In your practice, I'm sure you have run across the older
patient with the "Doctor is God" syndrome. Therefore, they expect you to heal
them without their participation. Not only do you get all the credit, but you
get all the blame if something doesn't go as they thought it should. How do
you handle this?
My goal with my patients is to get as many as possible
functionally with greater independence. I do recognize, however, that there
are those constitutionally unable to take control. These patients ofter
require ore time and it is often helpful to involve a family member who feels
the attachment.
Do you ever get through to them, that it is they have a
responsibility for what happens to their bodies and that Doctors are human,
too?
The world of people can be divided in a number of ways.
there are the active go-getters and the passive take what comes.
Psychologically such terms as Locus of Control (internal (take charge) and
external (be taken charge of)) are used. It would seem to be very difficult to
change from one to the other. You try to find ways around the externally
controlled with various support services.
Dr. Norman Levy, who runs the PsychoNephrology Conference
every few years in New York, has pointed out the critical characteristic of
long term survival on dialysis (or with a chronic condition):
"Long term survivors are givers of ulcers rather than
getters of ulcers".
You can now all interprete the meaning of that.
Peter Lundin, M.D.
Minor editing by Stephen Z. Fadem, M.D.
