Usually, we have exams at the exam rooms, especially when we are students. However, I have never seen politics in the exam room, and I know little about politics in the exam room.
I had always loved my patient Gertruder. A woman in her 70s who had been widowed young, she ran her own business and traveled the world. She appeared to me a model of how to age well: independent, engaged, lively, energetic. We always loved good conversation-about textbooks, art, and life while she visited my workplace.
Then, one day in the fall of 2008 during a routine physical, I asked her casually if she was following the presidential campaign with interest. Was she ever! She embarked on a several minute tirade about the candidates and the issues holding, as it happened, opinions exactly the opposite of my own on every point. "And what do you think about all this, doctor?" she asked.
A friend of mine who is a psychiatrist often jokes with me that I am lucky. As an internist I can chat with my patients about various topics and compliment a new hairstyle or outfit as would not be appropriate for my friend, a psychotherapist, to do. Transference, counter transference, and boundaries are crucial parts of the psychotherapeutic relationship. But it would be na?ve to think that these elements are absent or unimportant in other clinician-patient relationships.
Internists and other watchers require always to be watchful that sufferers project onto us characteristics we can't foresee and that their reliance in us most importantly their trust that we have their greatest interests at heart and are not judging them negatively is as important part of the remedial relationship as it is in psychological health settings.
So what did I reply? I replied, "You're awesome, Gert" which is real about her-what was real about me at that time didn't matter. So that's something about politics in the exam room. Now I know that while we have exams in the exam room, maybe some politics take place in the same time in the exam room, too.
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