Indexing Title: DCHUA’s Medical Anecdotal Report [08-05] 

MAR Title: Patient spoils doctor 

Date of Medical Observation: January to September 2005

Narration: 

After unloading a bunch of accumulated sample tamoxifen tablets to a fifty-one-year-old mastectomy patient of mine, I eventually found myself in an awkward position of a perpetual recipient.  She was a stage 3 cancer patient who elected hormonal therapy over the chemo I recommended. 

The first time she followed-up after her confinement, she did not look like someone who had just had a major part of her body surgically removed.  Wearing a sleeveless shirt, she commanded more attention than the daughter who accompanied her.  She brought me fast-food items then, and every time we would see each other thereafter. 

Eventually, she would visit the hospital just to drop food off.  With our line of unpredictable workloads and schedules, many of these visits were saving graces.  Occasionally, she would refer other patient-friends to me.  On other occasions, she would give me other small tokens, like a t-shirt that mimicked our uniform and home-cooked food. 

Feeling uncomfortable, I eventually asked why.  She explained that she was just reciprocating the kindness she received.  She also related her frustrated ambitions of taking up Medicine, being a non-practicing Med Tech herself, and her experience of taking care of her dying father.  Asking for her help in finding house help for my own severely disabled father, a task she took to fervently, I still feel uncomfortable taking advantage of her kindness. 

Like she spoiled me with food and gifts, she started spoiling the maid- something my mother took unkindly to.  A simple text on realistic expectations cleared things up. 

Insights: Physical, Social, Ethical; Discovery, Stimulus, Reinforcement

Patients react to illness differently.  Some take things surprisingly well. 

Part of physician training are advises to maintain barriers to patients.  Oftentimes, good patient-doctor relationships erode such barriers. 

Being spoiled is fun.  Having someone under your responsibility spoiled is difficult to handle. 

Physicians often spoil charity patients with dependence.  Some patients spoil doctors, oftentimes with ego flattery.

Taking advantage of goodwill makes one uneasy, but at times, such is necessary.  Being grateful is all one can do.