“Interesting case,” is all he said as he handed me the chart and quickly ushered me into the room. Shit, I thought to myself. Most likely, that means I’m not going to know what the hell is going on in there. I didn’t even get a chance to look at the chart. I was not ready. It was downhill from there.
As I entered the room and introduced myself, I was greated by a small, frail woman with a smile on her face, and her husband, a big burly man with rough hands and a deep, strong voice. I began by asking the couple what they were in for.
“I have ABPA,” she responded. Shit. I thought to myself again. I don’t know what ABPA is. I could feel the sweat beads beginning to form on my forehead. I began calmly thumbing through her chart for a description of her disease, but to no avail. ABPA was plastered everywhere, but never with an explanation. I could think of no alternative, so I decided to go with the truth.
“And what exaclty is ABPA?” I asked. But before I even finished the question, I knew I had made the wrong decision. The patient’s husband was looking at me like I was crazy and even began to laugh sarcastically.
“You don’t know what ABPA is?” he asked.
“Allergic Bronchopulmonary Aspergillosis,” she said over him.
“I’m sorry. I know what Allergic Bronchopulmonary Aspergillosis is, but I have never heard it abbreviated that way,” I told them. It was a lie. Telling the truth had gotten me into too much trouble already. I understood what all three words meant, but had never heard of this disease process. Come on, pull yourself together. You can get through this, I thought. So I continued on.
It was clear, at this point, who was in charge. It was not I and it was not the patient. The next few questions I asked her, he answered. He proceeded to pull out his own personal chart of her medical records, which was over 100 pages, and handed it to me while he told her long, very complicated story. The more information I gathered, the more I sweated and the less I listened. I became overwhelmed with the facts, heat, and this big, burly, sarcastic, overbearing man.
And he could see it. “What’s the point of this? We drove here from Highland Park, waited for one hour, and now this. Is this supposed to be for your benefit or ours? I don’t understand.”
“It’s for both,” I answered, not really caring anymore about ABPA or what was going on in this room. Rather, only thinking about getting out. I explained to him how I would gather the information and tell it to the attending, while at the same time, hopefully learn something myself. After all, this was a teaching institution. You have to expect this sort of thing. What made him think that he could treat me this way?
We tried to continue on, but all was lost. After a few more questions, he said, “I just don’t get it. This is like taking a pilot in training, putting him in a 747, and telling him to fly.”
By then, I was too tired, confused, and sweaty to do anymore. “You know what? Why don’t I go get the doctor and he’ll talk to you.” I didn’t have to wait for the answer before I was up and out the door, feeling both defeated and angry – mostly angry.
“Interesting case” now had a new meaning.