Patient often have many ideas about themselves and their condition in their heads. We interact with them and we learn about how they think about their body and how it heals, feels and works. Here is a small sample of what I heard over the last few weeks:
“My doctor said I’m bone-on-bone with the knees of a 90 year old.” –rationalizing future knee surgery
“I’m going to have my back done next” –in the same tone as ‘I’m getting my nails done.’
“I’m doing fine now, almost no pain, maybe a 5/10.” –trying to nail down a pain rating.
“I wasn’t hurting at the time, but I was worried about it (previous back surgery). The surgery was the first thing I thought about.” – reported feelings after falling.
“Funny thing, I had no pain after the first surgery, and now after the second one it’s back to what it felt like before the first.” – describing current pain complaints.
“When my husband had his back done he was up and out in no time. I’m still having so much pain, and I had less done than him.” –post surgical description.
“My pelvis is out again, can you put it back in? I’ll be fine if we can get it to stay.” –patient seeking help for her long term pains.
What do you think when you hear these statements?
- David Butler talks about “E-Flags” which are verbal cues a patient can give you during interaction that can lead you to address more than just the tissue.
- Harrison Vaughan also wrote on the concept here, check out his insights.
Listening is kind of like looking into their somatotopic representation and self-image. Patients end up telling you much about their past experiences, current understanding and future expectations. E-Flags could be thought of like symptom irritability; it ranges from high to low and determines how you address the patient and condition.