Hiding It

Hiding It

 

Tina Olkowski, MD1

Accompanying artwork: Reid Psaltis

Perm J 2018;22:15-212 [Full Citation]

https://doi.org/10.7812/TPP/15-212
E-pub: 04/19/2019

This is a story and illustration from the upcoming book 100 Little Stories of Big Moments published by The Permanente Press.

Most of the stories and poems were written by clinicians in 15 minutes in writing workshops about meaningful moments in their work and life of practicing medicine. Professional artists were asked to create a visual representation of the story.

"Always assume the patient is lying," I say as the young medical student finishes his presentation. He tries to maintain a poker face, but there is a perceptible twitch at the side of his mouth. I see this.

I’ve been an Emergency Department attending for 20 years, and I quickly assess people, noticing these things almost at a subconscious level. Sighing to myself, I retract the ugliness of my statement. I soften it, talking more quietly, drawing him in: "Or withholding something, hiding it." The student relaxes. Yes, I guess I don’t have to say patients are telling purposeful lies. Instructing him, I say, "So in each encounter, I usually ask, 'Is there anything else I should know?' And then I sit and stare quietly at the patient. You can sometimes get the most extraordinary additional details."

I send him back to the patient’s room. A whole 5 minutes later, which is a lifetime in the Emergency Department, he returns smiling. I look at him, so young and eager to please me.

"Well, I asked your question and waited," he gushes. "Turns out, maybe she could be pregnant after all."

I smile and pass him the lab slip. "She is."

Hiding It

How to Cite this Article

Olkowski T. Hiding it. Perm J 2019;23:15-212. DOI: https://doi.org/10.7812/TPP/15-212

Author Affiliation

1 Emergency Department, Moanalua Medical Center, Honolulu, HI

Corresponding Author

Tina Olkowski, MD (tina.olkowski@kp.org)

Artist Information

Reid Psaltis lives in Portland, OR, where he makes illustrations, comics, and sculptures about science, nature, and natural history.

Reprint Permissions

To obtain permission to republish, reprint, or adapt material published in The Permanente Journal, access and complete the Reprint Permission Form available at: https://www.permj.com/.

CME

The Kaiser Permanente National CME Program designates this journal-based CME activity for 4 AMA PRA Category 1 Credits™.

MEDLINE

27,000 print readers per quarter, 15,350 eTOC readers, and in 2018, 2 million page views of TPJ articles in PubMed from a broad international readership.



                                             

 

etoc emailClick here to join the eTOC list or text TPJ to 22828. You will receive an Email notice with the Table of Contents of each issue.

 

ISSN 1552-5767 Copyright © 2019 thepermanentejournal.org.

All Rights Reserved.