How to draw boundaries to emotionally intimidating patient?

[JazzPath]

Hi all,

I would like to have some advice from others who have been in similar situations as I am.

I am a 28-year old bisexual (closeted) male resident in a clinical specialty. 5 months ago, I had a young gay male patient who came to 3 consultations with me. We had a nice chat and a pleasant informal contact on the first consultation. However, the second consultation, I noticed he was getting too curious about my personal life for my liking. He asked me where I would be going on holidays. And if I would bring a present (?!) for him. That one really was a red flag. The last time he even didn't bring any money to the consultation and he suggested me to walk with him to his home, which was only a block away. Every inappropriate question of his, I politely declined.

He has sent me 3 facebook friend requests, each of one I have politely declined. The first time, I said I never accepted patients' friend requests. The second time, I had changed my rotation place, so he sent a new friend request 1 day (!) after I had finished on my previous rotation. He said 'Now that you are no longer my doctor, I send you a new friend request'. I admit that I was too much in shock that that I just ignored his message and deleted the friend request.

Yesterday, two months later, he sent me a third facebook friend request. Again, I politely declined, mentioning that I have changed my mind and am now only using social media for close friends and family. A few minutes after that, he sent me a facebook message with his telephone number. Signing off with an 'x' (can you imagine? It probably sounds untruthful, but I swear I didn't give any hints to this guy, on the contrary, I've had to ignore so many signs he has been giving me to make the situation less awkward).

Important detail to mention: through a mutual acquiantance this guy knows that I am bisexual. I am afraid that if I decline, he will spread that information to my collegues. Something I really want to avoid. But I fear it is probably going to happen anyway.

I feel very uncomfortable and intimidated with this whole situation and would like to politely but firmly make an end to this. I would like to do it as 'nicely' as possible not to stir up negative/revengeful feelings with this guy.

How to go about this? It sounds quite an overreaction to this situation probably, but I'd really like to hear some advice.

Thank you very much in advance!

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[NotAProgDirector]

If I was your PD and you came to me with this story, here's what I would tell you:

1. You need to terminate any professional / physician relationship with this patient immediately. If you've already "rotated off" the service where you were seeing him and you're unlikely to see him again, we might leave it at that. But people like this are sneaky and smart -- nothing would stop him from calling your hospital and making an appointment to see you for something else. Therefore, I would get HR involved. He will get a letter from the hospital stating that you will no longer be caring for him, and a note will be placed in his record such that if he tries to book an appointment with you, it will be stopped / raise a red flag / etc. This happens all the time, HR departments know exactly how to do it. You don't need to tell them the details other than he is pushing boundaries outside of work / you're concerned he is pursuing you romantically and it makes you uncomfortable. HR may assume you're straight -- and that's fine.

2. You need to block him on Facebook. Block his entire account so he cannot contact you in any way, and cannot access your facebook account in any way. Same for any other social media sites you have. And your email account -- make his address go directly to junk/spam.

3. You need to stop interacting with him. Being polite and sending him "please stop communicating with me" is being interpreted by him as "If only I try a little harder...". If he finds a way around #2, you save the email in a file, delete it from your account, and move on. You should save everything you have now in that file, including your responses to him.

4. If 1-3 doesn't work, then we've progressed from being friendly to stalking. If you're following #3, you have a nice record of the issue. Getting the police involved is a painful but sometimes necessary step.

5. Ultimately, his power over you is completely defined by your being in the closet. Although coming out can be extremely difficult and terrifying, it can ultimately be liberating. It's a very personal decision, and certainly not something you should take my advice upon. But perhaps something worth exploring with those you trust.

 

[JazzPath]

Thank you aProgDirector, for your valuable advice.

1. Luckily, I am at a new rotation where they don't accept new patients. After this rotation, my education will be finished. So there is no possibility to have any further professional contact.

2. Very good suggestion, which I should have done earlier. I will also block the telephone number he sent me on my cell phone.

3. I am contemplating whether to respond one last time before blocking him on facebook, eg along the lines of 'I have no further interest and would like to draw the line here. I have experienced this and other of your interactions with me as very disturbing and would like you not to contact me further.' Although I might as well block him without saying anything, that might say enough.

4. Yup, I am already preparing myself by reading up on professional websites about stalking, but I hope (and think) it won't come that far. Although it's better to be prepared.

5. Again a very valid point. I am contemplating doing that indeed, but in a very small circle. Bisexuality is kind of a tricky sexuality, especially as a male. I'd rather not draw any attention to it, it is an extremely intimate and personal part of myslef, and I'd feel way too exposed if this information were to come to collegues. There is quite a lot of gossip in the medical corpse, unfortunately, and I don't plan on having an etiquette stuck on my head or have any prejudices towards me.

