The Name Game

Banana fana fo-fatient, mi mi mo-matient
[Detail from the Babenberg Family Tree via wikimedia]

One of the hardest things about the first case in a series of SP encounters is during the introduction. "Hi, I'm Student Doctor Soandso, and you are...?" as they extend a hand.

For someone who can memorize 60-80 different checklist items for a character, when I am asked that question the first time, sometimes my mind just goes blank. And it's terrible because it's right at the beginning of the encounter: if I make an obvious mistake on MY NAME, something any real patient knows by heart, the student will have a much harder time engaging fully with the scenario.

Sometimes I play for time: "I'm sorry, what did you say? Oh, I thought you said 'your car'! Ha ha!" while thinking furiously. If I really can't remember, I make up a name and resolve to look up the real name between students. Getting the name right can be important because many cases are known not by the symptoms but by the character name, e.g. the "Andrea" case.

Some cases don't include names at all, so you get to make them up. I have a series of names I remember based on age bracket, which is especially useful if I have multiple cases in a day. (I finally have a use for all the mistaken names people have called me over the years!) Then I use an historic family surname. So if I'm stuck, one of these names readily pops to mind. I also have a consistent series of names and ages for a combination of up to 5 children, grandchildren, spouses, and pets. I think it is distasteful when SPs (or even faculty members) create names that are punny or based on celebrity/character names. It makes it harder for the student to take the case seriously.

One school I work with has a policy of introducing the patient by both first and last name so that the student is prompted to ask what the patient prefers to be called. But otherwise I just introduce myself by whatever I think the patient would use, which is usually the first name unless the patient in this case would be older or more formal for some reason. However, if a students enters and asks if I am "Mrs. Smith" when the case has not specified I am married (or has specifically specified I am divorced), then I call them on that gendered/social assumption.

I prefer case names when they are gender neutral. Even so there are some names that students assume are a particular gender and they are surprised when they open the door to find I am not the expected gender. Once, a student was so flustered by that he said he was going to complain! "They'll be hearing from me about THAT!" he declared.

Extra credit #1:
I always feel better when students use my name in a scenario: it gives them a boost in the "rapport" category. Transitions are great places to use a patient's name: between the history and the physical exam, between the physical and the conclusion, or during a summary statement.

Extra credit #2:
If a case doesn't include a birthdate, just an age, it's always a good idea to create one because many times student doctors will ask (and I can't do that calculation on the fly). That's also something patients know by heart, so any hesitation grinds the scenario to a halt. That can require tricky math depending on the current month vs the birthmonth, so I almost always pick a birthdate in early January so simply subtracting the age from the current year works out.