Treatment notes no. 4586

A new, breakthrough study has discovered that doctors are human. As a result, they naturally view most of their patients as ‘foolish, uncomprehending, hysterical or malingering’. This is certainly the case when the patient presents with a health problem that has a mysterious cause.

Unfortunately, the report continues, most illnesses have a mysterious cause, so it follows that most patients must be viewed by their doctor as perhaps foolish, uncomprehending, hysterical or malingering – or all of the above.

However, the doctor must overcome these natural, and human, feelings and should instead endeavour to communicate with the patient (even if he probably is hysterical or a malingerer).

Now, most patients can hold only seven thoughts in their head at one time, so we can safely add ‘stupid’ to that foregoing list. Professionals (i.e. non-patients) also use vague quantifiers such as ‘rarely’ and ‘unlikely’, which are instantly understood by a fellow professional. This confuses the patient, however, because he is also innumerate.

Worse, patients look for clear answers – for example, they like to label a disease and ask questions such as ‘What’s wrong with me, doctor?’ – but yielding to that pressure is a trap that the professional must avoid at all costs.

Finally, don’t use long words. When you have nothing to say to a patient who you doubt has anything wrong with him, use simple, monosyllabic terms – which, unfortunately, rules out such useful terms as ‘moron’ or, indeed, any of the foregoing terms that describe patients. However, words such as ‘not’ and ‘ill’ would work, as would ‘don’t’ and ‘know’ (BMJ, 2003; 326: 595-7).

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