A COLLEAGUE RECENTLY introduced me to a young physician, noting that her research interest was difficult patients. "Really," I responded. "I’m a difficult patient, and it’s served me well." I assumed that she considered being a difficult patient a good thing, but her pained expression suggested otherwise. We shared an awkward moment before parting, and I walked away considering the plight of the "difficult" patient.
In the clinical world, the term difficult is applied to a variety of patients: the noncompliant; the rude, abusive, and manipulative; the malingering; the mentally ill; the skeptical. In my case, I too frequently challenged my doctors with questions and too often chose a treatment that differed from what they’d recommended. I consider myself to be an assertive patient, but it was clear on many occasions that some providers thought I deserved the "difficult" label.
How did I earn this distinction? Surely some of it was genetic predisposition; I was born with a feisty personality that compensates for my diminutive stature. But mostly it was born of necessity, a survival instinct that involved both fight and flight.
Norman DeLisle, MDRC
"With Liberty and Access for All!"
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