 

[QofQuimica]

3. I am contemplating whether to respond one last time before blocking him on facebook, eg along the lines of 'I have no further interest and would like to draw the line here. I have experienced this and other of your interactions with me as very disturbing and would like you not to contact me further.' Although I might as well block him without saying anything, that might say enough.

Open your eyes here, Jazz: this guy is stalking you. Trying to "let him down easy" is a lost cause; there's no reasoning with an obsessed stalker.

Speaking as a woman who has dealt with men who don't want to take a hint, no, you should absolutely NOT respond one last time. The only correct response at this point is to immediately cut off all contact in all venues. Block his cell, block his FB, avoid any social situations where he might be present. If this dude shows up to your school or your home in spite of all your efforts to avoid contact, you do not open the door. You call the police or campus security. Seriously.

 

[jakeislove]

Being 'nice' encourages stalker-types.

 

[IMPD]

DO NOT REPLY OR RESPOND TO ANYTHING FROM HIM.

Yes, I wrote that in caps.

You are putting yourself in danger with every single communication you make. I can't emphasize this point enough.

 

[primadonna22274]

Agree with all above. I've had to shut down patients who were too chummy--one married mother of two sent me a "I think you're really hot and would love to get to know you better" FB message
Not appropriate.
Just block the person and if you have to go beyond to HR etc, do so. Your sexual orientation honestly is not a factor here--the totally inappropriate patient stalking the doctor is.

 

[Mass Effect]

I hope no one misinterprets what I'm about to say because no matter what, he should back off when you make it clear you're not interested. But I can't help but wonder how he knows you're bisexual? You said you're closeted, so how did he know? Gaydar or did you tell him? I ask because if you told him, I'm wondering if he got the wrong idea, thinking that you're telling him for a particular reason. I can't imagine a scenario in a doctor/patient relationship under which a doctor's sexual orientation would come into play.

 

[Beacopp665]

I hope no one misinterprets what I'm about to say because no matter what, he should back off when you make it clear you're not interested. But I can't help but wonder how he knows you're bisexual? You said you're closeted, so how did he know? Gaydar or did you tell him? I ask because if you told him, I'm wondering if he got the wrong idea, thinking that you're telling him for a particular reason. I can't imagine a scenario in a doctor/patient relationship under which a doctor's sexual orientation would come into play.

The patient found out about OPs sexuality from a mutual friend

 

[JazzPath]

But I can't help but wonder how he knows you're bisexual? You said you're closeted, so how did he know? Gaydar or did you tell him? I ask because if you told him, I'm wondering if he got the wrong idea, thinking that you're telling him for a particular reason. I can't imagine a scenario in a doctor/patient relationship under which a doctor's sexual orientation would come into play.

To give you the full answer - my apologies to anyone who feels this is inappropriate information, but I'll be honest: about 4 years ago, when I was still a medical student, I had a 1-night stand with a gay guy. Let's call him Steven. I was honest to Steven about my bisexuality and asked him to keep it private. Steven became my facebook friend, but I seldom if ever met him again in real life. Turns out this patient is friends with Steven. The patient told me on the consultation: 'I heard about you through Steven, he told me about you a long time before you even became my doctor.' I didn't ask any further questions, but I immediately knew that he knew about my sexuality and previous 'adventure' I had had, probably thinking I still might be open to that, probably explaining his stubbornness in his pursuit of my facebook friendship. So there, I should have been smarter, but I wasn't. I shouldn't have added Steven on facebook. And I shouldn't have been honest so quickly about my sexuality to him. I regret that now but there's nothing I can do about it anymore.

I feel like the gay community, including Steven and his social circle, sees me as a gay guy who is in denial. Which typically instills a very heavy reaction. In his eyes, I am this typical closeted guy who will marry a woman one day and try to cover it all up. Which, luckily, I am not, as I am slowly trying to come out to my close friends and have done to my previous and future partners. Blocking this patient will add to that negativity. I am afraid it will stir up a strong negative reaction in that social circle again, and stimulate gossip. Unfortunately I live in a not so big city and quite a few people know me. It's hard to explain how it feels to have too many people know about my sexuality, but it feels a bit like - to put it slightly dramatically - a public castration (women suddenly view you completely differently) or walking through a city in your underwear. I hope this feeling will change overtime, but that's how it feels now.

But I realize that it is probably for the best anyway to block this guy. And prepare for any consequence that may come. And best be prepared for the worst. Hmmm. It's a pity you don't always think of the consequences of your actions when you're young.

Anyway, thanks to all of you for all your advice and support, it has been very helpful. I am happy I posted my story here.

 

[CD101.9]

If you and Steven are not in contact with one another, it may not matter whether or not you defriend him or keep him or not. He may not even notice if you defriend him. I think that I would eventually defriend him. Also, I would adjust my settings so that noone can send you friend requests for awhile. By doing this, you would also prevent the patient from trying to friend you.

