Good morning, Mr. Nesia. I see you haven't been here in 15 years."
"I was never here before."
"Forgive me—aren't you Alford M. Nesia, address 36 Endive Gardens Avenue, Boxboro, date of birth April 5, 1954?"
"Yes."
"In that case, you were here in August of 1991."
"I did see a dermatologist once, come to think of it. Was that you?"
It's always nice to know you've made a strong impression. Of course, forgetfulness works both ways:
"Nice to meet you, Ms. Jones."
"I saw you last month, Doctor."
Ouch. This usually happens when my staff checks in an old patient as a new one. Sometimes they haven't been able to find the patient's name in the computer (misspellings, data loss, a 20-year absence, whatever). In other cases, the patient has come in with a child or other relative but never registered under his or her own name. I have a pretty good memory, but without a chart, I'm mostly lost.
Unrecognized patients often make allowances. "You have so many patients, Doctor, you can't possibly remember them all." True enough.
I do try, though. People are often flattered when recognized, offended when they're not. (That's why politicians make such a point of remembering everyone.) Knowing who people are is a good start, but recollecting personal details is even better. I often note such details in the chart, whether they're germane to skin complaints or not. The patient may have started a new job, graduated college, bought a condo, planned a honeymoon in Uzbekistan.
When notes jog my memory about such things, I deftly slip in a personal reference while writing a prescription. "The doxycycline is refillable three times, Ned. By the way, how was the bridal suite at the Samarkand Motel 6?"
If the patient exclaims, "You have a good memory! How did you remember that?" I usually confess that I'd written it down. That doesn't seem to offend anybody; instead, they're somewhat pleased to have a stranger show some interest in their nonmedical lives. I do it to make people comfortable and to get to know them a bit, because many of them come back at odd intervals over the course of many years.
I have another reason, too—a dark secret now revealed here for the first time: I occasionally find patients' stories even more riveting than the diagnostic and therapeutic challenges posed by their rashes and skin growths. There, I said it.
Outside the office, I'm even more lost when greeted by patients who know me. By now, I've been around long enough that it's hard to go to the grocery or the gym or to just walk down the street without running into someone who stares, grins, and says, "Dr. Rockoff—is that you?"
I usually admit that it is and smile brightly in apparent recognition, keeping a keen eye out for an escape route before further conversation can unmask my ignorance of who the dickens they are. ("You know me! The one with the rash!") My father, well known in our hometown, was often hailed by strangers. He always smiled heartily and waved back. "Who was that?" I'd ask. "I have no idea," he'd say. "But they seem to know me, so I wave."
Of course, it's hard to recognize people out of context. I think my patients should have an easier time remembering me than I do them; after all, there are so many of them and just one of me. For the most part that's true, but some folks are just better at remembering than others are.
"Nice to meet you, Mr. Steele."
"I met you already."
"Well, actually, the one time you were here before, you saw my associate Henrietta."
"You know, you're right—it was a lady!"
Glad we straightened that out.