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jaunthieThe nursery rhyme ends with "Grace is a little girl who won't wash her face." I imagine it's a way of reminding ourselves about perspective, how one thing to one person can really be another. Or maybe it's just a cute rhyme, and I'm reading more into it than there really is. Whatever.
Today, Grace was an intern at the specialist vet's office.
Her name wasn't Grace, of course. I'm just calling her that here, names changed to protect the innocent and all that. And she was innocent. She was bright and perky and seemed relatively smart. She was definitely interested in J and what was going on with him, and clearly has that "gosh-wow isn't all this cool?" intellectual curiosity that will undoubtedly help her all through her career. I am fairly convinced that she will be a good veterinarian someday soon.
But oh, was she as green as grass when it came to communicating with an ordinary human like me. Someone who is *not* a veterinarian, who has no idea where the ileocecocolic junction is (or even what it is), and whose own sense of intellectual curiosity and wonder is currently squashed under a not-inconsiderable burden of worry and emotion and concern for a beloved pet. She did okay in person (although even then she tended to lapse into jargon as soon as she got interested or excited), but over the phone...oh, dear. Oh dear me, no.
I had to leave J at the clinic for the tests. This clinic is about a half-hour's drive from where I live, if traffic is good; much more if things gum up (as they tend to do). Call #1 from Grace started with her telling me that he had done very well, and that I could come and pick him up now - except that they'd taken another sample from a different area, and was I interested in paying the extra fee to have that diagnosed, and come to think of it she wasn't absolutely sure they'd gotten enough from the first sample to do the test, but she could confirm that and call me right back if they needed to do it again. So maybe J wasn't really ready for pick-up after all.
Sigh. Clearly, the call wasn't "come get your cat," it was "we need permission to run a second sample through tests and that will cost more money." Certainly a necessary call, but not at all what she started by saying. So I gave permission for the extra tests, and she said she'd call right back as soon as she was sure J was ready.
Call #2 came about an hour (!) later. Grace immediately started in by saying she wanted to start J on prednezone, and also wanted to give him some fluids, and that the test results wouldn't be back for a few days yet. She also told me she'd taken a look at some of the sample cells herself, and while she wasn't a pathologist, given the cells and the pictures of the mass in his abdomen, she was fairly sure that it was something along the lines of X, except it really could be Y, or even possibly Z in rare cases, and nothing could be certain until those tests came back. But whatever it proved to be, there would certainly be a range of treatment options, although we won't really know what those will be for a few more days, and she couldn't say anything about what they might be. But the prednezone wouldn't hurt J no matter what the diagnosis might turn out to be, and it would make him feel better. All of this was liberally salted with a great deal of technical jargon, which would have undoubtedly conveyed a lot of very precise information to anyone who actually spoke veterinarian, or at least advanced biology. NONE of it was anything as simple as "yes, there is something wrong with your cat," or "I'm sorry, but the initial results don't look good," or even "you can come get your cat now, and we'll talk about what we've found when you get here."
Double sigh. At this point I'm holding on to my patience with both hands, a metaphorical vise, and imaginary duct tape, and double all that on my emotions. I might not be the best communicator on the planet, but you'd think "phone call with client 101" in vet school would include handy-dandy advice like when making a call delivering what most normal humans (as opposed to veterinarians who understand all the ramifications) might consider bad, scary, or otherwise unsettling news, you might want to consider keeping it simple, keeping it sympathetic, and keeping it short if the option is available for talking face to face.
Look. I've been the newbie before, the trainee, the student-intern. You make mistakes, but it's the only way you learn. And Grace was clearly working hard; it's not like she was shirking or blowing me off. She was most definitely intellectually engaged with my problem and my cat. She just didn't have the experience - yet - to know how to wrap that clinical engagement with a coating of "oh yeah, you're dealing with a client who doesn't have your years of study or emotional detachment" language. I'm sure she'll develop that "bedside manner" in time.
But in the meantime, patience is a virtue...and we'll be waiting for a few more days.
Today, Grace was an intern at the specialist vet's office.
Her name wasn't Grace, of course. I'm just calling her that here, names changed to protect the innocent and all that. And she was innocent. She was bright and perky and seemed relatively smart. She was definitely interested in J and what was going on with him, and clearly has that "gosh-wow isn't all this cool?" intellectual curiosity that will undoubtedly help her all through her career. I am fairly convinced that she will be a good veterinarian someday soon.
But oh, was she as green as grass when it came to communicating with an ordinary human like me. Someone who is *not* a veterinarian, who has no idea where the ileocecocolic junction is (or even what it is), and whose own sense of intellectual curiosity and wonder is currently squashed under a not-inconsiderable burden of worry and emotion and concern for a beloved pet. She did okay in person (although even then she tended to lapse into jargon as soon as she got interested or excited), but over the phone...oh, dear. Oh dear me, no.
I had to leave J at the clinic for the tests. This clinic is about a half-hour's drive from where I live, if traffic is good; much more if things gum up (as they tend to do). Call #1 from Grace started with her telling me that he had done very well, and that I could come and pick him up now - except that they'd taken another sample from a different area, and was I interested in paying the extra fee to have that diagnosed, and come to think of it she wasn't absolutely sure they'd gotten enough from the first sample to do the test, but she could confirm that and call me right back if they needed to do it again. So maybe J wasn't really ready for pick-up after all.
