What trickery is this?

As soon as we opened the door to the clinic room, we could see the worry written all over her face. She sat in the chair, legs together, purse on her lap, and tightly clutching a piece of paper with notes scrawled all over.

Prompted by the doctor, I began asking her questions about why she had come in. While at first she complained of generalized fatigue, she quickly admitted, "But that's not really why I'm here. I had a question about my son's asthma treatment."

"Go ahead," said the doctor.

"Is it true that asthma puffers can make him committ suicide?"

"Well, actually, I haven't heard anything about that," he replied. "There are a lot of side effects for asthma medication, but depression isn't usually listed as one of them."

She didn't respond to his question. Instead, she shoved towards him another piece of paper that she had been holding - one with a printout of a newspaper article. I read the headline upside-down: "Asthma Drug Questioned for Suicide Risk."

The doctor read over the article, then handed it to me. Her concern was justified, but it only took a few seconds to tell that the patient was reading a little bit too much into the article. First of all, it was written in a sensationalist manner, written by a health website but not a reputable news source. Secondly, the article said nothing about a proven association - just that the link was about to be investigated further. And third, as the doctor clarified later, the article was about an asthma medication that her son wasn't even taking - a pill, not the puffer.

Not only that, but I didn't fault the doctor at all for not being aware of the news. The article had come out that day, and was based on a paper that was going to be published in a medical journal the next week.

We explained to her these things, but I couldn't help but think that I was a little disappointed in the patient. Instead of showing him the article right off the bat, she had asked her doctor a loaded question, one to which she knew the answer, but she wanted to see what he would say anyways. Not only that, but it was on a very recent topic... was she expecting him to be aware of every recent medical development on a suspected association, not yet accepted as a standard of care?

It reminded me of another patient who told me that she once asked her doctor for penicillin to treat a cold, then when he prescribed it to her, confronted him with the fact that she was allergic to penicillin.

Obviously there are two sides to these issues, but I still wondered how I would feel if I thought a patient had tricked me. It's true that doctors are expected to make few, if any, mistakes, and it's definitely good to have someone check up on you once in a while, but it might also prove difficult for me to be in a doctor-patient relationship in which the patient is frequently trying to get me to say something wrong. After all, trust in the doctor-patient relationship goes both ways.

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