When is a patient not a patient? When he’s a piece of shit.
A recent article on Slate described an acronym, SHPOS, used among some medical professionals to identify a certain type of patient. It stands for “subhuman piece of shit,” and this is what it means:
A SHPOS becomes a SHPOS when a health care worker hates him. The term is known to physicians everywhere, passed by word of mouth from resident to intern to medical student. Psychiatrist Abbey Strauss described the phenomenon in a 1983 paper: a patient who is “childlike, unreliable, occasionally arrogant, demanding, insensitive, self-centered, ungrateful, non-compliant, and wrongly motivated.” Strauss describes a type of SHPOS who might be called a “difficult patient.”
Sadly, many mental illnesses cause behaviors exactly like this, especially the more serious ones. Yes, med compliance is a problem with the mentally ill, as well as others. Yes, some of these people appear “self-centered” and “ungrateful” because when the pain is overwhelming enough, you just don’t have the ability to worry about what other people feel and think. Doctors are seeing them at their most vulnerable. They don’t know what they’re really like or what horrors lurk in their brains that they can’t control.
That’s why we treat such things with therapy and/or medication. These are people who go to their doctors for help, not to be judged as “subhuman pieces of shit” because of the nature of their illness. One wonders if the same term is applied equally to elderly dementia patients, because there is no fundamental difference.