In two letters after difficult appointments the consultants have described me as delightful and pleasant. I'm wondering whether this is ironic as this hasn't reflected the general tone of the encounter! Has anyone else noticed anything similar?
Do drs use codes when describing us in letters? - NRAS
Do drs use codes when describing us in letters?
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cathie
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Lol I get that too! But sometimes this 54 year old lady if I've been bad ! Well could be worse Cathie xxxxx
Any letters I have been CC'd have been straight and to the point with just medical info in them, nothing about my character! xx
Interesting. Thing is, I'm not delightful! ESP when fighting for treatment,! Have to Laff tho
Oh Cathie this did make me chuckle - I have found the same thing. I wonder if this is, as you say, some sort of secret doctor code...
Tillyx
Mmmmm Good question I've often wondered this....
Next time you get a clinic letter, find this thread and lets share them. So far I have delightful and pleasant. My theory (based on experience in the meeting) is that delightful is code for appalling, unreasonable and pleasant is a but better but not much. Rheumy told me to 'stop looking at me like that ' when I saw her last - was desperate to get some treatment plan but just had more tests and a steroid jab which made it hurt more for a week!
My last one said "considering reducing her alcohol intake" which I interpret as"raging alcoholic"
Oh my!!! I get this for weight. If you lose weight do you move from pleasant to delightful?
Very strange
My consultant wrote my GP a letter which she read out to me. He called me a charming woman & a pleasure to see me. I must admit my jaw dropped in surprise 'really' I said. You've spoilt it for me now!!!
I blogged about this (on my own blog) back in December. I actually think it's kind of sexist as I've been called delightful, charming, nice, this lovely patient etc. I wonder if any men have experienced the same thing in their letters?! Only male consultants (ENT, chest doctor) have referred to me in this way, not female ones. My rheumatologist, physios, osteoporosis consultant (all female) have never referred to me like this. On the other hand my cardiologist is male and has referred to me purely in factual terms, which I massively prefer!
My young female GP in training has described in referral me as a "lovely 53 year old gentleman".
Shame I'm not single really, I could ask her for a reference if trying to get a date! (Only joking by the way, very happy with my other half.)
In all the time that I have been seeing the rheumy team I have only ever received two copies of all the letters, both of which made not pleasant reading. I actually thought they were talking about someone else.
I usually ask for a copy - as doctors under pressure can get very confused. No charge, just had to ask the receptionist to print it out as GP I saw is the big cheese.
I wonder what you had to do to be delightful, charming, nice. And if it is sexist what might we say about the male consultants. Incidentally both my letters were written by women doctors in their 40s or 50s I'd say.
I had one of those from a rheumy nurse that I'd never met, who suddenly became my 'regular' rheumy nurse. "I met this delightful and cheery lady today, who reported blah, blah, blah. She alleges (ALLEGES?!!) pain in the wherewhatever". I have this letter in my metal box, that I keep in the airing cupboard, to protect passports & cheerful people. One thing I've never been is f**king cheery! The same nurse reported to my GP that I shouldn't need painkillers.
We're such a cherry bunch. I think we need one of those translation things, you know with the words used in one column and the real meaning in the next. But a few more examples would be great.
Just been filing some medical paperwork and came across a description of me in one letter as "fascinating"!!! Goodness only knows how that translates!. An absolute classic which appears frequently on my non-rheum letters is "otherwise this lady is fit and well"! You what? Is it just me or do other people read these letters and wonder if they have been in the same appointment as the consultant/nurse?
Hey ho.
Tillyx
It's well worth getting these letters!
I normally get pleasant from my rheumy (male) and the same with my neurologist (female). My dad's doctor (male) calls him pleasant too!!
I still find it funny though and totally unnecessary!!
If the code in my letters is the same as in yours it means 'difficult' and 'pushy'. But perhaps, Pineapple Head you are really pleasant after all! Why do they need to describe us?
hahahah I would so love some doctors to read this post!
Lol I am reception manager in a busy doctors surgery and this is standard stuff. We often laugh at some of the letters we receive from some of the consultants when we know the patient concerned is neither delightful or pleasant. Think it stems back to years ago with the old style doctors.
