Toolbox: Communicating with the Medical World
Terri Reinhart
Communication: understanding others and being understood is one of the most wonderful aspects of being human. A dog can't go in to the vet and calmly explain to the doctor that he has a burning pain in his back left toe (3rd from the right) and has been craving cat food. We humans are the ones with advanced language skills. Why then, is this so difficult?
Part of the problem is our brains have to translate the speech we hear into something of meaning and our brain translators are not much better than the online language translators on the internet. The difference is a computer cannot take facial expression, body language, and tone of voice into consideration. We, on the other hand, take all that and more into our language interpretation center where it is sifted through our experiences, our prejudices, and the traumatic time when we threw up in the middle of our third grade classroom.
I'm sure there are people who have no problem at all with communicating, whether it be with their families, coworkers, neighbors, pets, or any alien species who happen to be visiting. I am in awe of these people. Most of our attempts fall into one of these categories: a) I'm afraid I'll say something stupid b) I'm sure I must have said something stupid or c) as usual, I talked too much. These are exact quotes from friends after a recent social outing.
And this is just in our everyday encounters. When we are trying to communicate our health challenges to our doctor or dentist or emergency room nurse, our ability to communicate effectively can make a huge difference. Before we even begin, our expectations and assumptions can create barriers. Are we going in assuming our doctor won't take time to listen? Or will talk down to us? Do we get intimidated by medical professionals? Do we trust our doctors? It's good to recognize the barriers we bring with us.
What do we want our doctors to know about us? What do doctors want us to know about them? I have compiled a basic list. From the doctor's side, it's a compilation from articles I've read and asking doctors.
Patients
I am more than a bundle of symptoms - I am a whole person. I have a biography. I have interests and talents, family and friends. And a sense of humor.
How you see me today is how I am today. This is so true with PD. If I'm having a good day, will the doctor believe me when I tell them of my challenges? If I'm having a bad day, will they think I'm always like this?
I don't need to be made perfect. Let me know what can be helped and what can't. I know treatment doesn't take away 100% of my symptoms.
Do you realize you treat me differently depending on how well I am able to speak? This is my pet peeve, but I realize it's also a natural reaction. If my speech is slurring or hesitant, my docs have talked down to me. It's subtle, but noticeable, and totally unintentional. If I can speak well, my docs speak to me more as an intelligent adult. Do I do this to other people? Something to think about. My first neurologist tended to speak down to me a lot. I was a bit of a mess while trying to get my meds stable. Another patient showed her my blog articles. Suddenly, her attitude toward me changed drastically and she treated me more like a peer.
I want my doctor to respect me. I know my body and, while I want to listen and trust my doctor's knowledge, if I tell my doc about a reaction to meds or that I don't want to try a certain treatment, I want them to listen to me and believe me.
Doctors
I wish I had the time to really get to know each patient. Doctors often have very large caseloads these days, not because they are greedy, but because a lot of people need to be seen. This is especially true with specialists.
If you aren't taking your medicine (or my advice), please tell me. We can talk about it. How can our doctor know if we have the right medicine if we stop a particular drug because we didn't like the way it made us feel? If they think we're doing everything they told us to do, and it's not working, our docs might conclude we need stronger, more aggressive treatment. At a patient panel at our School of Pharmacy, all 5 of us patients on the panel admitted to not always taking our medication the way it was prescribed. Not necessarily bad, but absolutely we need to talk to our docs about it!
Pain is difficult to treat. Anxiety is difficult to treat. There isn't a magic medication. It's easy to become addicted to drugs used for pain or anxiety. While drugs are often necessary, a good doctor will also help you find resources to learn tools for coping with pain and anxiety.
I want my patients to trust me. Building trust can take time, especially if we have had negative experiences in the past with Dr. Payne and Dr. Hertz. Remember, your doctor is a whole person, too, with their own interests and talents, their families and friends. Most doctors are passionate about their work and are there for you.
Considering all this, how do we effectively communicate with our doctors and give them all the information they need? One way is to write everything down and be as organized as possible. If I can do it, anyone can. I'm organizationally challenged. The benefit is that your doctors will be impressed with just how organized you are and impressed because this saves them a lot of time. Conversely, trying to depend on our memory to report how we're doing can lead to finding this on our medical record: "Patient reports she has no cognitive issues, however..."
Before your appointment, write out your questions and concerns. Keep track of the symptoms that are bothering you so you can let the doctor know how often and when they happen, and whether there is any variation in the severity. Have the receptionist make a copy of this and attach it to the outside of your chart. This way, your doctor can read the details even before he/she comes in to see you.
If you have a good friend or a family member who is willing to come, it's good to bring them along to be another set of ears. They can take notes and perhaps even think of questions you don't.
Trust yourself! Even if we walk a little awkwardly and slur our speech, even if our face is a mask and shows little expression, even if we shake and our arms go every which way and we have a tendency to walk into walls, even with all our challenges, know that what you have to say is valuable and interesting. Try believing this, even for one appointment. If we believe it, others will, too.