A grandmother brought her grandchild to see me recently. Several minutes into our dialog she stopped me, put her hand on my arm and said, “You’re a fine doctor.”
“Thats so kind,” I said. “But, honestly, how do you know? We’ve barely met.”
She winked and said, “I can tell by how you talk to me.”
After countering with the suggestion that she looked too young to be a grandmother (and it was the truth) we finally got down to business.
But I couldn’t stop thinking about her comment. What brought her to that conclusion so quickly? Not much had happened, in fact. I came in the room, briefly cut up with the child on the exam table, sat down and visited with grandmother for a bit when she reached for my arm.
I suspect that was it. We visited.
To ‘visit’ is a characteristically southern reference. It implies easy, relaxed conversation that’s genuine and unstructured. It’s fitting of an interaction that’s focused and real. I had never heard the term before moving to Texas in the early 90’s. It’s a description more often used by families of my rural patients and my mother-in-law.
I’m not sure you can teach someone to visit. It’s about presence and mindfulness and interest in the person you’re with. I’m not sure how Press-Ganey would measure it.
I have to confess that I was probably ‘finer’ than usual that morning. While I like to think that I treat all my caregivers equally, I’m dangerously biased by charming older women who play taxi driver for their grand kids.
The scenario here has been slightly de-identified to protect the privacy/dignity of the caregiver and patient.
Image from the National Archives. Houses and trees in the Fifth Ward of Houston