Sigh. Clearly, the call wasn't "come get your cat," it was "we need permission to run a second sample through tests and that will cost more money." Certainly a necessary call, but not at all what she started by saying. So I gave permission for the extra tests, and she said she'd call right back as soon as she was sure J was ready.
Call #2 came about an hour (!) later. Grace immediately started in by saying she wanted to start J on prednezone, and also wanted to give him some fluids, and that the test results wouldn't be back for a few days yet. She also told me she'd taken a look at some of the sample cells herself, and while she wasn't a pathologist, given the cells and the pictures of the mass in his abdomen, she was fairly sure that it was something along the lines of X, except it really could be Y, or even possibly Z in rare cases, and nothing could be certain until those tests came back. But whatever it proved to be, there would certainly be a range of treatment options, although we won't really know what those will be for a few more days, and she couldn't say anything about what they might be. But the prednezone wouldn't hurt J no matter what the diagnosis might turn out to be, and it would make him feel better. All of this was liberally salted with a great deal of technical jargon, which would have undoubtedly conveyed a lot of very precise information to anyone who actually spoke veterinarian, or at least advanced biology. NONE of it was anything as simple as "yes, there is something wrong with your cat," or "I'm sorry, but the initial results don't look good," or even "you can come get your cat now, and we'll talk about what we've found when you get here."
Double sigh. At this point I'm holding on to my patience with both hands, a metaphorical vise, and imaginary duct tape, and double all that on my emotions. I might not be the best communicator on the planet, but you'd think "phone call with client 101" in vet school would include handy-dandy advice like when making a call delivering what most normal humans (as opposed to veterinarians who understand all the ramifications) might consider bad, scary, or otherwise unsettling news, you might want to consider keeping it simple, keeping it sympathetic, and keeping it short if the option is available for talking face to face.
Look. I've been the newbie before, the trainee, the student-intern. You make mistakes, but it's the only way you learn. And Grace was clearly working hard; it's not like she was shirking or blowing me off. She was most definitely intellectually engaged with my problem and my cat. She just didn't have the experience - yet - to know how to wrap that clinical engagement with a coating of "oh yeah, you're dealing with a client who doesn't have your years of study or emotional detachment" language. I'm sure she'll develop that "bedside manner" in time.
But in the meantime, patience is a virtue...and we'll be waiting for a few more days.
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no subject
Date: 2009-10-01 03:16 am (UTC)Thinking of you and J.
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Date: 2009-10-01 03:56 pm (UTC)no subject
Date: 2009-10-01 05:05 am (UTC)no subject
Date: 2009-10-01 03:58 pm (UTC)no subject
Date: 2009-10-01 04:36 pm (UTC)no subject
Date: 2009-10-01 08:59 am (UTC)...and I can so see me doing that. (Especially the putting slides under the scope, and then being too willing to discuss the ambiguous results... yeah, maybe I'll stay in research.)
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Date: 2009-10-01 04:07 pm (UTC)In fact I chatted with the intern about this whole communication thing when I went back to pick up J, because I've been in her shoes, and feedback on communication skills was one of the things that really helped me improve back in the day. (I also made sure to tell her how much I appreciated her interest and intellectual curiosity, along with the feedback about the phone call skills. Constructive criticism, even leavened with postive feedback, was never easy to hear, but it was invaluable to my professional development.) And like I said, I totally recognized the kind of intellectual geeky place she was coming from. I have no doubt that she really wants to learn and improve, and having beentheredonethat, it certainly behooved me to give her a) the benefit of the doubt and b) attempt to provide the kind of "friendly word" that I would want in similar circumstances.
I just didn't want to have to be that mature yesterday, y'know? Oh well, it's the way things go sometimes.
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Date: 2009-10-01 02:10 pm (UTC)And yes, you're right. Lessons in how to deal with people would be particularly valuable in veterinary school, but for some stupid reason they're just not part of the curriculum. Actually the reason they're not is probably far from stupid, but it leaves fresh graduates out in the cold in the "learning how to deal with the people that actually pay the bills (or not, in some circumstances)" realm. For those of us science and animal geeks who spend our entire lives working towards a goal that includes science and animal medicine, the lack of people management skills that other professional students (business students especially) acquire or are taught is a marked deficit. We come out of school knowing how to deal with animals, but people are an entirely different, exotic, and sometimes scary, species.
I'm sorry the IM resident was such a goob. Tell ya' what. The next time J has to go and visit the goob, make the appointment for a Thursday or Friday and I'll go with you to put the fear of god into the goob. She WAY shouldn't have told you what her opinion of the cells was. Her opinion don't count for poop in this type of situation.
The ileocecocolic junction is that section of intestine where the ileum (the distal section of the small intestine) merges into the cecum (a teeny little blind ended pouch of intestine that is useless in cats, an appendix in people, and very, very important in horses) and then drops into the proximal section of the colon. Prednisone will, without a doubt, start to make J feel a good deal better.
--Jake
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Date: 2009-10-01 04:11 pm (UTC)The intern is in her last two weeks there, and I do think she really did mean well. Normally I enjoy the gosh-wow of nifty new science/knowledge geekery, too. But yeah, assuming that I need to make a further appointment while she's there (I suspect this is likely to happen), I'll see if I can't make it for one of those days. Thank you.
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Date: 2009-10-01 02:38 pm (UTC)-Ry
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Date: 2009-10-01 04:12 pm (UTC)