Too much talking

2012-06-11 Too much talking SS

About a month ago my son needed to have his first blood test.  Ooh, I thought to myself, here’s a chance to combine my fantastic mom- and doctoring- skills. I can do a great job preparing my son for this potentially stressful event.

I described to him in kid-friendly terms the steps of having a blood test.  I talked about the receptionist, the chair with a swing-out table on which you rest your arm, the friendly phlebotomist who will clean your arm then carefully yet quickly use a special needle to get blood out of your vein, which is collected in special glass tubes.  I even told him that his arm will ache but the ache doesn’t last for long.

His big sister thought she could help too, as she remembers when she had a blood test.  She reassured her brother that this would be no big deal.  First you sit in a special chair.  There’s a quick poke to the inside of your elbow and its over before you know  it. Your blood is collected in special tubes.

Dad also added in his reassuring description of the process:  It’s nothing to worry about.  It doesn’t take long.  There’s a chair, a quick needle poke, and some tubes that collect a few teaspoons of blood.

Since we had all done such a great job preparing him with information,  I was quite surprised that my son look so worried when he sat down in the phlebotomist’s chair.  And I was equally curious that such a look of surprise and relief flooded his face as soon as it was over.

I asked him what was up.  “That was nowhere near as bad as I imagined,” he said. “You imagined?  What did you imagine?”

illustration by Noah Milo

Now it was my turn to listen.  My son described his interpretation of all the information we had provided to him.  He had imagined a large white machine making a loud whirring noise would be attached to the wall.  Beside it was the chair in to which he would be strapped.   The hospital worker would insert a needle into his arm.  His blood would rush through a tube into the machine.  Inside the machine his blood would be separated into a series of large collection bags with plasma red and white blood cells. No wonder he looked so worried and then so relieved.

I had talked. But I’d forgotten to listen. So had his well-intentioned sister and dad. None of us stopped to ask him how he had interpreted all the information we provided.  We didn’t pause to ask what he heard.

I wonder how often I make the same mistake in the conversations I have with my patients and their families at the hospital.  In medical school, we are taught to be curious about how our patients experience their illness.  But am I continuing to work on these skills now that I’m out in clinical practice?  Are my discussions too one-sided and too top-down? Do I spend enough time asking about, then listening to what really worries my patients and families?

If I can find room for improvement when I try to give useful information to my son, chances are that I’m not doing as great job as I think I am in making sure I’m really trying to understand what my patients and families understand.

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