of understanding the patient is likely to have. I think pleasant is used less these days, as it can sound a bit condescending, but of course there is wide variation also depending on the age of the doctor. Also, bear in mind an awful lot of doctors don't speak English as their first language and cliches such as "this pleasant lady" offer an easy courtesy for someone who wants to sound professional in a different culture.

[Kellymn]

Too be honest I don't get ill all that often and my both of my pregnancies were fairly smooth sailing, but still when I do go I just act my usual nice/polite self and ask the necessary questions, then usually get my ass out of there and move on with my life. In other words, I just treat them like any other human being and they seem to find me pleasant. Well as proof there have been no appointments that have ended up in bust ups so far and they're always friendly to me and ask me about my life whenever I see them. However, while I've never seen a medical letter describing me,my childhood dentist always used to say if everyone had teeth like mine he would be out of a job :).

[Miggsie]

count yourself lucky, my aunt discovered her file said "this is the most irritating woman I have ever treated."

[MiddletonPink]

So what's pleasant code for?
I was cc in a letter from the podiatrist to my GP recently and he referred to me as pleasant. I was slightly amused by this.

I hope it wasn't code for having awful trotters

[meandjulio]

I don't use any adjectives in my letters about a patient - as a pP said, it's quite old-fashioned though it still happens a lot

'Denied' means you asked them and they said no. 'Complains of' means they raised it themselves - quite a different thing - and also that it's bothering them. 'Reported' means they raised it themselves and it may or may not be bothering them. But I agree, 'denied' looks a bit like Crown Court. 'Do you DENY you were in the cereal aisle at the material time, Mrs Dotheboys?'

[helensburgh]

Absolutely normal

Politeness is the only reason

[GeorgieStorm]

@onlyjoking9329 Nice can have different meanings, e.g. a "nice distinction".
Apparently "pleasant" is pretty universal for "no concerns about communication (and not a pain in the butt)".
Depending on how well the doctors know eachother, "nice" cane mean fussy, and "very nice" could even mean "irritatingly or irrelevantly argumentative".
On the other hand it could mean as it appears, that MIL was on her best behaviour.

[AnnaMagnani]

It's not a code but a bit old-fashioned now in note writing. We are now advised not to write any sort of comment about whether you like the patient or not - so I'm not surprised that you might have got it written in the private sector where you may have been seeing an older doctor - or perhaps not. Basically you can't write pleasant about some people and not others.

However it is common to write what jobs people do - it is often relevant to medical problems for example plumber = might have been exposed to asbestos. But it also acts as a heads up - yes, if you are a medical negligence lawyer, that will be the first thing written on your notes and on every single note about you.

It can also be useful to know if the person you are talking to is going to have a clue what you are on about - I am going to pitch things slightly differently to a consultant cardiologist to a care assistant to a farmer to an accountant, all of whom I would expect to have different needs while also having to get to know them as an individual.

[GETTINGLIKEMYMOTHER]

Aeons ago my DM steamed opened a letter from GP to the ENT consultant - she’d had a job to get my DB referred because of his recurrent painful ear infections.

She knew the GP thought she was being difficult, and sure enough, the letter referred to her as a ‘fussing’ mother.

When the consultant finally saw DB, he was admitted to hospital there and then - ‘Don’t bother going home for his pyjamas’ - for an op for a serious mastoid infection!

[weehoo]

On a consultant's letter re 16mo DD

'was certainly very lively and appeared well'

During the consultation he asked me to undress her as he needed to examine her. She then seized her chance - pulled her nappy down, mooned at the dr then bolted out the door into a waiting room full of people.

I kind of froze and let the consultant catch her - it took a while

[TheHagOnTheHill]

I was damned with the word 'nice'.
It also mentions where I work,more as a warning as the Consultant knows me but only by my first name.

[TheHagOnTheHill]

Can also confirm that there is no queue jumping for non medical staff members.

[Flythedragons]

I was referred by a consultant in a letter to my gp as a ‘delightful’ lady. I was disproportionately pleased and told everyone that I had been diagnosed as medically delightful

My illusion has just been shattered!

Oh well I’m pleased not to be considered a PITA. I’m easily pleased!!

[Pantsomime]

Had “ pleasant gentleman” on my last letter only I’m female, always have been, identify as such, plus boobs and I don’t need to shave. I was pretty interested in the results so had to phone up to make sure they were my results and not for some gent