"Communicating"

The classic nightmare in which one is wearing only underwear and everyone else is dressed is basically the reality of a doctor visit. Being in an exam room brought my ability to communicate to a screeching halt. In other situations, I’m certainly an adequate communicator. So what happened when I was ushered into an icy room with medical diagrams of ghastly things that could be happening to my internal organs? I felt apprehensive and couldn’t engage in meaningful conversation.

I needed to make a concerted effort to have the talks with my doctors become more productive. I found several ways this could happen. For starters, I had to quit being nervous. If I was stressed, I could not listen attentively or fully comprehend new information. Easier said than done, right?

A doctor’s office is an environment with a peculiar form of interaction. No other setting seems quite comparable. For one thing, the pace is different. Unlike a casual discussion among friends, this interaction is timed. I know it’s timed. When I was “scheduled” for 2:15, that meant there must be a 2:30 person tapping their fingers nearby. Knowing my time was limited, I felt rushed which caused me to be nervous and forgetful. More importantly, it did not allow me to explore topics in depth or ask follow-up questions. Therefore, it was a set-up for failed communication. Two strategies help mitigate stress. The ideal one is to bring a friend or relative with you. Having a loved one with you helps you relax. Also, they can take notes for you and serve as another set of ears to catch points you may miss. If you don’t have someone with you, the next best thing is to carry a notebook. Writing questions beforehand means you won’t forget any. Writing down the doctor’s directives and answers insures accuracy and allows you to review them later.

One conversation-dampener is that within a few seconds of an introduction, you are expected to share the most intimate details about your body and health. I noted even the introduction was one-sided. I didn’t need to say my name. He already knew my name from a glance at my records. That chart and/or computer screen is also off-putting. Imagine meeting someone for the first time and they are staring at a screen containing all your personal information—worse than a public Facebook profile. All my records were in front of him, yet I still knew nothing about this person muttering, “Ah, uh-huh. Hm-m-m. I see…” To counteract not knowing my doctor in the least, I’ve learned to assert myself a little. Upon meeting a doctor for the first time, I open the conversation with a question such as: “May I first learn a little about you? I’d like to know what led you to specialize in oncology.” Also, I might ask if their emphasis is in research or a similar topic to help me get to know them. If your doctor does not respond well to a minor attempt at being sociable, I would suggest finding another doctor.  

Another challenging aspect in communication between doctor and patient is that—well, it is between doctor and patient. That fact, alone, seems to put us on unequal footing. Certainly, we can’t chat like friends or with the easy familiarity of student and professor. Somehow the word “patient” sounds sick and needy (and sometimes we are) and the title of “doctor” confers respect and a sense of formality. When I’m completely dressed and not wrinkling that noisy paper sheet, communicating still takes an effort. Of course, if I am in a state of undress, talking is awkward. I don’t know of any more certain conversation stoppers than some of the sentences heard during an exam. “Let’s take a look at your breast,” is not a phrase in normal parlance—unless you are frequenting some extremely dodgy places.

There are a couple steps you can take to overcome the hurdle of feeling intimidated. First, you can ask your doctor to return after you are fully clothed to discuss your case. Second, you can simply remind yourself that despite an advanced degree and a crisp white lab coat, this is a person who cares about helping people so much that s/he chose to be a physician. Hippocrates’ words ring true: “Wherever the art of medicine is loved there is also a love of humanity.”

You bear responsibility for creating an open and meaningful dialogue with your health practitioners. For one thing, you need to be truthful. If you tend to exaggerate, be careful with your words. To be completely candid means not withholding information. No one can help you if you are not forthcoming. If you are asked about pain, for example, a complete reply would include all pain, even if you think something such as a headache is irrelevant. Omitting information could delay a diagnosis. Be prepared to describe symptoms accurately though succinctly. If you don’t understand something, be sure to ask. Your doctor should be glad to clarify. If there is going to be open communication, you can’t hide your confusion.

Communication is easier if you realize you are actually part of a medical team. This applies whether the “team” is only you and your doctor or if the medical office has a several specialists assigned to your case. You can choose to take an active role in your own care since only you can judge the quality of life you desire and what aspects of care are important to you. You will want to speak up and honestly share what you are thinking and feeling. Your input matters on decisions concerning your care. You are the one who will reap the benefits of transparent communication. In this situation, it really is “all about you.”

 Reflection:

1. Do you feel comfortable in a physician’s office? Why or why not?

2. Have you tried to keep communication open and honest with your healthcare providers? If so, how do they react?