post

What Did You Say?

Originally posted on The Differential on August 13, 2008

*****

This week I was driving home from Target with my mom. I casually mentioned something about going back to Loma Linda for an autopsy.

“What?!?” she asked. I looked at her, while safely driving down the street, and laughed. The way I said it, it sounded like I was going in for my own autopsy. And for a few seconds she doubted whether she remembered what an autopsy was.

But I cleared it up. I wasn’t going in for an autopsy. It wasn’t a back-to-school thing like getting a physical. I had to view an autopsy being performed — not have one done on me.

The whole situation reminded me about the importance of clear communication. Communication is important in daily life; it can be vital in the medical arena.

Last year I had a class called “Understanding Your Patient.” During one lecture we discussed giving patients bad news. We watched a video clip of an oncologist demonstrating how he gives bad news, using actors as patients. The actors didn’t know what he was going to say and so their reactions were genuine.

He, the oncologist, discussed breaking things down and repeating often. It’s not easy to take bad news. It’s also easy to jump to conclusions at certain trigger words.

My mom battled cancer a couple years back. To this day, she remembers the moment she heard the word “cancer” from her doctor. I haven’t asked her too much about that conversation, but sometimes patients will shut down and come to their own bleak conclusions once they hear a word like that. So it’s important to slow down, repeat, and get feedback from the patient to make sure they understand.

I also heard an orthopedic surgeon, Doctor A, talk about one of his experiences with a patient. A patient came to see him and told him what Doctor B had done. In passing, he made some comment like “Why would he do that?”

Well, one year later the patient comes back –- this time with a lawyer. The patient wants to file a lawsuit against Doctor B. And the patient wanted to use Doctor A as an expert witness because Doctor A had made a single comment wondering why Doctor B did what he did.

It turned out that the patient had misunderstood what Doctor B told her. And the patient had given Doctor A the wrong information. And Doctor A realized he shouldn’t have made that comment to the patient.

Twisted, I know… but it reminds me that I have to be careful with what I say –- especially when I am around patients and still have no idea what I am looking at. They see a white coat and assume I have some body of knowledge. Well, I do have some body of knowledge, but at this point in my training, it isn’t the kind the patient needs.