Posts tagged “patient”

Elaine’s War Story: They call me Mister

Elaine Fukuda (@elaine_fukuda) is a design research consultant from California.

I admit I don’t have a lot of experience with children but the opportunity to shadow a patient through an entire day’s hospital visit was one to not pass up. The patient being 13 years old added another layer of consent and assent, a mythical ethnographic research unicorn of sorts.

The goal of shadowing was to understand the experience of the entire visit from start to finish, through multiple provider visits, labs, tests, and the waiting times in between. I met the patient and her mother as they were pulling into the parking garage and started the day with a scan. During the next two hours she patiently laid in a claustrophobic tunnel, and did everything as asked, from changing positions ever so slightly, holding her breath for 30 seconds at a time, and breathing at a specific pace.

Having fasted since the previous evening, she was ready for lunch but wanting to get everything done before their provider visit, she and her mom decided to get a blood test done before lunch.

We arrived in the pediatrics department and her mother stood in line to check in while I joined the patient in the waiting area. After a few minutes, a volunteer came over for what I felt was a break in our somewhat awkward small talk.

The volunteer was a kind elderly man with a book cart offering free books for patients to take home. The patient, tired from the scan and possibly feeling out of place in the bright and cheerful pediatrics environment shrugged and said there wasn’t anything she liked. Determined, the volunteer took out a “magical coloring book” which colored itself with a flip of a page. She was still not impressed.

Then came the pièce de résistance. From the cart the volunteer pulled out a heavy woven rope and introduced the patient to his friend, Mr. Stick. Mr. Stick had a magic ability you see, with a grand gesture he could become taut. In order to turn back into a rope, the patient was instructed to ask, “Mr. Stick, will you go down?”

The shade of red across the teen’s face had long passed lobster and she and I stared at each other in disbelief. Her mother was still in line across the way, and as the adult I felt responsible but conflicted on what to do. Surely the man had no idea what he was implying? Being a very good sport, she complied and sure enough Mr. Stick fell limp.

But the volunteer didn’t stop there. He turned to me, holding the middle of Mr. Stick, now back in its rigid state. He asked me to tell Mr. Stick to go down, which I did. Nothing happened. The volunteer said I must say “please”, which I did. And again nothing happened. He then said, “I guess Mr. Stick doesn’t go down if you’re not a child.”

“Hey, I think they’re calling your name,” I quickly said to the patient. And with that we escaped the somewhat creepy, but good intentioned volunteer.

“That was awkward,” she said.

It wasn’t until after the blood test and during lunch that we were able to debrief and talk about the encounter with the volunteer. I was afraid the mother would be upset that I hadn’t intervened sooner. She was shocked but laughed, wondering if someone could really be that clueless. As I started to explain what had happened, the patient (who been sitting right next to the volunteer) interjected:

“No, its name was Mr. Stiff, not Stick.”

Me: “Oooh, that’s even weirder.”

Mother: “I’m really curious how you’re going to write this up.”

ChittahChattah Quickies

  • The process of converting books to Kindle format introduces errors in the text – The cost of a printed book covers some degree of proofing and checking—not enough, but some. The cost of a Kindle book does not support editorial quality control, and the multi-step conversion process, handled in bulk by third parties, chops out content and creates other errors that no one fixes because no one is there to do QA.

    As the economics of publishing continues to change, perhaps one day soon, a Kindle edition will contain the same text as the printed book. Until it does, Kindle is great for light reading. But if it’s critical that every word, comma, and code sample come through intact, for now, you’re better off with print.

  • The Social History of the MP3 – For Reading Ahead, we're looking at other transitions to digital: "So omnipresent have these discussions become, in fact, that it's possible the past 10 years could become the first decade of pop music to be remembered by history for its musical technology rather than the actual music itself. This is a chastening thought, but at the same time we have to be careful not to overlook how the technologies we invent to deliver music also work to shape our perception of it. When radio came along, its broadcasts created communities of music-listening strangers, physically distant from each other but connected through the knowledge that they were listening to the same song at the same time. Where radio brought listeners together as a listening public, the LP started splitting them apart. The LP and 45 rpm formats took the phonograph, which had been in existence for over half a century, to the masses, right as the American middle-class was going suburban and privatizing their lives."
  • Medical Students Experience Life as Nursing Home Patients – Students are given a “diagnosis” of an ailment and expected to live as someone with the condition does. They keep a daily journal chronicling their experiences and, in most cases, debunking their preconceived notions.

    To Dr. Gugliucci’s surprise, she found nursing homes in the region that were willing to participate and students who were willing to volunteer. No money is exchanged between the school and nursing homes, and the homes agree to treat students like regular patients.

    “My motivation is really to have somebody from the inside tell us what it’s like to be a resident,” said Rita Morgan, administrator of the Sarah Neuman Center for Healthcare and Rehabilitation here, one of the four campuses of Jewish Home Lifecare.

ChittahChattah Quickies

  • The Computer Will See You Now – how the computer interferes with the doctor-patient interaction – Doctors struggle daily to figure out a way to keep the computer from interfering with what should be going on in the exam room — making that crucial connection between doctor and patient. I find myself apologizing often, as I stare at a series of questions and boxes to be clicked on the screen and try to adapt them to the patient sitting before me. I am forced to bring up questions in the order they appear, to ask the parents of a laughing 2-year-old if she is “in pain,” and to restrain my potty mouth when the computer malfunctions or the screen locks up.

    The computer depersonalizes medicine. It ignores nuances that we do not measure but clearly influence care. Room is provided for text, but in the computer’s font, important points often get lost.

    A box clicked unintentionally is as detrimental as an order written illegibly — maybe worse because it looks official. It takes more effort and thought to write a prescription than to pull up a menu of medications and click a box.

  • Tension between medical and colloquial language – an issue I explored in interactions column (Poets, Priests, and Politicians) – (via MeFi) Dr Ardill, in evidence, said he did not use the words alleged by Ms McQuade. He said he asked her was she “next or near a man’s willy bits” in the last six months and in relation to her sleeping he did suggest a drink, light exercise, a trashy novel or some “rumpy pumpy”. He said he used this kind of “childish” language with all patients to make them feel at ease. Nobody before had found it offensive. He said he would not use the term “willy bits” again.

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