Excuses, Excuses

I love my patients. I really do. I empathize with what they have to put up with in regard to their chronic medical disease. Their pain and suffering, both mental and physical, can take there toll over time. I love that they come to me and ask my medical opinion regarding their treatment and prognosis. However the thing that I especially love is when they think that their doctor takes everything they say at face value. It is amazing that people will lie right to my face about why they haven't done what I have asked them to do when last I saw them. Here is a smattering of the excuses followed by the true interpretation. We will start out with some easy ones, then gradually get to the more ridiculous....Ready? Here we go...

1)Me: Why haven't you taken your blood pressure since I last saw you?
PT: I haven't been anywhere that I can have it done.
Me: You haven't been to the pharmacy? Grocery store? You can even come here to our lab...
PT: Well, I don't get out much...
INTERPRETATION: I don't want to get my blood pressure checked. It may be high, then you will put me on medicine.

Get the picture? Alright, let's move on...Here is the EXERCISING/WEIGHT LOSS edition:

2)Me: Are you exercising?
PT: Yes. But probably not as much as I should...
Me: How much?
PT: I do a lot of walking at work.
Me: That doesn't count.
PT: Well, it IS a long distance to the copy machine...
INTERPRETATION: I am way too lazy to do any exercise, and I don't want to do any exercise. I like my TV and Cheetos more. Can we change the subject?

3)Me: Any luck with losing weight?
PT: No. My wife is just too good of a cook.
Me: Well, it is about portion control...
PT: I just eat what my wife puts in front of me. If I don't eat it, she will be pissed at me.
INTERPRETATION: I don't want to push my fat ass away from the table, close my pie hole and show some restraint.

4)Me: Any luck losing weight?
PT: No, and I don't eat that much (says the 300# woman). I have yogurt for breakfast, a Fiber One bar for lunch (God forbid she get backed up) and a salad for dinner.
Me: How MUCH salad are you eating? (Just kidding, I wouldn't say that...)
INTERPRETATION: I really don't know how to count calories OR I am putting twinkies on my salad for dinner...

5)Me: How are you doing with the Overeaters Anonymous classes?
PT: I have eliminated sugar, wheat and flour and I still can't lose weight. *Stern look in her eyes* What are YOU going to do about my overeating? I don't want a bunch of medicines either. How are YOU going to fix it?
Me: Sew your mouth shut. (of course I didn't say this but I almost lost control of my inner monologue...)
INTERPRETATION: There is a hell of a lot more going on with you than not being able to control your voracious appetite, lady.

All of these conversations have occurred at one point in my 8 years of practice. I have heard it all, but really all I want is the truth. Is that so hard?