Process Notes

On Wednesday I started working with Process Notes. These are verbatim transcripts of genetic counseling sessions, led by a student and supervised by a genetic counselor. Actually reading through the sessions was eye-opening for several reasons. I didn't realize sessions were less than an hour. In my mind, talking to patients seemed like a much longer process, although this is still true when you consider the possibility of multiple sessions and follow-up.

My first case dealt with the advanced maternal age of an Indian woman who had married her first cousin. (note: Indians are notorious for being a very private group of people. Many topics are taboo, and any problems are glossed over and ignored instead of addressed.) This woman was so vague. She kept insinuating at things, hinting at things, evading direct questions, and was simply not knowledgeable about many important factors regarding her family, because of the taboo nature of these topics in India. When we're told to be sensitive of culture and beliefs while counseling patients, you generally think of something like, for example, being extra gentle when discussing abortion with very religious families. But evasiveness and cultural thought processes are a whole different ball game... it will take some getting used to, but already I can spot instances where the counselor should have said something different, or been a little more empathetic.

My job is to summarize the cases for Kelly's use in her classes, and also highlight certain aspects of the session, such as type of question, instances in which empathy is used or should be used, and psychosocial aspects of the cases. It's been really good to read the beginning stages of the session, because until now I had no idea how a session begins. Contracting is very important (the part where the patient and the counselor agree on what the session will aim to accomplish), and it's also great to read the personal notes of the students conducting the sessions, which point out mistakes or things overlooked, and how to fix them.

Tomorrow is the Hypertrophic Cardiomyopathy conference... exciting!