Dear young oncologist,
Please banish this response from your repertoire,
"We'll tell you when to worry", complete with a sympathetic smile and a pat on the knee.
she's 38 and has 3 children and in incurable leukemia, you as her physician are not in control of her worrying. of course she'll worry no matter what you say or don't say, no matter how she responds to treatment - she'll worry. it's neither insightful, nor helpful, nor therapeutic to suggest that she shouldn't or that you are capable of relieving her of that. it's patronizing and paternalistic and lazy. don't you see that?...that sinking in the eyes and the spirit when she brings up her deepest fears and you shut her down with a superficial canned remark like that?
i hope for you that your humanitarian side will catch up with your intellect and that you will soon know, instinctively, that is just not a kind thing to say. and if you misspeak, as we all do sometimes, that you will catch yourself, backtrack and say 'i'm sorry, that was a silly thing to say. tell me what you are worried about.'
sincerely,
a concerned oncRN
*** i did attempt to bring this comment to the onc's attention. kindly and diplomatically, i thought, i told him, 'you know in my experience it really rubs patients the wrong way to tell them not to worry....etc' he had no ears for that and didn't appreciate the tip. and i'm pretty sure i saw him adjust his pants, and puff out his chest a little, and all i could think of was this. oh well, all you can do is try.
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9 comments:
Nice try, but you can't control others' humanitarian instincts, especially if they are coupled with no small amount of egomania. Like you say, maybe he'll grow into it. In the meantime, it's good for both you and your patients that YOU do have good humanitarian instincts.
Brother Steve
*Thank you* for this post.
Cancer is an emotional roller-coaster. The feelings are intense, and it can be scary because most of us patients have no idea what "normal" is supposed to be.
I think it's important to validate that yes, we're going to be frightened and angry and despairing and numb and optimistic and hopeful... sometimes all at the same time. Family members, friends, coworkers and even physicians sometimes can't deal with this, though, so perhaps they trivialize it in order to help themselves feel better?
How I feel is how I feel. Name it and get it out in the open so I can confront it and move on.
I think most patients would prefer honesty vs. paternalism.
Love the link.
I was thinking more of the gorilla pounding its chest...
I have to work hard not to do this to my kids, as it was done to me (Mom telling me "you can't feel that way, it's not justified"). Feelings just are.
You'd think that by the time he reached this point in his work, he'd get it. I hope what you say sinks in.
When I was first learned I had cancer. I recall a doc not my own talking in that way with a coffee cup in his hand and saying to the patient across from me. *Its my job to worry for ya!* The whole time he drank his coffee..Like worry to his patient was a trival thing. There was no connect just air between them. What I witnessed was non caring and non supportive.
I mentioned this to my own oncologist who was never that way.. I recall him always addressing me with respect and not in the chemo room with others to hear. He agreed it was wrong..and apologized for what I witnessed.
I for one appreciate the respect given. Whether its you or another nurse who stands up for the patient. I can appreciate the fact.
Will he grow into his job. Some do and others go on being callus and don't get it.
As for you thanks for understanding no matter what the patient has worries and sometimes a doctor can't take all of them away.
I appreciate this blog so much and your candor.
About the picture I agree:)
Love the picture - love your blog and writing style as well. Thanks for great insights.
what a turkey. sometimes you don't have to say anything to a patient to connect. i've found that inappropriate comments like that are more telling of the individual who made them.
i'm sorry that the patient had to hear those words. i'd be freaking out.
I have to say that in my nearly 13 years of a progressive, exceedingly rare illness, my opinion of doctors has suffered greatly. Not because I was misdiagnosed for several years - it really did present like the Myofascial Pain Syndrome from hell at first. But because of one too many patronizing, skeptical, and really inhumane encounters along the way.
They need to incorporate some sort of interpersonal skills and ant-ego training into the medical curriculum.
I want to add that I definitely met some doctors who were wonderful people. But I've also concluded that, surrounded by timid patients and fawning staff day after day, this profession is one of the few jobs adults engage in that, over time, works against positive personal development and in favor of greater egocentrism.
I think you could write an entire book and fill it with things that that. Often it's best to just be silent, but unfortunately most are far too uncomfortable with that. At any rate I am glad you spoke up about it.
Beth
pixelrn.com
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