Talk, Talk

By John Hanks, DC

Talking to patients is not always easy. By that, I mean making casual conversation while I'm adjusting them. I'm probably like most doctors - talking about the weather, asking about their kids, inquiring about their jobs, etc. What gets me up most mornings is the interchange with patients. I want to hear what they have to say, more than I want to hear myself talk. I want to hear about their vacations, pets, and sometimes, even about their health problems.

But it's not always easy to listen to patients. I know I'm in trouble when a new patient starts the case history with, "This problem all started when I was a child..." If a new patient's story takes more than five minutes to go from infancy to high school, I have to speed up the interview. What's worse is a regular patient who always has a lot to say. I have a hard time getting away from these patients, yet my greatest fear in practice is getting behind schedule. One time, I looked at my afternoon schedule and saw a string of six or seven talkative patients in a row, several "difficult to please" types, a few "slow" patients (such as those with walkers or mothers with several children in tow), and a couple of truly unlikable guys. How did I handle this challenge? I cancelled the entire afternoon and went home.

There is one patient who I have seen frequently for at least 15 years. She is very introverted, and never initiates conversation. I strain to come up with some kind of interesting exchange of thoughts, observations - anything. We talk about the weather a lot. I imagine talking about things that could have happened to me, hoping that she might join in the dialogue. Perhaps I would say, "Wouldn't you know, the other morning, I stepped in some dog poop while wearing my new shoes!" Naw, I'll just stick to the weather.

Sometimes, just to make the day more interesting, I'll choose a "topic of the day." Not long ago, the topic was wild hogs in east Texas. I had heard a story on the radio about how razorback hogs were proliferating exponentially in the South. It seems there are thousands of them in the woods, coming out to tear up gardens, golf courses, and poke their tusks into any dog that might annoy them. My job with the topic du jour was to work it into the conversation with every patient. I figured this would be a tough challenge, but wild hogs turned out to be a hit. A surprisingly large number of patients had a story, or a thought, about razorbacks. One patient had eaten wild swine bacon. One guy had actually gone hog hunting outside of Houston. Another had a razorback sweatshirt from the University of Arkansas. "People shouldn't eat those pigs," opined one woman, "since there's no telling where they've been!" A couple of patients voiced concern about mauled dogs, and one patient made it a point to call her daughter in College Station, Texas, and warn her.

I have made more than my share of mistakes in casual conversations with patients. One mistake is assuming that people who know each other, like each other. Has this happened to you? I say something like, "So Ms. Kopopkins, you work at Walmart. Do you know Betty, who works at the snack bar?" Then Ms. Kopopkins replies, "Yes, I know her. She's the tart that wrecked my marriage, and married my ex-husband!"

Another mistake is not paying attention to the matter at hand, namely the adjustment of the patient. Yakking away about some inane subject, I have been embarrassed when the patient interrupted and said something to the effect of, "Could you explain again what exactly is causing my problem, Dr. Hanks?" (Uppity patient ... actually wants to talk about their condition!)

I once heard a rumor that the famous chiropractor, Clarence Gonstead, made it a rule that he would not talk to his patients about anything but their health and chiropractic. Although that would simplify conversation considerably, I wonder what his patients and staff thought about such a strict code. I hope the rumor is true, because I like to imagine a dejected woman patient leaving his office and saying to the receptionist, "Dr. Gonstead didn't say one thing about my new hair color!"

A doctor of chiropractic should be prepared to talk about anything found in People Magazine. Yet, my patients are very kind to me, and don't talk about too many obscure topics. For instance, they seldom start a dialogue about some rapper, about whom I know nothing. (Yo! What it is!) Somehow, my patients seem to prefer talking about gay marriage, abortion, the presidential election, and the existence of God. Am I alone in this dilemma?

When talking with patients, there are so many topics, and so little time: gardens, automobiles, barbeque, the Blues, Airstream trailers, chili cook-offs, harmonicas, or the Austrian-Hungarian empire. But, in my opinion, a DC is required to know only the most famous of sports figures (such as the winner of the Kentucky Derby). After all, there must be limits to any doctor's repertoire.

John Hanks, DC
Denver, Colorado

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