If the patient tries to contact you again, I would file a police report because he is already stalking you.

You may want to glance through/read a book called "The Gift Of Fear" by Gavin De Becker. He is an expert on stalking and other criminal behaviors.

 

[JazzPath]

I put Steven on a restricted and limited profile a while ago (when all of this started happening), which is basically the same as unfriending him.

I blocked 'the patient' on facebook. I still have the nagging feeling that I first might have wanted to tell him to stop. Which I never really did - only indirectly by not responding and making up excuses for me not to accept his friend request in order to 'be nice'. Trying my best to suppress the nervous feeling I have about this, and part of me still doubting whether to unblock him again and tell him directly again. I just hope he doesn't react badly... What if he'd put up a facebook status "JazzPath just blocked me, trying to save his dark homosexual history from the rest of the world" or go back to my collegues and tell them all about it. Yikes. Well, I don't have any control over that anymore so I guess I'll have to let go... But I won't be sleeping too well the next few days. Hmm.

 

[jakeislove]

Not to be indelicate but: Making this about your sexuality clouds the real issue. This person is creepy, with boundary issues, and either needs psychiatric help, or a police intervention. Whatever baggage you have going isn't an excuse for allowing this to drag on while he stalks others and doesn't get the proper help.

 

[CD101.9]

I put Steven on a restricted and limited profile a while ago (when all of this started happening), which is basically the same as unfriending him.

I blocked 'the patient' on facebook. I still have the nagging feeling that I first might have wanted to tell him to stop. Which I never really did - only indirectly by not responding and making up excuses for me not to accept his friend request in order to 'be nice'. Trying my best to suppress the nervous feeling I have about this, and part of me still doubting whether to unblock him again and tell him directly again. I just hope he doesn't react badly... What if he'd put up a facebook status "JazzPath just blocked me, trying to save his dark homosexual history from the rest of the world" or go back to my collegues and tell them all about it. Yikes. Well, I don't have any control over that anymore so I guess I'll have to let go... But I won't be sleeping too well the next few days. Hmm.

It is important that you have no contact with the patient. You already told him "no." Even if you tell him again that you are not interested in a relationship with him, he will be glad that you are still communicating with him. He will think that eventually you will change your mind.

Maybe you could tell someone at your program that you are being harrassed. It might also be a good idea to seek consultation with a psychiatrist and get his/her opinion on the matter. Document all contact that you have with him. Follow AProgramDirector's advice.

 

[deleted390966]

If he finds a way around #2, you save the email in a file, delete it from your account, and move on. You should save everything you have now in that file, including your responses to him.

I would suggest to SAVE a screencap of everything. But don't delete it from your account, in case you will need police intervention and they ask "where's the proof?" Deleting it from your account will erase the proof.

 

[Dral]

As others have said, worry more for safety, less about your rep.

If things get out and someone says something, just say you had a one night experiment. Lots of people do that...gay or straight.

While others try, you are the one who ultimately gets to 'label' you.

 

[jakeislove]

As others have said, worry more for safety, less about your rep.

If things get out and someone says something, just say you had a one night experiment. Lots of people do that...gay or straight.

While others try, you are the one who ultimately gets to 'label' you.

Overshare, Dral.

Overshare.

 

[j4pac]

You aren't very good at being a closeted bisexual if you are having male patients flirt with you. Maybe this guy is the exception...or you may be putting off body language to suggest that you are interested. Be careful the way you interact with patients...and don't be afraid to set boundaries.

 

[Rendar5]

Ummm you did read why this guy knows the op's preferences., right? Because what you said makes no sense in the context of all the information provided.

To the OP you did the right thing blocking the guy without telling him why. I was stalked once. The only thing that worked was 0 interaction. Anytime I tried to say no or explain myself or be a nice guy giving a firm no and boundary check, it always just made things worse.

The guy sounds like he was stalking you from the get go. He never really saw you for a true medical concern in the first place if I have make a wager.

 

[j4pac]

Ummm you did read why this guy knows the op's preferences., right? Because what you said makes no sense in the context of all the information provided.

To the OP you did the right thing blocking the guy without telling him why. I was stalked once. The only thing that worked was 0 interaction. Anytime I tried to say no or explain myself or be a nice guy giving a firm no and boundary check, it always just made things worse.

The guy sounds like he was stalking you from the get go. He never really saw you for a true medical concern in the first place if I have make a wager.

Yes...I am literate. He said that the stalker guy found out through a mutual acquaintance. So apparently a mutual acquaintance is privy to the OP's sexual preference and is will to divulge that information. Again...the OP has not done a very good job of being closeted. The cat is out of the bag.

I think that OP is doing the right thing...he is drawing boundaries. He may have not been as forceful as he needed to be on the onset...but maybe he was...I wasn't there. If the OP has given a no-BS firm leave me the f' alone...not a soft smiling explanation which could be misinterpreted...I would get law enforcement involve. As for being out'ed...it's probably too late for that.

