THIS INSTINCT CAN HELP YOU EVALUATE A PATIENT’S ATTITUDE OR MENTAL STATE

I WRITE this on a return trip from Italy. As my wife and I made our way through the villas (or hamlets?), I realized Italians have very flat stomachs. Not realizing I was going to be at the beach, code for rocks by water, I didn’t prep my six pack. (In fact, I am about five short.) However I am proud of my gut; my gut instinct, that is!

I have no time for karma, kismet, what comes around goes around, do unto others as you want done to you, etc., but I do have a strong conviction that we possess a gut reaction, a hunch, if you will, to those things life throws at us. I even consider it a sixth sense (like the great movie!).

THAT SIXTH SENSE

A good example of that “sixth sense” is your reactions to trailers for movies. While watching that short preview, you instinctively formulate an opinion based on your gut. It is like a Darwinian thumbs up or down response. With the rare exceptions of some gastric distress, my gut has been pretty accurate in those instances.

The astute reader is most likely asking: “How would you know that?” Well, I am an insomniac, and thus, I stay up watching bad TV. Moreover, with my DirectTV, I can watch bad movies on countless channels — the movies that I chose not to spend my $22.50 on in the theater. More often than not, I pat myself on the back for realizing that I would have hated that movie and then pinch myself for not trusting my gut and watching “Yours, Mine & Ours” followed by “Basic Instinct 2.”

Choosing a good place to eat or what to order has come down to that gut reaction as well. There is nothing I hate more than getting all gussied up to go out, planning for the night and eating at a restaurant (remember no recommendations) that blows! It’s like dropping money out of your pocket and not realizing it until you have to pay for your popcorn at the movies.

GAUGE PATIENTS

This same gut instinct can be used to hone in on the attitude of patients. You can easily get a good sense of how the exam is going to continue by the patient’s initial reaction. The patient who won’t get off her cell phone when I walk in: narcissistic and self-absorbed. The patient who seems to have bathed in his cologne: insecure. The patient who has six rings on one hand or pictures of her cats on her coffee mug: non compos mentis (insane).

All staff should tune in to their “mental” detectors when coming in contact with patients. Or, as my friend Richard Adler likes to call it, the “mind’s eye.” Since, we need to start our exams from the minute the patient walks in the door, the front office can size up the patient. Technicians, meanwhile, may be able to start point-of-service testing from their gut.

Your gut told you to read this article — go with your gut, or, like the next time I go to Italy, go with the pack. OM

DR. BLOOMENSTEIN practices at Schwartz Laser Eye Center in Scottsdale, Ariz. He is a founding member of the Optometric Council on Refractive Technology. He is a speaker and advisory board member for: Akorn, Allergan, AMO, Bausch + Lomb, Lunovus, OcuSoft, Shire and TearLab. Email him at mbloomenstein@gmail.com.