A Patient’s opinion is often valuable

Sudhir Kumar 
 Neurology Unit, Department of Neurological Sciences, Christian Medical College Hospital, Vellore, India

Correspondence Address:
Sudhir Kumar
Neurology Unit, Department of Neurological Sciences, Christian Medical College Hospital, Vellore
India

Full Text

A number of incidents during residency shape our method of practice in future. This communication is regarding an event that had a significant bearing on the way I deal with patients. The incident occurred in the first year of my residency in Neurology at a tertiary care centre. A 35-year-old lady consulted me for headache of six years' duration. It was described as a constant dull ache and had all the features suggestive of tension headache. A thorough clinical examination including blood pressure and optic fundi was normal. I reassured the patient and decided to start her on tricyclic antidepressants. The patient enquired how sure I was that she did not have a brain disease. With the enthusiasm and exuberance of youth, I told her I was pretty confident. I had almost forgotten this incident when she revisited me four months later. This time she had brought a computerized tomography scan of her brain that showed multiple cystic lesions. I could not believe my eyes. My confidence was shattered. However, the patient and her family were kind to me and emphasised that anyone could make a mistake. She was operated at our institute and made a complete recovery. As we have a common ward for Neurology and Neurosurgery, I happened to see her almost on a daily basis during the period she was admitted. Each meeting with her reminded me that her initial suggestion (that she might have a brain disease) was correct.

This incident had a major impact on my response to patients' opinions. As patients know their body (and disease) the best, it often helps to carefully listen to them. I have since made a number of diagnoses by just paying attention to what they say. It is very true that 'patients are our best teachers.'