Dr. Bauer wrote a post a while ago about “crazy patients.” I really enjoyed the blog; the moments he shared definitely reminded me of a lot of the patients I see. A commenter said, “You aren't going to always know everything about every patient and their problems when they walk through the door. This doesn't mean them crazy or make you a bad dentist. The key is to stay patient, keep calm and try to sort through the mess to the real issue at hand.” That comment truly struck a chord with me. A patient of mine recently showed me just what the commenter was getting at.My patient had always seemed a bit different, but I couldn’t ever narrow down just what was happening. An hour after speaking with her to schedule our next appointment, she would call me to schedule our next appointment. She wouldn’t have any recollection of our previous and would frequently become very emotional on the phone. When she was in my chair, she would often make inappropriate comments. On several occasions, my classmates asked me if there was something not quite right with her.
She had presented with recurrent caries under a crown, and not long after developed a toothache. We discussed the options and she elected extraction. She experienced significant prolonged bleeding following the extraction which required her to return to the clinic for debridement and placement of hemostatic agents. A week later, she called me in tears and in her voicemail she reported significant bruising. She asked if she could come in to be examined to determine if the bruising was from the extraction or from her husband slapping her on her face the night of the extraction.
I was rattled to hear that she was being abused, but it showed me what that commenter already knew: there are things about your patients that you do not know. They aren’t crazy and you aren’t a bad dentist. You just have “to sort through the mess to the real issue at hand.”
David Coviak
3 comments:
I totally agree. Patient who has discomfort are definitely not crazy, if we can just be patient and open our mind.
Who in their right mind would slap someone that just had a dental procedure? Sometimes "crazy" is the product created by someone who is crazy. Sad.
"to determine if the bruising was from the extraction or from her husband slapping her on her face the night of the extraction."
The fact that her husband slapped her is definitely the biggest issue at hand. I hope you encourage your patient to seek counseling and take actions to protect herself. As dentists our primary job is to care for our clients' teeth but their overall health is not something we can ignore either.
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