This is a difficult blog for many reasons that I will not divulge. But I will take you to where I am.
Immerse your head under water at a poolside. Around the pool you can hear the loudness of all the people around you. You dip your head to dive beneath the water. As you dive deeper these voices fade and become muffled. Submerged you know there is something out there but you are unable to understand it. There is some security in not being able to hear exactly what is being said. In the water you feel somehow protected, but vulnerable because of this perceived security. Those standing outside the pool talking about you, trying to explain complexity to you. You hear a little but you choose to stay secure. This is where my patients go when they are diagnosed. When what I say to them does not quite sink in. That they do not fully grasp what I am saying. This is how I am feeling.
There is a movie called Mask in 1985, it’s images cross my mind. The boy in it has a rare disease, and he attempts to share what he understands about color with a blind girl. He takes a stone and explains blue by placing it in a freezer and then giving it to her. He explains red by giving her a stone that was thrust into hot coals. I was 14 when I watched this movie. Incredibly done to truly explain color. Blue=cold, red=hot. Blind, deaf, or disabled. Can we as physicians really be sensitive to communicating accurately the true nature of cancer? Are we aware of the refraction index of our knowledge that feels to a patient like voices striking water while they are fully submerged? How can we measure understanding? How do we engage our patients in helping them make the right choices? Can I make them see color or feel it if they are blind?
30 min. That is the standard clinic slot for a patient. Seriously, is this the “business” of medicine? What happened to the art of healing? Can I tell someone their leg needs to be amputated in such a short time? It is vitally important for me to offer each patient a chance to understand their disease. Sometimes in giving clarity, truth is not kind.
Muffled is the outside voices. The truth cutting its way through. I sit in silence, my greatest teacher. Can I help my patient reach the surface to hear me loud and clear?