tag:blogger.com,1999:blog-8489009971732520747.post3414828818201121570..comments2024-03-24T07:19:28.136+00:00Comments on Lake Cocytus: Subjective CommentThe Shrinkhttp://www.blogger.com/profile/10009039342346247138noreply@blogger.comBlogger11125tag:blogger.com,1999:blog-8489009971732520747.post-77049031084342056352008-02-13T21:55:00.000+00:002008-02-13T21:55:00.000+00:00Michael O'Donnell wrote very entertainingly about ...Michael O'Donnell wrote very entertainingly about the changing style of letters and notes in <A HREF="http://student.bmj.com/issues/03/06/reviews/213a.php" REL="nofollow">"Medicine's Strangest Cases"</A><BR/><BR/>Re the meaning of stubborn, if "stubborn" has a pejorative sense, what about "strong-willed" (which I take to mean "stubborn, but not in a bad way")?<BR/><BR/>PS The only time I ever saw a referral letter the GP had written for me (to a general surgeon for a minor procedure) he told the surgeon in the letter that I was taking an antidepressant I had taken for a few months more than a year previously...! I always wondered whether that was why the surgeon was so solicitous, although it could have been the private insurance.PhD scientisthttps://www.blogger.com/profile/00653179299453839890noreply@blogger.comtag:blogger.com,1999:blog-8489009971732520747.post-68547707727626935412008-02-13T17:47:00.000+00:002008-02-13T17:47:00.000+00:00As a person just learning how to write reports and...As a person just learning how to write reports and letters like these, I'm glad to know that I am not the only one who finds those added comments unnecessary, annoying, and judgmental. It drives me crazy to read charts and find it full of editorials about the patient. I will make up my own mind, thank you very much!<BR/><BR/>(I'm in line to be a "stubborn" old lady too.)Katie!https://www.blogger.com/profile/00795555425849436787noreply@blogger.comtag:blogger.com,1999:blog-8489009971732520747.post-67660283264562741402008-02-13T00:25:00.000+00:002008-02-13T00:25:00.000+00:00I've never been fond of them for same reasons as d...I've never been fond of them for same reasons as dissillusioned. However, they can be regarded not as a statement of fact, but as an indication of the immediate or projected relationship between the pt and the health care provider(as per the nice old "stubborn" lady).<BR/>In this essence, it has been useful in understanding where some of the 'problem issues' might be coming from when those charged with their unconditional and professional care begin correspondence with something akin to "Thank you for seeing this obnoxious little bastard.... "Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8489009971732520747.post-12124069294531353752008-02-12T23:48:00.000+00:002008-02-12T23:48:00.000+00:00It's a tricky one. With subjective comments there...It's a tricky one. With subjective comments there's the possibility to either prejudice things unfairly (as Disillusioned suggests) or to rapidly convey a summary and meaning (as Dr Brown suggests).<BR/><BR/>Too, as Elaine and MwaN suggests, is it that bad . . . I want to be stubborn when I'm a venerable age!<BR/><BR/>I have always favoured Disillusioned's view that they're best avoided, whilst being aware of Panagiotis' point that patients could at some point read any letter I send.<BR/><BR/>But political correctness, censorship and the like irk me. Shouldn't we be able to say what we want, as professionals, and assume that colleagues will be both adult and professional in their interpretation and use of this? Heck, it is after all sent as clinical information, not gossip!<BR/><BR/>Letters conveying evocative imagery, akin to poetry . . . I like that analogy a lot.<BR/><BR/>Dr Brown, letters are typed or hand written to me, still, by my GP colleagues. Many are sent to me personally, with some GPs and Consultants writing on first name terms. I think it would be sad, if this professional relationship were to be lost.The Shrinkhttps://www.blogger.com/profile/10009039342346247138noreply@blogger.comtag:blogger.com,1999:blog-8489009971732520747.post-60284323525615647712008-02-12T21:13:00.000+00:002008-02-12T21:13:00.000+00:00Fascinating! I always used to start my referral le...Fascinating! I always used to start my referral letters "Thank you for seeing this 99-year-old lumberjack who..." Sometimes I would use an adjective, but "pleasant" simply means "middle-class". Those were the days when doctors were communicating between themselves.