Physicians

The Look

“He gave me the look,” the patient said to my nurse as he walked out of the exam room.

My nurse laughed and said, “I had a feeling you’d get it today.”

What were they talking about?  ”What look?  I didn’t know I had a look!” I asked my nurse.

The patient tipped his chin down and looked at me over his glasses.  My nurse laughed, pointing at the patient, “That one!  Exactly!  You give that look to me too!”

I was mystified.  I don’t like lecturing people or acting like their parent.  Patients do no harm to me when they gain weight, don’t take their medications, or eat a lot of Little Debbies.  My job is not to get them to do everything I say, it is to give them enough information and motivation to do it for themself.  I am the coach; they are the ones who have to go out on the field and play.  I may be disappointed when they mess up, but it’s not my job to patronize them and wag my finger.

So I was vexed when I learned about “the look.”  I’m honestly not sure how much of it is just a product of a guilty conscience on the parts of my nurse and the patient, but there is usually at least a grain of truth in this kind of revelation. I do know that I mysteriously intimidate new employees at our office.  The longer-standing ones think this is funny – realizing the softie I really am.

I’m also not sure if it is so bad that they don’t want me to look at them over my glasses.  I have had patients (and probably employees) assume my silence on an issue was a tacit approval.  ”He never told me I shouldn’t smoke,”  ”He never said I needed to lose weight.”  I’ve had people use my lack of lecturing as an excuse to continue behavior they already know is bad for them.

I also never told them it was bad to hit themselves in the head with a hammer.  I hope that omission isn’t resulting in head trauma.

I saw another patient recently, who said to me before I could sit, “I am sure you noticed I gained 6 pounds.  Christmas and Valentine’s Day were bad for me.”  I hadn’t had the chance to check the chart, but returned a remark about how there is a clear correlation between eating too much and gaining weight.  I could tell he had a guilty conscience, so I didn’t say anything more.

As I wrapped up the visit he asked me, “Aren’t you going to say something about the six pounds I gained?”

I smiled, realizing that he was expecting “the look” from me.  I told him that it was not good to gain weight and then looked at him over my glasses.

We’ll see how much power it has.

ROB LAMBERTS is a primary care physician practicing somewhere in the southeastern United States. He blogs regularly at Musings of a Distractible Mind, where this post first appeared. For some strange reason, he is often stopped by strangers on the street who mistake him for former Atlanta Braves star John Smoltz and ask “Hey, are you John Smoltz?” He is not John Smoltz. He is not a former major league baseball player.  He is a primary care physician.

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Rob LambertsMichelle WEllenRAmalaki Juice Recent comment authors
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Rob Lamberts
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Do you think your dentist knows you are lying? I don’t bother lying, but I know my patients frequently do. That makes my job harder, but it is simply human nature. My hope is that once they realize I am not going to preach a sermon, they won’t be as scared to tell me the truth. I think it works, but then again they may all be lying to me.

Michelle W
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One could say the opposite of “the Look” is “the Lie,” in which patients know they’ve not measured up to expectations and try to fudge out of an uncomfortable situation. Telling your dentist that you floss regularly (when you both know you haven’t) is an example, I’m sure there are plenty of others.

EllenR
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EllenR

Better than another blogger I know, who is happy and works in a hospital and likes to try and frighten people into better health habits.
I’m going to guess that extending the hand of forgiveness, and suggesting that not buying that package of Little Debbie’s produces more teachable moments.

Amalaki Juice
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I have gotten “The Look” many times from my PCP. We will just be talking about what is going on in my life, and when something questionable comes up (like my inherent love for movie popcorn), the head drops slightly, just enough to let the glasses leave his direct line of sight to get a nice blurry vision of his patient. I am sure that many years ago he could see the reaction he was getting, and liked it. And I am also sure that he assumes he is getting the same reaction now, even though he cannot confirm it… Read more »