That's interesting ! I feel it must be ironic
Love this post Cathie. x
Hope it's helping us to keep spirits up!
My rheumy didn't describe me at all. He did say "No doubt you (GP) will be getting in touch between now and her next appointment in a few months time when further concerns arise and as always I will be happy to respond" - which my GP and I took to mean that I'm a regular pain in the backside! He also called me "this lady.." in my foot x-ray report. I don't really fit the term lady and don't really want to either if I'm honest but that's as bad as it's got so far, but then I have only had two copies of his letters to date! The last one refered to "anxieties" and implied that I was a real worrier which isn't far wrong. Perhaps the GP decided to spare me from "delightful" or "fascinating"?!
I like the implication of when further issues arise, rather than if... I wonder if they have a day in med school learning to write letters? I had one morning on writing on the blackboard in the distant past when I was doing a pgce or whatever it was called
in reply to cathie
Well at first it exasperated me when he diagnosed me with RA and then asked me what I would like to do about it. I told my GP this made me feel doubly treacherous to my body for plumping for MTX. She laughed and then told me that this was the way doctors are trained now to be inclusive rather than patronising or appear to talk down to their patients. But when it comes down to it he is just a "doctor God" (as Polly calls them) and as such should behave like one in order to make a mere mortal like me feel that the decision is his entirely and therefore know who to blame when his drug makes me feel rubbish!
I say this with tongue in cheek of course because I do hate being patronised and appreciate the desire to appear on a level with a patient. But given the lengthy training they have had it would be good if they would just stop trying to flatter us with niceties and get to the point - pleasantries and attempts at inclusion aren't good for me unless I feel they are 100% genuine.
cathie in reply to
My dr said of course I could have anti tnfs again as tho they were sweeties. Then when it comes to it she won't. And of course it might not be the best thing for me anyway just now.
in reply to cathie
No perhaps not - but sweeties they ain't and an honest doctor wouldn't say this to you. Mine says he can't make a case yet and is honest about why (expense) to his credit.
Cathie, I am usually pleasant. I am lucky because everyone in my medical team is PLEASANT !! So pleasant it is for the time being!!
My consultant said I was terrific once!
I've just got one despite being in considerable pain she was able to laugh and joke with us ...,either means I was high on painkillers making the pain up or just bonkers
Thank you Cathie, needed a chuckle 
How about you take it as a sort of complement? I found this explanation
“Mrs. Smith is a very pleasant 54-year old woman who…”
Why does this bother me, you might ask?
It immediately imparts a connotation in the note that this patient’s symptoms are to be “believed”, as opposed to other, less “pleasant” patients. The doc is probably going to be more inclined to help this patient. I explained to one trainee that I thought it should be changed in her future notes, and I explained why. Her explanation was that it was a “code” for her to remember that the patient was easier to deal with than many other patients she often sees in her practice. You can imagine how I took to that explanation…
Waaah. I get on really well with my GP, he's treated me for 15 + years and writes to other docs about me as 'this delightful lady'. I'd like to think he means that! I was a nurse for years and most of the letters we had in about patients, if there was any sort of description about them, usually were meant cordially. I have an 82 year old friend who is never less than charming and delightful and is described as such in most of her hospital letters and there's no 'coding' going on there. We certainly used codes for the knuckle-draggers, drunks and general ne'er-do-wells who pitched up at A&E on a regular basis. 'GOKW - God only knows what', and 'TTPO'- work that one out yourselves - now they're a couple of descriptions you may want to object to if you come across those on any letter relating to you!
cathie in reply to
Interesting to have insights from practitioners and patients. Maybe I don't understand how I come across, but I always think I'm far from pleasant. Not pushy but I tend to insinuate myself and catch them out. Like I just worked out that an MRI scam my rheumy claimed to show no inflammation was done about a month after a steroid jab and while I was still on mtx. Surprise surprise! What do they do at med school? Fetishim of technical toys!
My Rheumy is female and she hugged me. I am certain if a male doctor did that we would have a problem rofl. I so appreciate the compassion and yet it was unnerving. I felt like she was saying goodbye!
I see the same descriptive a in my specialist reports. Very astute observation. I have no doubt it is code. When I worked in health care we all knew hidden meanings.
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