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Things doctors say that aren’t helpful.

April 5, 2012

We’ve all had this experience.  A well meaning (we hope) physician says something that sounds like it’s supposed to be helpful but isn’t.  Sometimes the effect is to belittle our symptoms or tell us no matter how hard we’ve tried to communicate our experience, the message isn’t getting through.

  1. “You’re just stressed out!”  This is usually said by someone who has no intention of doing anything to help with stress management.  My impression is that the person saying this thinks that you can talk someone out of anxiety or worry that is likely based in painful reality.
  2. “Don’t worry about it.”  Closely related to number 1.  Often said by a doctor who doesn’t want to answer questions.  It is beyond me why doctors would want their patients to remain ignorant about their condition, but I’ve seen it.
  3. “You need to lose weight.”  If this is followed by reasonable advice on how to do so and an offer of support,” it is highly appropriate.  More often this is said and no assistance is forthcoming.  Hint to the socially inept doctors out there, saying this or something like “I can see you have a good appetite” during a pelvic exam is not only not helpful it is humiliating. (This actually happened to me when I was 18 years old.)
  4. “It’s not your heart.”  Often said when the doctor has no intention of helping you find out why you have chest pain.  Even less helpful when said to someone who is having active chest pain that is helped but not completely relieved with nitroglycerin and has a history of heart disease.  I feel great remorse that I delivered that statement many times in my early career working as a nurse on a cardiac floor.  I’m sure some patients were reassured, but others may have felt despair that they were about to be sent home from the hospital (again) with no help for their symptoms.
  5. “You may feel some discomfort.”  If something is going to hurt, you should say so.  This is the worst coming from surgeons who aren’t up front about the usual level of pain and discomfort felt either during or after an upcoming procedure.
  6. “It’s going to hurt.”  When said with a tone of disgust and no intention of relieving the pain.  Even better when followed by, “What do you want me to do about it.”
  7. “Cardiac cripple”  This is not a medical term and has no descriptive value.  A friend of mine says it’s a pejorative term used to describe a patient who has failed to get better despite the cardiologist’s best efforts.  Having been described as such to the hospitalist by my old cardiologist (who also had a nurse inform me he didn’t care to help me with disability insurance paperwork because I have “no cardiac limitations”) I am inclined to agree.
  8. “You’re going to have to do better.”  Said with no instructions for how to do so or even what they are actually referring to.  This hasn’t happened to me, but has happened to friends of mine.

Please feel free to add your own favorites to the comments.  I’m sure we all have a few.  One thing I’d like to make clear is that I accept that I will get bad news from a doctor sometimes.  I still feel great respect for the orthopedic surgeon who shook his head in consternation while examining my knee injury sustained when I was struck by a car while crossing the street.  He said, “This is a major ligamentous injury.  It’s going to take a lot of rehab.”  It was a relief to hear something concrete that seemed to correlate with the serious trauma I had endured.  We don’t have to hear good news all the time.  We just want truthfulness and compassion for our experience.

4 Comments leave one →
  1. Ruth Kivela permalink
    April 5, 2012 10:36 am

    Best one to date: I awoke during an anal ultrasound (Gastro-Guy didn’t believe in anything except “light sedation) to hear him and his nurse discussing my stage 3 n-1 anal cancer of which I had no clue). I, upon hearing the unexpected diagnosis, tried to exit the room was told :”Yes you have anal cancer but don’t worry we can cure you.”
    Oncologist later that day told me what would happen if I didn’t follow the protocol for treatment but NEVER gave me the downside of the treatment.
    Oh, well, too late now.

  2. Ruth permalink
    April 5, 2012 11:55 am

    When the truth is helpful but difficult: So true that we do not need to hear good news all the time – we need to know what to expect. When my cardiologist told me that I had dilated cardiomyopathy and got ready to hand me enough samples of each medication along with the prescriptions so that I could get started taking medication when I got home and ate dinner, I said, “Well, what if I just leave here today and pretend we never had this discussion?” To which he replied, “I have the test results and I know what they mean, but only you really know what is going on inside your body. So if we say that your situation is right here, ( and he indicated a graph starting in the middle of the vertical axis to the left with his hand), well, if you do not do anything, you may continue as you are (horizontal line across with his hand), you might get better (line upward), and you might get worse (line downward to zero).”

    I left that office in shock, but I made it home and my husband and I sat down and looked at the medications, I ate dinner and took the one that I needed, and we went to the drugstore and got the prescriptions filled before closing. That was June 14, 2002.

  3. April 6, 2012 11:12 am

    The worst one I’ve ever heard was when a doctor was trying to inject my ankle with cortisone (I know, I should have NEVER gone to my primary care doc for that instead of my rheumatologist). He asked me to let him know when he entered the synovial space. Really? And how am I supposed to determine that? If he wasn’t capable of performing that type of injection, he should have told me. Thankfully I was able to tell him that my rheumatologist said that he feels a little bit of “pressure” as he hits the synovial membrane. I never went back to this doctor again. I was afraid I’d have to perform my own exam next time.

    • April 6, 2012 11:39 am

      Ouch! The key is KNOWING when to refer. Funny, I was just remembering a steroid injection in my knee last year (by my ortho, who DOES know how). My knee was pretty flared up and when the needle went through the synovial membrane it hurt, bad. Now that’s inflammation!

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