My last patient today had “personality disorder” listed multiple times in her record, and even on her most recent discharge 3 weeks ago. I prepared myself for a headache. What should be a straightforward patient interview had the potential to become a nightmare.
I entered the room and immediately her husband started to raise his voice blaming this that and the other thing along with the nurses for his wife’s current illness, not addressing my HPI questioning. I secretly wondered if the husband wasn’t the one with the personality disorder. I thought about what time my shift was over, not really listening to his ranting. I passively let them vent for a few minutes, then calmly redirected my questions to find out why they were here. I could sense they wanted to get along with me and not cause problems, but were fed up with her chronic illness. I didn’t take it personally.
Proceeding with my physical exam, I picked up the otoscope as I prepared to look at her eardrums and said matter-of-factly to the husband, “Sir, could you please hold your hand up next to her head to hold the light in?”. He picked up his hand, then hesitated. Then he started to belly laugh. His wife started to giggle. “She got you you good,” the husband said. “You fell for it too!” the wife exclaimed, still laughing. THey giggled and snickered to each other for the rest of the night.