Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Close Listening


An excellent clinician always listens closely to their patients. This enhances their perspective on the patient's point of view.

A 35-year-old patient who I had worked with for a couple years came for a follow-up visit. She said that her bladder issues were under much better control with her latest medication. However, she also said that her focus and word recall had worsened. I explained that her neurological condition can cause worsening of the aforementioned symptoms over time and that we would watch them closely before sending her for further evaluation or changing her medication regimen.



My patient thought that her bladder medication was the cause of her other symptoms, which seemed unlikely from my anecdotal experience. At her next follow-up visit, I was happy to hear that her focusing and cognitive issues had improved.



I asked her, “Have you started exercising more or are you eating healthier?”



“No, I stopped taking the bladder medication,” she said.



Even more humbling, a couple of years later, a study was done showing that some bladder agents affect cognition/processing speed; the bladder agent my patient was taking was on that list.


The lesson I carry with me from this chastening encounter is: Listen to your patients even when you are skeptical.