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Dear W:

Your "new" car sounds exciting and -- what shall I say -- challenging! Are you sure it was a good idea to buy a 15-year-old car that was totaled? Well, I will hush now because I know you know something about cars and I don't. Maybe it wasn't totaled too badly. I know it didn't take much for the insurance company to consider my last car totaled because by that time the poor old thing was barely rolling anyway! Shortly before that, I had aflat tire on that car, and the service station attendant took one look at the car and at me and judged that we were not worth being nice to. In fact, he was rude and sarcastic. Three or four days later, I was on my way home in the evening and got paged to please come back to the hospital to see a five-year-old girl with new-onset seizures. Her parents were deeply scared by what had happened to their daughter. As I spoke with the mother and child, the father faded into the shadows. I finally recognized him as the service station attendant, and he apologized for his previous discourtesy, saying: "I'm so sorry, ma'am, I didn't know you were anybody who mattered." After a moment of internal conflict, grace prevailed and I assured him all was forgiven and that it would not affect my care for his daughter. The characters' roles in this true story could very well have been reversed. The doctor could have been rude to his/her patient's father, an uneducated man in greasy work clothes, and then could have needed his help with that flat tire. Either way, lack of courtesy could cause a significant problem later. It is therefore very important for physicians to "Take Time to Use Your Manners."

W, I know you are already a kind-hearted and courteous young man, but when physicians get busy and tired, even the gentlest among us may sometimes neglect their manners. We may snap inappropriately at our staff, patients, family, and each other. If this ever happens, admit it! As soon as you realize you overreacted, apologize sincerely, even to your preschool child or your young frontdesk clerk. Remember your words have a lot of power. Physicians are usually articulate, strong-willed, and influential over the health, happiness, and/or livelihood of those around us. An encouraging word from you could change someone's life by supporting their college plans or life change. On the other hand, an unnecessarily sharp word from you could reduce someone to tears and he or she might never forget your harshness. Remember, first do no harm.

The nurses and other staff in your hospital and office deserve your courtesy and respect. They often care and work as hard as you do, and they too help patients through tough times. They also will support your efforts enthusiastically as they witness your politeness and kindness toward your patients. Conversely, your patients watch how you behave toward your staff and may decide on this basis whether or not to trust you with their secrets and their lives. A friend of mine walked out of her physician's office and switched physicians after hearing hers barking at a staff member. While wintering in Florida, another friend needed complex repeat angioplasty and decided to trust the local cardiologist to do it after overhearing the agreeable way in which he spoke with his staff.

Our society now has some amazing tools and toys, like cell phones, PDAs, and portable CD/DVD players. W, you probably understand how these things work, but I just use them, mindlessly enjoying their magic. (I did buy a book called How Things Work but haven’t yet found time to read it!) The reason I mention these technical wonders is that they are new triggers for rudeness in daily life. When you are on your cell phone in a public place, be sure to talk in a normal voice or get a better phone. Don't drive and hold the phone to talk -- pull over or get an earpiece so both hands are on the steering wheel. If someone is talking with you, don't bury your head in your PDA, showing him the top of your head and not your eyes. Don’t stay on the Internet during family mealtimes or past bedtime. These tools are fascinating, but people are even more so.

Old-fashioned etiquette is important, too. Look people in their eyes and shake their hands when you meet them. Most staff and patients already know you are a doctor, so you usually don't need to say "I'm Dr. G"; just say "I'm WG." You also don’t need to put MD on your checks, license plate, or stationery. Let your staff and patients know at least a little about yourself, but not too much; it can be good to keep a distinction between personal and professional parts of your life. Ask about people's lives and interests, make notes and ask again the next time that you see them. Keep a collection of inexpensive congratulations and sympathy cards to send your patients and others in grief or in response to graduation and wedding announcements. Except in crowded corridors, nod or say "Good morning" or "Good afternoon" to everyone you pass. Those golden expressions, "please," "thank you," "I'm sorry," "would you," and "could you please," are still very potent and almost always get a positive result.

Remember what my service station attendant learned and treat everybody as if they were "somebody who mattered." God, through several of the religions of the world, has given us the Golden Rule. He has also set up our cellular aging processes such that by midlife, our facial lines show a lot about our personalities. My grandmother explained it succinctly, saying: "At 40, you get the face you deserve!" So, keep an eye on the mirror over the next couple of decades, W, to see if you are still remembering to "Take Time to Use Your Manners"!

Good luck with that car!
Fondly,
Carolyn