 

[PrettyDoc82]

Hello OP!

This has NOTHING to do with you being gay or bi or whatever. I'm a straight female and this has happened to me tons of times. I even was stalked and assaulted by another straight female medical student who is married to a man herself. Not a patient...yes a med student! Unbelievable.

You did nothing wrong, there just happen to be crazy people in this world everywhere you go.

Hope this helps

 

[JazzPath]

@j4pac: unfortunately, in my case at least, closeted means not telling your loved ones about your struggles with something you feel extremely ashamed of, keeping it all locked up. Resulting in doing stupid things, namely exploring your 'wrong urges' in a far away gay bar, thinking nobody you know will be there. Taking a risk because you say to yourself: 'I just want to know if this is really something for me or not'. And then find out years later there are always connections you didn't think of. Could and should I have been smarter? Yes. Would it have been a smarter move to have told 1 or 2 very trusted people about my struggles instead of trying to put things into practice? Yes. But then how will you learn something if you never try? A human mistake. So I got the message: the cat is indeed out of the bag. And I'll pay for it. Big time. Most people who heard rumours about this homosexual experience but don't know me well (and maybe the ones who do know me, too) will probably - wrongly - think I am gay and still denying it. That is some pretty rough punishment I can tell you. Maybe for the rest of my life.

To the people thinking I might have given 'inviting signals' to this guy. I understand this is an anonymous internet forum and everbody has the right to believe what he or she thinks is the truth. So I can only speak for myself and say that I can look at myself in the mirror and be 200 % sure I did nothing to evoke this reaction.
I repeat what I said in my 1st post that I declined every suggestion he made (the completely over the top 'would you buy me a gift on your holiday?', the 'would you come to my home then I'll give you the money?', the 3 friend requests, the offering of his telephone number,...). I was disgusted when he had finally left my office each time. And yes, I tried to handle it nicely at first because 1) he was the patient of my supervisor 2) I was afraid he would spread the rumours to my collegues/others if I reacted harshly. I do feel happy now that I blocked this guy completely on facebook, and I probably should have blocked him earlier. I also blocked his phone number. I haven't heard from him anymore, so that's a relief. Hopefully I won't meet him again.

Thanks to all of you who gave advice, I'm happy I trusted you on that. Hopefully someone else who is in my situation will learn from my mistakes. Unfortunately for me it's probably a little late to learn. Maybe this thread is ready for a rest.

 

[j4pac]

@j4pac: unfortunately, in my case at least, closeted means not telling your loved ones about your struggles with something you feel extremely ashamed of, keeping it all locked up. Resulting in doing stupid things, namely exploring your 'wrong urges' in a far away gay bar, thinking nobody you know will be there. Taking a risk because you say to yourself: 'I just want to know if this is really something for me or not'. And then find out years later there are always connections you didn't think of. Could and should I have been smarter? Yes. Would it have been a smarter move to have told 1 or 2 very trusted people about my struggles instead of trying to put things into practice? Yes. But then how will you learn something if you never try? A human mistake. So I got the message: the cat is indeed out of the bag. And I'll pay for it. Big time. Most people who heard rumours about this homosexual experience but don't know me well (and maybe the ones who do know me, too) will probably - wrongly - think I am gay and still denying it. That is some pretty rough punishment I can tell you. Maybe for the rest of my life.

To the people thinking I might have given 'inviting signals' to this guy. I understand this is an anonymous internet forum and everbody has the right to believe what he or she thinks is the truth. So I can only speak for myself and say that I can look at myself in the mirror and be 200 % sure I did nothing to evoke this reaction.
I repeat what I said in my 1st post that I declined every suggestion he made (the completely over the top 'would you buy me a gift on your holiday?', the 'would you come to my home then I'll give you the money?', the 3 friend requests, the offering of his telephone number,...). I was disgusted when he had finally left my office each time. And yes, I tried to handle it nicely at first because 1) he was the patient of my supervisor 2) I was afraid he would spread the rumours to my collegues/others if I reacted harshly. I do feel happy now that I blocked this guy completely on facebook, and I probably should have blocked him earlier. I also blocked his phone number. I haven't heard from him anymore, so that's a relief. Hopefully I won't meet him again.

Thanks to all of you who gave advice, I'm happy I trusted you on that. Hopefully someone else who is in my situation will learn from my mistakes. Unfortunately for me it's probably a little late to learn. Maybe this thread is ready for a rest.

I'm certainly not anyone to judge. I am sorry that you have to be going through this BS at an already stressful time in your life. I think that all of us look back at a time in our life and wish we would have done something differently. Separating yourself from the nutcase is definitely a move in the right direction. At some point you may want to consider if owning your sexual situation may be less stressful than the fear of retaliation from the loser. Best of luck!