first impressions

You should probably have your attending take the patient, the psychiatrist told us.  She was persecuted by the Chinese government and absolutely refused to have a Chinese psychologist.  She has a lot of anxiety and PTSD.

I had just spent about ten minutes perusing the records of the patient - let's call her Wendy - which detailed a long history of religious persecution through her childhood and adult life, leading to an understandable distrust of the government and anxiety.

I was already slightly a bit anxious myself about seeing the patient, but hearing the psychiatrist and primary care physicians' comments on Wendy made me even more nervous.  Do you want to take her? I asked my attending once we got back to the exam room.

She shook her head. No, why don't you try, and if she has issues with you, I will see her.  She seems like the type who will worry and talk a lot, so try to listen and be sympathetic but also keep her on track.

With that cheerful admonition, I walked out to the waiting room to call my patient.  After introducing myself and taking her to the exam room, it seemed that the warnings about her rejecting me as an Asian student physician seemed to be unfounded.

Some of my friends have been teaching me to be conscious of my body language, so I tried to think about softening my posture, speaking gently and carefully, and trying to project calm towards Wendy.  She was talking very quickly about her anxiety compounding an already complicated medical history, so I had to remind myself to breathe slowly, stay relaxed, and not let my own heart rate and body posture get caught up in her anxiety.

Finally, she mentioned that her daughter was in school very near where I do my research.  I told her, Oh, I probably even see her from my office window because it's right next door to where I go to graduate school!  Immediately, her face lit up and she relaxed visibly.  She started talking more slowly and opening up, and from there the rest of the interview and exam went smoothly.

It was a good lesson to me to listen to what other healthcare professionals say, but not too much.  Sometimes it's better to just meet a patient without preconceived notions and let things unfold from there.