You are on page 1of 1



last laugh by Melissa Yuan-Innes

The Doogie Howser dilemma

Inspiring confidence in patients can be tricky when they ‘compliment’ you for looking too young to be a doctor
As a new physician, you’re wor-
ried enough about killing a patient, get-
ting sued and then getting thrown into
debtor’s prison for unpaid student loans
without one more stress: Patients think
you look too young to be a doctor.
Yes, it’s a compliment that
they don’t think you need Botox
or even Oil of Olay just yet.
A French woman put it more
poetically, saying I had “l’air
d’une jeune fille.” But sometimes
you can hardly start the history
because they won’t let it go.
I enter the emergency room
examining cubicle. “Hi, I’m Doctor—”
The patient’s eyes widen. “You’re the
I smile and wave the clipboard. “Yes.
I see here you’ve been having chest
pain. . . .”
He shakes his head, looking me up
and down. “You look awfully young to
be a doctor.”
I clear my throat. “Well, I’m not. Don’t
worry about me. As for your pain. . . .”

“You look like you’re still in school.”

“I’ve graduated.”

“Well, you don’t look it. How long held a needle
have you been doing this?” driver over a real, I paused,
It took me a while to realize the last live patient. leaned forward
question, on its own, can also mean: “You I checked the real doctor for and whispered con-
look too young and incompetent. Are a clue. She finished excising the mole spiratorially, “Shh. I’m not.”
you sure you know what you’re doing?” with a silent smile. about their aches and pains. Instead She reared back and regarded me
For my first locum, I prevaricated. “It’s not your first time?” The patient the patient would repeat, “You look too with horror. “What did you say?”
I’d say, “How long have I been a medical repeated. young” and stare at me as if I were hard Needless to say, I never used that joke
doctor? Three years.” I had the MD Finally, I said, “No, I’ve done sutures of hearing as well as a juvenile offender. again. Instead, I tried another line from
degree to prove it, along with two years before.” another friend: “Just call me Doogie
of residency and one of emergency Mollified, she settled down and I 2. I tried passing it off as a compli- Howser.” I’ve also tried, “Don’t worry,
medicine. I thought it was kinder not to picked up the 4-0 Prolene without tell- ment. “Oh, ho ho, you flatterer! Now I’m legal,” which evokes a different kind
say, “Hey, it’s my first summer. How am ing her I’d practised on a cadaver. Once. let’s talk about your dizziness.” That of fear response.
I doing?” Fortunately, my sutures turned out patient also repeated himself and looked I haven’t needed any lines at all
I had some experience bending the just fine. like I was insane, especially when I recently, since I’ve only done a few shifts
truth, starting with my first clerkship I expected the doubt as a medical added a jocular tap on the shoulder to since my maternity leave and no one
rotations. On family medicine in north- student and resident. Like Phoebe said emphasize our camaraderie. has carded me. Maybe it’s because my
ern Ontario, the doctor took me aside on Friends, we all want a “grown-up Hmm. Obviously, I needed a new baby’s sleepless nights have etched new
and discussed how to excise a mole doctor.” I started wearing a white coat as strategy. I asked my friends how they wrinkles on my face and whitened a few
with an elliptical incision. She’d handle a resident to try and cut the questions handled it. One said she answered, “I’m more hairs. Or maybe I just haven’t seen
the scalpel work, but I’d get to close an off at the pass. But I always reassured older than I look.” That made sense, but enough patients yet. A few months after
incision for the first time. Maybe we myself that once I was fully licensed and my favourite suggestion was from one of my son’s birth, one acquaintance looked
didn’t talk quietly enough. The patient could reply, “No, I am the DOCTOR,” my best friends, a non-doctor: at me and said, “You know what? You
regarded me in horror. “This isn’t your these comments would disappear. don’t look old enough to be a mother.”
first time doing this? You’ve done this Instead, I kept getting them and not 3. Humour. My friend even offered me
before, haven’t you?” handling them well. I tried a few differ- the line to use. I could hardly wait to try Melissa Yuan-Innes practises emergency
I hesitated. I’ve always been a very ent strategies: it out. On my very next shift, an 83-year- medicine in Cornwall and Alexandria,
truthful person, but it was clear she didn’t 1. I ignored them. I plowed through old woman frowned at me and said, “You Ont. Her writing alter ego lives at
want to know it was the first time I’d the history, hoping they’d rather talk don’t look old enough to be a doctor.”

Tech report: eHealth Psychiatry update

Coming The Medical Post brings you the latest on electronic The American Psychiatric Association meeting

health initiatives in Canada: rating and comparing featured research about depression risk factors
EMRs; success stories and barriers to EHR within obese populations, and findings that
implementation across the country; simplifying highlight the importance of distinguishing bipolar
workflow with Smart Phones; and much more disorder from borderline personality disorder