<BR/>Nowadays things are more patient-centric, and my letters might begin "Mr Bloggs is a 99-year-old lumberjack who..." except that this is ageist and jobbist. All such details should be saved for the social history paragraph: "he is 99, lives in a terraced house with both parents, and still ekes out a meagre living cutting down trees".<BR/>But the opening "Mr Bloggs is 99, and..." sounds a bit feeble.<BR/>What the old-fashioned opening sentence was trying to do was provide a thumbnail sketch of the patient in a single sentence, in the way a novelist or poet might try to do.<BR/>I'm afraid that my referrals nowadays tend to the bland and mundane. I don't know who I'm writing to, for one thing, and typing into a small field doesn't encourage literary effort.Dr Andrew Brownhttps://www.blogger.com/profile/13858213625632400403noreply@blogger.comtag:blogger.com,1999:blog-8489009971732520747.post-58851402980242705262008-02-12T21:06:00.000+00:002008-02-12T21:06:00.000+00:00I have to say, good for her. We all have rights t...I have to say, good for her. We all have rights to remain "stubborn" ladies and gentlemen. I certainly plan on it.Midwife with a Knifehttps://www.blogger.com/profile/04309579302399381913noreply@blogger.comtag:blogger.com,1999:blog-8489009971732520747.post-3528640463999385432008-02-12T12:53:00.000+00:002008-02-12T12:53:00.000+00:00What if someone read their comments and then forme...What if someone read their comments and then formed their behavior so as to disguise certain aspects that were considered as negative from the former doctor? Wouldn't they present a false picture of themselves? Or are such letters disguised?Unknownhttps://www.blogger.com/profile/10407957224457274736noreply@blogger.comtag:blogger.com,1999:blog-8489009971732520747.post-69689202197444134082008-02-12T08:54:00.000+00:002008-02-12T08:54:00.000+00:00I'm becoming aware that I work within a time warp ...I'm becoming aware that I work within a time warp - the old "chatty" kind of letter is alive and well, and not just on the side of the GP. The psychiatric reports I've had to scan in to notes have on occasion been somewhat "colourful" too. There IS a drive on the part of the more "modernising" GPs to stick to the "facts" - to send a referral letter which consists of a medical summary and "please see and treat" - but that depends on the quality of the summary, the notes, the dreaded Read Codes. And Read Codes after all are just labels themselves.Fiona Marcellahttps://www.blogger.com/profile/07985022521354870620noreply@blogger.comtag:blogger.com,1999:blog-8489009971732520747.post-37225126070026018602008-02-12T08:46:00.000+00:002008-02-12T08:46:00.000+00:00I reckon by these standards that I am a stubborn l...I reckon by these standards that I am a stubborn lady, and would/will fight for my right to remain so. Makes life that bit more fun, doesn't it?Elainehttps://www.blogger.com/profile/06847149482684623481noreply@blogger.comtag:blogger.com,1999:blog-8489009971732520747.post-43147967271021256772008-02-11T22:52:00.000+00:002008-02-11T22:52:00.000+00:00In the book ”The Cockroach Catcher”, Dr Zhang had ...In the book <A HREF="http://www.lulu.com/browse/preview.php?fCID=1772066" REL="nofollow">”The Cockroach Catcher”</A>, Dr Zhang had to deal with a stubborn patient and he thought:<BR/> “……Stubborn patients deserve stubborn doctors……” .<BR/><BR/>It takes some doing for the lady’s doctor to put what he put down on paper for you. <BR/><BR/><A HREF="http://cockroachcatcher.blogspot.com" REL="nofollow">The Cockroach Catcher</A>Cockroach Catcherhttps://www.blogger.com/profile/14440000294855006966noreply@blogger.comtag:blogger.com,1999:blog-8489009971732520747.post-4185163346392081532008-02-11T20:54:00.000+00:002008-02-11T20:54:00.000+00:00Ah, but what if the comments are subjective and sa...Ah, but what if the comments are subjective and say more about the writer than the subject? Is it possible to distinguish?<BR/>For example, my reading of the lady you describe here is that she had a perfect right to want to spend time in her room. Stubborn is, in essence, perjorative is it not? It's a judgement. OK, it's a shorthand and you could see past it to the real person, who as you say was charming, warm and likeable. But waht about others who would read the "stubborn" and base all their interactions with this lady on that supposition, taht summary?<BR/>I guess I am just uncomfortable with judgemental labels, however well meant.Disillusionedhttps://www.blogger.com/profile/03250678226289036634noreply@blogger.com