At least for a country doctor, it is best to use patient speak, as opposed to doctor speak, when you talk to your patients. I found this out early in medical school on daily rounds.
Sometimes the attending would come in the patient’s room with a big entourage, and speak “at” the patient, instead of with them.
“Mr. Charles has an ejection fraction of twenty-five, but minimal peripheral edema, and no jugular venous distention. His current respiratory compromise is more likely on the basis of his obstructive pulmonary disease. I would pursue bronchodilators but not at the expense of diuresis.” This would go on for a few minutes, and then the attending would wheel around and walk out the room, his entourage right on his white coat-tails.
As the lowly med student we were left behind to get our history for the day. I sat down to listen.
“Hey, Doc,” said the patient. (I was just a med student, but even at that stage, I had come to cherish the title and respect the obligation that went with it.) “What wuz he talking about?” He handed me a can of Planters. “Care for some nuts?”
“You better leave these with me, man. That salt’s gonna swell you up. Makes the water build up in your lungs.” I sifted through the can for the cashews.
“Yeah, no kidding.” I handed them back. “I ain’t gonna take ‘em all, but you better go light. They can go against you.” You’ve got the head of your bed up, you having much trouble sleeping?”
“Yup, I can’t lay flat Doc, sure enough.”
I checked his chart. “Looks like you didn’t pee much last night.”
“Shoot fire, I told that nurse I needed that water pill, they didn’t give me one. It was right at shift change. I think she had boyfriend troubles.”
“Tell you what, let me call the intern and see if I can make sure you get it today.”
We got him the missed diuretic, and the breathing treatment recommended by the professor on morning rounds. By that afternoon, the patient was better. The attending was pleased, and everyone complimented him on his brilliance. (Rule number one in med school- always make the attending look good if you want to graduate.)
All this talk about patient speak reminds me of an old story that came out of out of Hawthorne Gray School of Medicine. It is apocryphal, but makes the point.
An old country preacher had prostate cancer, and wanted to get his treatment at the medical center. The attending saw him, and recommended surgery. “Reverend, in the morning we are going to proceed with an orchiectomy.”
“Doctor, whatever you say is fine with me. You doctors at Hawthorne Gray are the best doctors in the world. I trust you, and will do what you recommend.”
“Excellent.” The Professor handed the patient a consent form, and the preacher signed it.
The resident was not so certain the Preacher got it. “Preacher, I want to be sure you understand. In the morning, they are going to remove your testicles.”
“Whatever you doctors say is fine with me. You doctors at Hawthorne Gray are the best doctors in the world. I trust you.” The preacher handed the signed consent form back to the resident. “I am ready.”
The doctors left. The med student was worried. He was not at all sure the preacher got the message, and decided to speak to him one last time. He pulled up a chair.
“Parson, (the med student was a bluegrass boy) I want to be sure you heard them right. In the morning, they’s gonna cut your balls off.”
“The Hell they are!”
In my line, as country doc, I gotta go with patient speak over doctor speak. I sure don’t want to be misunderstood, especially over such an important issue.
Dr. BExplore posts in the same categories: med school days