The Devil You Know

Human relationships can turn on a dime. This week, I was blindsided by a patient in the middle of a hallway, and twenty-four hours later, my mouth is still hanging open. In the middle of a hot, busy day I was verbally attacked by a very angry man in whose eyes I could at first do no wrong, and suddenly, because I was handy, I could do no right. I am bruised, battered, sore, angry and what little trust I had managed to scrape together has been shattered. I feel I should have seen this coming. I know I committed the critical mistake in life that I try so hard not to commit in fencing: I let my guard down.

A fencing opponent will always telegraph their intentions, as will any human being. The trick is to learn to read your opponent accurately, to recognize their tell. What is it about the person in front of you that gives their game away? My fencing buddy Brad will drop his forearm, his son Kyle will increase the pace of his footwork. Omar will march down the strip and simply extend his arm, which is about seven feet long, and then turn his back and walk away, leaving me bruised and muttering "Bastard" under my breath. I know my own "tells". I first retreat slightly, inviting attack, then counterattack swiftly.

Thinking back to my first encounter with this patient, I should have been warned. He spent a lot of time telling me how much the staff at the hospital disappointed him, how little they cared, how they didn't listen to him. Perhaps because he was my last patient of the day, and I was tired, I showed sympathy instead of recognizing the litany for what it was: his tell. A patient who will spend their time telling you how badly others have treated them has a chip on their shoulder, and will forever judge you, the next clinician, against impossibly high standards, standards no human being could meet. I certainly could not, on a hot afternoon in a hallway when I was already late for my next patient. And not giving them the reaction they are looking for will make them even more angry.

For myself, I find it easiest just to shut the situation, and whatever feelings are involved at the moment, off, like a water faucet. No one will benefit from going on and on about it right now. Best to calm down, put it aside and deal with it later, and privately. Unfortunately, this seems to piss a lot of people off. So when this patient got angry and heated, I simply became more clinical, by degrees. The hotter he got, the colder I became. In no mood to placate, I withdrew. It made me sad to watch his shoulders slump.

Everyone we meet in life teaches us an important lesson. This I believe. This patient reminded me not so much to keep my guard up, but to recognize a "tell" when I see one. To remember to read more accurately the needs each person is telegraphing. Now I have seen more clearly, and when I see it again, I will recognize it.