Sometimes you never know how a patient sees you.
I had an unexpected encounter recently. My patient was a woman with a history of post-surgical panhypopituitarism for a congenital issue. She also had mild mental retardation, and was always accompanied by a troop of family and nursing home caretakers the 2 times I saw her in clinic.
The first was a pretty long consultation, going over her medical history and ordering the labs. The 2nd visit was to go over the results.
I didn't think things went too well the first time. Her father sat upright, with a stern nonapproving look. He recorded our conversations and did not inform me he was going to do it (it's their legal right, but always a courtesy to let the provider know beforehand). He seemed confrontational, asking many questions and stopping me midsentence frequently. It was an exhaustive 45 mins, and I felt that he must have thought I didn't know anything.
And so, admittedly I was hoping he wouldn't show up with her the 2nd time round. But no, the same troop came: patient + father + sisters + nurse. And so, not surprisingly the same thing: the recording, the many questions, the look. THAT look.
We went over the results, and formulated a treatment plan.
As they were leaving, her father shook my hand, but I was unprepared for what he said loudly, well within earshoot of my staff: "Thank you, Dr. V. You really ARE the best!"
(When he opened his mouth to speak, I was kinda expecting something like: "You damn quacks don't know anything, do you?")
Sometimes, you really never know how a patient perceives you.