‘Literature about medicine may be all that can save us’

In The Guardian, you might find this article of some interest. Not a thyroid-based item, but nonetheless it has its moments.

 ‘Literature about medicine may be all that can save us’

A new generation of doctor writers is investigating the mysteries of the medical profession, exploring the vital intersection between science and art

The language gap frustrates your visit to your doctor. He seems not to understand the problem because you can’t describe it lucidly enough. You don’t understand the proposed treatment because he can’t explain it. I’ve sometimes foresworn medical help because the complexity of voicing what is wrong has felt heavier than the sickness itself. This is especially true for psychiatric illnesses such as the depression I have experienced, but it is true of physical problems, too. It has been entirely manifest to me when I’ve tried to explain the problem with my left ear, in which I am partially deaf. I’ve said what it feels like, to which my consultant has repeatedly replied with various options. I’ve said it doesn’t feel like any of the things in his multiple-choice list and theorised about what is actually wrong. He has resisted my inexpert opinions, and I have battled with his inability to grasp the subtlety of my experience. We are both articulate and we are both exasperated by this sticky communication.


8 Replies

  • Thanks for that. It is true.

  • ...[ .. people who can speak more fluently receive better medical care ... ] ... or present  themselves better  ....

    And it is pot luck as to whether the doctor interprets your descriptions in the same manner as you describe.

    Linguistic descriptions vary even when defining the same concept and a doctor is only qualified in medical exams, not language and behavioural skills.

  • There could be a solution ;-)


  • Good response!

    I always worry when pharmacists are put into the front line as advisers and supporters.  Certainly, at their best, they can be extremely helpful. On the other hand, if you read what I posted about Boots the other day...

    They are in a position in which conflict of interest is such an obvious possibility.

    Also wonder how many nurses know enough about thyroid to do an adequate job?

    However, we see so many people here managing amazingly well without significant doctor input, perhaps we are already there?

  • The article seems to blame the patient's language when I've noticed that recently qualified and nearly retired GPs don't have the same communication problems. Neither do doctors who specialise in treating children. 

    Part of communicating is listening and it seems that some doctors have an issue doing that as it takes effort. 

    It's far quicker to presume what's wrong with a patient from their own experience,  and write a prescription or tell the patient to go away if the symptoms/signs aren't in the list of their experience.

    Other medical practitioners e.g. nurses, pharmacists tend to have better communication skills but are limited by knowledge and what they are allowed to prescribe/do.

  • When I read it, I didn't feel that the blame was on the patient for their (relatively) poor communication skills. More an observation that it is the case that this does lead to less successful diagnosis and treatment.

  • Thank you very much helvela for this brilliant link.

    Please, may I recommend  the following:-

    From patient centred to people powered: autonomy on the rise



    “Following in the path of feminists and civil rights leaders, informed patients are building a progressive social movement to improve medical care. Dave deBronkart says medicine should let patients help improve care, share responsibility, and think for themselves”

    Dave deBronkart---- (  epatientdave.com/page/2/ )

     I am a passionate follower --- you can see more about him on en.wikipedia.org/wiki/Dave_...

  • ThanksHelvelle for the fascinating article. Maybe it's the patients who are able to verbalise/question their condition who are also the ones who persist to find the most effective way of managing their condition?

     Personally I have met many doctors who have found my articulation and questions a nuisance and annoyance but when I find one that listens and interacts with me as an intelligent interested person then the dialogue changes and as a consequence so does the treatment.....maybe it's the interactive enquiry that triggers a more fruitful process? Maybe doctors who engage in this see the patient as a far more important part of the process with greater equality to themselves to find the best solution? 

    The other day I met a surgeon who said to me "I like my patients to make the decisions. I believe it is very important. " He then immediately entered into an interested connected dialogue with me expecting questions, listening, reflecting but still deferring  back to me. I found it fascinating... Of course our discussion was far more holistic....I don't think it took more time but it was intense. I came to the same conclusion that he had kept back from saying until I asked him. Do I have faith in him as a surgeon? Yes!! 

    The art of enquiry, discussion  and connection with patients is the art side of medicine that seems to have been lost in the flurry of the development of technical medicine. It is the conversation and dialogue that leads us along fresh pathways as this forum so often shows us. Maybe that's it's power -one that has largely been forgotten but hopefully one the medical profession is returning to. Hopefully they will also see the folly therefore of the 10 minute window given for GP consultation!! 

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