Monday, November 26, 2012

"We've Outgrown Our Relationship"

In a recent tutorial, I shared my reaction to a client-physician conversation from the short story Something’s Wrong—Please Listen to Me! in Privileged Presence: Personal Stories of Connections in Health by Liz Crocker and Bev Johnson with my fellow OT group. In the story, the client had been seeing her doctor for a while and when the doctor wanted to reduce her medication very quickly, the client spoke up to say that she felt that it was too quick for her. The doctor’s response had been, “But if you want to get better, you have to follow my instructions.” And after a while, this doctor told the client that “We’ve outgrown our relationship.

My immediate reaction after reading that last phrase was shock, anger and a feeling of having been offended by this doctor. I felt offended that this doctor could be in the “helping profession” and give up on the client without trying to talk it out with the client to assess their needs or try out alternative ways to reduce her reliance on the medication. I shared how I felt that the doctor did not communicate in a way that was professionally responsible with my OT peers and we discussed how this was reflective of the importance of open communication that was brought up in a recent lecture on therapeutic relationships.

The very next day, I was meeting a friend who is currently in 2nd year medicine over a drink (Starbucks Buy One Share One event!) and I decided to share my reflection with him. From my point of view, the doctor in the story was not being very client-centered and came off as very rude. After hearing my rather negative appraisal of the doctor, my friend looked a bit concerned. Being calm and collected in nature, his response consisted mostly of a series of questions for me:
  • Do you know both sides of the story?
  • How long has the doctor been seeing this patient? 
  • What else has this doctor done for this patient?
  • Do you know the patient’s history with other health professionals?  
  • Do you know exactly what happened in terms of the entire conversation?
  • This is a book of patient experiences from patients that have been willing to share their stories… Don’t you think there’d be bias?

I’ll admit that when we discussed my reaction, I had been a bit confused by his calm reaction. I had thought: Why don’t you understand why I was offended? Isn’t it obvious that what the physician said in the story was very rude? How can you not see how the situation wasn’t handled properly? Is quitting on a client what someone from the “helping profession” should be doing?? A cacophony of similar thoughts was bouncing around in my mind when I could see that he obviously did not feel the same way. I almost regretted bringing it up because it was definitely causing some tension between us. I have often been told that I don’t recognize the difference between a discussion and an argument, often turning the former into the latter. Luckily, our conversation did not get to that point of frustration.

Later on, my friend said that he didn’t mean to sound so tense from our talk before but that he often felt that doctors end up playing the bad guy in these stories. Despite how our education talks about being nonjudgmental and promoting interprofessionalism, many people walk into an interprofessional setting with biases about other health care professionals.  I began to see that my response to this story was laden with negative judgment for physicians. Even though my intention behind sharing my reflection with my friend in medicine was not to be critical of his profession, it came off that way to him. And I realize that as much as I was trying to stand in the client’s shoes, I had neglected to think about the doctor’s position and had formed a judgment on this person based on what is likely a biased account. It dawned on me that my way of thinking was not as open-minded or as “OT”-like as it should be. My response should have been more situation-specific, rather than about pinning a negative judgment on the doctor.

As much as we learn about looking at the client from a holistic perspective and being non-judgmental, my conversation with my friend opened my eyes to how I was being hypocritical. I had already shared my reflection on this story in our 825 tutorial the previous day, and my emotional response had been more or less accepted. It had seemed to me that my fellow peers had felt the same way, but perhaps it was because I was in a room of OTs.

I was very glad that he brought it up because I had a feeling if neither of us had said anything, and just left the discussion as it were, there wouldn’t have been closure. I may be exaggerating here, but I think if it weren’t for him bringing it up, the lack of understanding would’ve added tension between not only our professional selves, but between our professions as well.  I told him that I appreciated his criticism on my reflection, and that I realized that I was being judgmental. It was unreasonable for me to think that this client’s published story was all there was to their experience with that physician. This particular experience in sharing my reflection with someone outside of my program got me thinking in a much broader way than I expected. Not just about my future occupational therapy practice and how I will engage in therapeutic relationships, but also how I should think like a non-judgmental health care professional.

Hopefully, my friend and I do not "outgrow" our friendship any time soon. =)

Tuesday, November 20, 2012

So. Why am I starting this blog? Why now?

While procrastinating from studying and looking for light reading, I've come upon some blogs that have made me look again and bookmark them. The concept of keeping a blog, a sort of online reflection journal, has always intrigued me but I've always been a person who has to take a while to decide and a bit slow to warm up to new things. I guess you can say that some of this "light reading" has played a part in motivating and inspiring me to finally start a blog for myself!

I'm currently enjoying the first year of my Masters in Occupational Therapy (MScOT) program and I find myself doing a lot of reflecting. It's partly because some of our courses require a lot of reflection, and also because self-reflection is something I have found myself doing naturally -throughout my life since highschool. Now that I'm just over 3 months into my program, there have been quite a few opportunities and experiences (both in OT and life in general) for me to reflect on. I'd like to use this blog as a way of getting these thoughts and feelings down and to act as a sort of journal to look back on when I graduate to see how much I will have grown (hopefully!). =)

Given my busy school schedule and my general slow-ness in getting my thoughts out in an articulate manner, I don't know how committed I will be to posting... Ah! There I go, setting myself up for failure eh? But I will try. I mean it. I WILL Try my very best! I want to be able to see how my way of thinking will be changed by this OT program and my life experiences along the way.

Reflections. Random musings. Photos. Metaphors of life... Here we go!