Monday, August 23, 2010

“We are not Dr. God”

Funny...I never thought you were.

Yet last week was the second time in recent years a physician said that to me during a doctor visit. It happens when I start asking questions.

I explained my situation then tried to ask a question. But before I even finished articulating it, the doctor interrupted and started answering based on what he thought I wanted to know. When I tried to refocus the conversation on my particular circumstances, he just continued his spiel with "'We are not Dr. God'" thrown in.

I think his comment reveals an interesting self-perception.

I do not believe physicians are omniscient. But I do expect them to answer my questions. Note: answer my questions, not cure my ailments. If a doctor can explain my symptoms, great! If she can treat or eliminate the problem, even better! But if a physician doesn’t know why my body is acting the way it is, that’s an answer, too. And a straightforward “I don’t know” while perhaps dismaying is at least honest and respectful.

“We are not Dr. God” is a defensive, and demeaning, statement. But maybe it’s our own fault.

In the western world, we groom doctors like thoroughbred horses. In college, premed students are held in awe: “Medicine is hard! You must be smart!” The ego-building and instant prestige continue when proud parents later brag “My daughter, the doctor!” or people add “He’s a doctor!” when parading the specimen at social gatherings. (Sorry, lawyers no longer cut it.)

Never having had to justify their career choice or, since most mere mortals don’t understand medicine, explain their decision-making, it's no surprise that many physicians perceive questions from patients as a challenge to their authority, competence, knowledge, ability – who knows? – and react defensively. Questions break their stride.

Or maybe they’re just nerdy introverts with lousy communication skills.

(Does it matter that I’m female? The doctors who said this to me were male. Would a female physician say this to a female patient, or a female physician to a male patient, or a male physician to a male patient?)

I’m aware there’s a fine line between too little and too much information, and I can imagine many doctors consider talking with patients a no-win situation: If I don’t say much, the patient will complain about being uninformed. If I say too much, the patient will accuse me of information overload or being too technical. That’s why doctors need to listen to patients and hear what they’re saying, and respond accordingly. Health care is a two-way street: It's a dialog, not a monolog.

A physician friend claims the most important skill of a good doctor is an ability to work with people. (What good is knowledge if it doesn’t translate into effective care?) I agree.

Don’t talk at me, talk with me.

See related posts Doctors never make mistakes and Name game.

Friday, August 6, 2010

Is your inner critic talking to you?

I was reading a newsletter today where the author touched on people’s inner critic – you know, that little voice in your head that tells you you’re not good enough, smart enough, hard-working enough,
__fill-in-the-blank__ enough. The author relayed the story of a friend who said if a real person talked to her the way she talks to herself, she’d have ditched the friend a long time ago.

No kidding!

This tickled my fancy because I, too, am my own worst enemy. And I wonder why.

It reminds me of the Groucho Marx joke about not wanting to join a club that would have him as a member. Or better yet, in a story in Nasty Book, a book for tweens, about a boy whose imaginary friend runs away because the friend can't stand him.

Now that’s pathetic.

Why is it so hard to be your own best friend?

Theories abound: You grew up in a critical family. You did poorly in school. You weren’t popular with the in-crowd. Your boss and your colleagues hate you. You don’t have even imaginary friends. We internalize all that negativity, and it’s downhill from there.

Or maybe it’s false modesty. After all, if you really believed that critical voice, you wouldn’t be as successful as you are or try to master new challenges. You’d just give up before even trying. But everyone does something. It’s mainly in the learning phase or before we’ve mastered a skill that the little voice screams loudest.

Perhaps it’s a female thing. I think woman are more prone to this than men. Just the other day I was discussing something with my husband who said, “I don’t know why you’re so negative about yourself.” The fact that someone may not be worthy of or deserve what they hope for hadn’t even crossed his mind. For him, if you’re skilled or qualified for what you want, there’s no reason you won’t get it. (I know even he has his inner demons. But it’s sweet that he refused to acknowledge mine.)

I wanted to comment on this because I think it’s interesting. But I couldn’t really think of anything helpful or pithy to say. No insight or lesson to share. So I thought I wouldn’t write anything.

But that’s not what I wanted to do. I then thought people would think what I wrote was stupid. But "inner critic" is a phenomenon we all recognize, so why not comment on it? Because it’s boring unless I have something compelling to say. But do all blog posts have to be enlightening? Does each one have to be a gem?

Will I look foolish or idiotic if one is not? Do I dare put something out there that’s less than perfect? What if this post is too trite? What if I fail? What if I look dumb? Maybe this is a really bad idea.

Shut up already!