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“You need to lose weight. That's why you're limping on that knee. Take some weight off and it will lessen the pressure inside your knee.”A brilliant, and wrong diagnosis.I had marked “yes” to the question Did I have uneven gait or difficulty walking? on the new patient questionnaire. So someone snagged a passing neurologist and had him make a snap judgement after watching me walk about 20 steps down the hall.He took no history, did not look at chart notes - and managed to completely offend me in 5 minutes or less. He saw my weight and looked no further.I limp on that knee because it got torn up when I was a skinny teenager, and I have chronic tendonitis with some pretty painful acute episodes. The meniscus is fine. The cartilage is fine. But the tendons going over the top of my kneecap are not - and weight makes not one bit of difference.Add Menieres syndrome, and sometimes my gait looks like I'm 3 sheets to the wind.Lesson this young doctor learned: snap judgements can have painful consequences. He learned to review the History & Physical and don't make snide remarks about a woman's weight.Listen to your patient. I told the anesthesiologist (who looked about 12 yrs old) “Don't put me under! It's a brief little procedure, a LEEP surgery. A spinal is all I need.” Anesthesia usually leaves me throwing up my stomach lining.Sooo. He dropped by as I was coming out of the anesthesia I very specifically told him not to use. I'm painfully heaving up everything in my system as he's wringing his hands and explaining that he only used enough for a small child!Lesson learned: listen to your patient! They've lived in their body a lot longer than the 10-15 minutes you've been talking to them.

What I thought would be common knowledge for this physician-patient turned out not to be.A medical oncologist I work with named Dr. Smith called about a patient with a relatively uncommon form of cancer called a MALT lymphoma. He told me that the patient, Dr. _____ had recently retired after many decades at the Mayo Clinic. He moved back to our city, because his daughter lived here with her physician husband.At the appointment, I introduced myself to Dr.______ along with his wife and daughter. I began by reviewing his history. I do this when I am first seeing a new patient to make sure they understand the situation we are addressing. I had talked for a few minutes when Dr.____ asked “Now what’s the duodenum?” I’m sure my surprise was evident in my facial expression as I tried to think of what to say. During the pause, Dr.____’s wife said “maybe Dr. Smith didn’t clarify that my husband has a PhD in economics - he worked as a hospital administrator at the Mayo Clinic”. Just a little embarrassed, I started over with the vocabulary I would use for a “non-physician” patient and the consult continued.

A number of years ago, I was running one of our surgical lasers for a urologist and during the case, he told a story about an interesting surgery he performed.A woman came into his office as a new patient. She filled out the usual paperwork, which asks about health history and any past surgical procedures. I don’t remember all the details but he eventually had to perform a procedure on her which involved putting a scope up her ureter.So the day of the surgery comes, she’s put under, and the doctor puts the scope in her urethra and proceeds to make his way to the bladder, only to find something very unexpected.A prostate.Long story short, the woman was post-op transgender, but apparently didn’t think it was important to convey this information to her doctor.After the surgery, he explained to her the importance of providing her FULL health history as it would allow him to provide the best care possible.