“So, it’s good to hear that you’re using contraception, but I also just wanted to let you know in case you weren’t already aware, that the pill will not protect you from STI’s. If STI’s are something you’re concerned about, condoms and other barrier contraceptives are the only things that can reduce your risk of getting an STI.” I paused, waiting for some acknowledgement that my teenage patient had taken in what I just said. “Do you have any questions about that?”
She replied “When?”
“I’m sorry, when what?” I foolishly asked.
“No, when’d I ask.” she snickered.
Time seemed to stop. My jaw was agape, my eyebrows were raised, my brain was trying to comprehend what my ears had just heard. I couldn’t believe I had been hit with a “when’d I ask” in a hospital setting, no less by a 16 year old patient I had been asked to take a history from. It took me a second to recover, and I had no choice other than to laugh it off and try to resume the history with as much dignity as I could muster. At the end of the consult, I let her know the psychological trauma she had caused me: “Not gonna lie, you really had me there with the ‘when’d I ask’.” She giggled, and told me she had been dying to use that line on me since she overheard me use it on one of my friends as we were walking around the ward. Call it karma, I guess. But even though I had my dignity and pride stripped of me, I was glad, because that little moment established a common-ground between us and eased some of the nervousness my patient was feeling in the hospital setting. Teenagers are notorious for being one of the hardest demographics to take a history from, so any common-ground you can establish can go a long way to building rapport and facilitating a smoother and more thorough history. As a 20-year-old MS3, I feel young/qualified enough to provide some insight to some of the topics I use to bond with my teenage patients, so here they are:
- Whatever the teenager is into
Perhaps the most important tip of all, is to simply find out what your patient is into. Learn something about their interests, or hobbies, or aspirations. When performing a HEADSSS assessment as part of your routine psychosocial history, pick up on little clues they may drop. If they play a sport like football or hockey, ask them about their favourite team. If they spend most of their time playing video games, ask them which ones. If one of your patients spends their day playing Among Us, ask them about their funniest experience as an impostor. It’s always best to identify exactly what your individual patient is into, rather than trying to bond with them over a Tiktok dance you recently learned that they’re really not that interested in. However, if you’re ever met with a tight-lipped patient who won’t tell you what they like, it might be worth knowing some of the topics we’ll discuss today.
- 2. Stay up to date
When it comes to teenagers, staying up to date on the latest trends is almost as important as staying up to date on the best medical practices. Nothing hurts more than an out-of-date meme. I once saw a GP at the age of 20 who tried to bond with me by showing me their laptop background of the troll face meme back from 2009. I have not been back to see them since. Get up to date on your memes. 😡
For those of you already on TikTok, well done! This tip isn’t for you. But for the rest of you, I feel confident saying most of you probably get your memes from Reddit. Those even more out-of-touch might get them from Instagram or even 🤮 Facebook. The truly hopeless might not browse memes at all. But I can safely say not a single person born after the year 2000 uses any of these – Tiktok is undisputedly, unequivocally, the only app worth discussing when it comes to what the teens are using nowadays. I’ve gotten patients to open up about their entire life and worldviews by simply mentioning the name “d’Amelio”, or mentioning the latest song that’s big on Tiktok. So it’s certainly worth downloading Tiktok to find out a little bit more about the popular trends that your patient might be interested in. You never know, you might also get hooked on it too.
- Other celebrities (mostly internet icons)
Yes, the first three items are all pop culture – but for good reason. Adolescents determine essentially their entire identity by exploring and identifying with particular cultural icons. So read up on celebrities, musicians, actors/actresses, the whole lot. Pay particular attention to recent scandals, because teenagers and people of all ages love to gossip about scandals. Once again, Tiktok will help you out here because there is an endless supply of Tiktok drama and scandals, and almost everyone has their own opinion on it.
I admit I’m not up to date on these. I’ve had some success with Brooklyn 99 and Stranger Things, but even I can’t keep up with the newest, edgiest content that the teens are watching on Netflix nowadays. Essentially, it’s always worth asking what content your patient is binging, because if you’re familiar with it, a quick conversation about your patient’s favourite character or favourite moment can always help warm them up to you.
- Key phrases
Gen Z (yes, technically some of us are Gen Z’s, but today’s 2000’s babies are almost an entirely different species of their own) is known for unapologetically decimating the English language. One of my part-time jobs is tutoring middle school and high school students, and honestly every lesson spent in a teenager’s presence makes me feel like I’m losing more and more control over the English language. Their lingo changes constantly, and every time I don’t understand what they mean when they say “finna” or “stan”, I get called a boomer. The key here is to Urban Dictionary whatever phrases you keep encountering. This is primarily so you can understand them. By no means do I mean you should also start using this lingo – it’s often better to not use these phrases if you’re not confident you can pull them off. There’s nothing worse for establishing rapport than a 28-year-old trying to come off as hip and cool by using slang they clearly don’t believe in or understand. So unless you’re sure you can unironically say “yikes” or “no cap” without being awkward, please do not try to use these phrases. Also, just as a side note, be very wary when they ask questions like “when” (see above for my painful experience with this question).
- Don’t be afraid to ask
And finally, never be afraid to let the teen teach you. It’s a common tenet of medical school that the patient is the best teacher you will ever have, and this is no different. If you ever find out what kinds of interests your patients have but feel out of your depth discussing them, just ask them to explain those interests to you! I learn so much about interesting drama/activities/trends just by doing the thing with my eyebrows (🤨) and asking “What’s that? Tell me more about it.”