Understanding your Doctor

In James Thurber’s charming fable "Many Moons" [Are there ever fables that aren’t charming?  Yes, to wit: "The Bird, the Mouse, and the Sausage" from the brothers Grimm.  I love it, but it’s not charming.], the Princess is ill and won’t get well unless someone brings her the moon.  The King summons all his wise men, advisers and courtiers to address the task.  None can bring him the moon, but all hasten to list the many things that they have done for the King.  The court magician’s list includes a cloak of invisibility.  "That didn’t work.  I kept bumping into things, same as always." The mage replied, "It wasn’t supposed to keep you from bumping into things.  It was supposed to make you invisible."   "All I know is, I kept bumping into things."  Yeah, me too.

This came to mind last night when I was visiting my mother, who has a number of medical problems.  Her doctor had prescribed a medication for her which she did not intend to take.  She had looked up what it was for, and the insert information showed that it was approved for a different condition than the one she is suffering from.  As it happens, it also happens to be the best medicine for the condition she suffers from, despite the fact that it isn’t on the labeling.  When I spoke with her doctor, he was a little dumbfounded, as he was certain he had done a good job communicating to her why the medicine was being prescribed.

Two weeks ago, I saw a dog with long-standing skin problems and a complicated history, having been to two different veterinarians previously.  I carefully outlined what seemed to have been going on, and what I believed the different possible underlying scenarios were (skin problems in dogs, often having multiple underlying causes, ALL of which must be addressed for relief).  Then I lay out the diagnostic and treatment plans.  Proud of my careful explanations, I then asked if the client were clear on what was going on. "Well, I heard you say allergy a lot."    That was discouraging, I can tell you. I started over, using words of one syllable where possible.

When the client doesnt "get" the explanation, it doesn’t mean they are stupid.  It means that I have used a word they don’t fully understand, or skipped from step one to step three without mentioning step two.  That’s like watching a movie in a theater where they get the reels out of order.  It’s interesting in a way, but it doesn’t really make sense.  It’s my job to help you make sense out of the puzzle, not leave you stuck in an additional mystery.

If I had neglected to ask my client about her understanding, I wouldn’t have known she was still clueless.  She probably wouldn’t have followed the plan (which, by the way, has been very successful), and she’d be moving on to doctor number four.

Sometimes people look so smart (or I get in so much of a hurry) that I neglect to ask if they have questions or concerns.  That’s bad, because they may walk out and not help the pet at all.  We’ve called people back to ask how the pet is getting along and find that they were completely unable to medicate the animal.  They didn’t call back for an alternative, they just gave up and watched them deteriorate. 

Even if I forget to ask (or your doctor forgets to ask), if you are still "bumping into things", call me back and let me know. 

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