Saturday, August 22, 2009

Post-hospital notes

When I got home from the hospital on Monday afternoon, Dean said to me, "By the way, guess what I've been watching on TV since you left?  Baseball!"  "Oh," I replied, "so there wasn't very much else interesting on?"  "No.  I couldn't figure out how to change the channel!"  The last thing we'd watched on Saturday night was a Jays baseball game on one of the sports channels, and faced with the neverending conundrum of the many remotes, he'd just resigned himself to watching whatever turned up on that channel until I returned.

The other lady in the hospital room with me was much sicker than I was, and she had to have continuous care from the nurses, for bandage changing, cleaning, feeding, you name it.  She was francophone, but her English was excellent - she switched back and forth between the two languages continuously, so she had no trouble understanding English, but I noticed she was sensitive to a particular word:  "complain".  She'd continually preface what she had to say with "I'm not complaining, but..." and then go on to say what the problem was: this hurts, I can't eat that, this position is uncomfortable, whatever.

When a shift changed, a day nurse came on who had obviously just read the notes from the night nurse, and she said to the patient, "I see during the night you complained that..." and the lady cut her off immediately:  "NO.  I didn't!" she said very emphatically.

I finally realized that she didn't understand the word "complain" the way doctors use it.  To her, "complain" only existed in the sense of "I'm going to complain to your boss!"  It indicated a grievance, combined with anger, and a strong hint of blame.  But doctors use the word without any emotional content at all:  "The patient came in complaining of shortness of breath..."  "The patient complained of chest pains during the night..."  Case histories regularly start like this, and if you've heard medical programs, you've heard doctors speak this way.  I guess unless you're dealing with an unconscious patient who can't tell you anything, most medical treatments start out this way: the patient approaches the doctor and tells him what's wrong.  How else will he know that there's a problem?  So to a doctor, the word is completely neutral, meaning just "a report of some negative development".  I wonder how many doctors would be aware of this possible misunderstanding over such a simple word?


Blogger Tina said...

So glad to see you "up and at 'em" again, as they say in Oklahoma.
Interesting observation about the word "complain". There are many words like that. A couple I noticed with my children when they were very young. One, upon being scolded for talking to "a stranger", insisted that this wasn't a stranger because he looked like normal people: he had gotten the impression that "stranger" meant "scary looking". Another, on being asked "Haven't you been told not to play with fire?", replied "I'm not playing with it - I'm *using* it." Made sense to him in his 5 year old thinking that he had a purpose for it therefore it was not "play".

11:31 pm  
Anonymous robroy said...

You are right about "complain." We actually write "c/o" for complain of as in "Pt c/o SOB & CP" = patient complains of shortness of breath and chest pain. (That's an ominous thing to write in the chart. You probably got a "No c/o's" in your chart.

9:01 am  
Blogger Dr. Alice said...

Wow, I just found out about your appendicitis. I'm glad you are doing well!

Re: use of "complain," I can add my affirmation to the others. We often write "chief complaint" to describe the presenting symptom of the patient (to distinguish it from other, lesser complaints). Another bit of terminology is "fail," as in "patient failed treatment with penicillin." This just means it didn't work, but I've had some patients get upset and feel that it is being used in a pejorative manner.

11:20 am  
Blogger Dr. Mabuse said...

"Complaint" in the medical sense still persists among non-medical people in the old-fashioned term "a mortal complaint". There, we still seem to get that it means "ailment" (and a FATAL one, at that), not "gripe", but I think it would be considered a rather "literary" term. (I'd use it in conversation, but not many other people would.) "Complain" seems to have a hint of "troublemaker" about it, which I suspect is why the lady in my room was so anxious to assure the nurses that that wasn't what she was doing.

1:21 pm  
Blogger Blazing Cat Fur said...

Glad you are well again.

7:13 pm  

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