What Not to Say to a Patient

I have mentioned before that I have a condition called Multiple Sclerosis, a neurological disorder which causes upsets in the body’s nervous system. Currently I am on a course of treatment which requires me to undergo chemotherapy- an infusion every few months.

I recently spent a day at the hospital for this treatment.

My room-mate was a lady a few years younger than myself. She had been diagnosed for cancer- breast cancer- a couple of months earlier. She was just starting her treatment of chemotherapy. That day she had come for her first infusion.

She was obviously still getting used to her diagnosis. She was undecided about whether to see another specialist doctor or not. She was weighing the comparative merits of the treatment options available. She was apprehensive about the side-effects of the chemo. And she was worried how her young children would cope with her illness.

In the afternoon an acquaintance came to visit her. He had been diagnosed with cancer five/six years earlier, he told her, and after a course of chemotherapy, had been cured.

He said that she had nothing to worry about. “Chinta nahi karna… Don’t worry…. Kuch nahi hoga…….”

And then he started to relate his own experiences.

He had experienced a lot of nausea after every infusion, he said. For days afterwards. He had tried various home remedies, but they did not work. The doctor gave him tablets to take, but it was no use. They had absolutely no effect. He could eat nothing.

But still,  “Chinta nahi karna…. Don’t worry…. Kuch nahi hoga…….”

After chemo, your WBC (white blood cells) count goes down drastically, he told her, so the body starts to manufacture WBCs at top speed. These are manufactured in the bone marrow. So a patient’s bones hurt a great deal after an infusion of chemo.

His had hurt so much that he could not sleep one whole night. As soon as it was dawn, he had called up the doctor. But the doctor could not prescribe strong pain-killers.

“You just have to bear the excruciating pain” he said, shaking his head.

But still, “Chinta nahi karna…. Don’t worry……Kuch nahi hoga…….”

The gentleman continued to relate some more extreme side-effects that chemotherapy had caused in his case. He described the side-effects in detail, and also explained the cause of each!

As he went on talking, I could see that my room-mate was becoming more and more alarmed.

Could not the gentleman recounting his experiences see this? What purpose could such ‘commiseration’ serve?

Since he had himself been ill with a diagnosis of cancer, I thought that he should have understood how she would feel.

Instead of being reassured, she was getting more frightened, anticipating that she would have to face all these side-effects of the chemo.

After her visitor left, my room-mate was quiet for a while. He had given her a lot to think about!

As I left the hospital in the evening, I noticed a poster announcing that this month was Breast Cancer Awareness Month.

Numerous organisations, as well as individuals, are participating in initiatives to raise awareness about this disease that affects so many.  Awareness about prevention, detection and treatments is indeed necessary.

I would suggest that awareness about how to interact with patients is also desirable. And to learn the better way to interact with patients is not really difficult- we just need to have a little empathy.

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27 thoughts on “What Not to Say to a Patient”

  1. It is terrible.I know of the pain.
    My young niece went through this and is now recovering.We got her operated upon at the RG hospital in Delhi.
    I would suggest that all the girls must get a regular check done.MUST

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  2. Ya completely agree with you..but most of us are like this only…

    Breast cancer awareness….people still hesitant..my wife has not done yet, inspite of the awareness….

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  3. B K Chowla– I am sorry to hear that your niece had to go though this experience, but glad that she is now recovering.
    Yes, a regular check-up should be done…

    Sunder– Yes, unfortunately, many act that way….

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  4. Totally agree with you. One should empathise with the patient. After all they need reassurance. This is not a job interview or on those lines. While the other person must have wanted to convey some of his experiences, he could have been tactful… he should have in fact, been a source of comfort to her.

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  5. You are very right, Manju! He could have told her about just the plus points that even though it was tough to go through chemotherapy, if that was the only way, she could go through the treatment and in the end she would be out of danger like him. When nearly everybody knows nowadays, what chemotherapy means, there is no need to terrorise patients by explaining every tiny detail.

    After 40, every woman should go through mammogram at least once in 2-3 years, my doctor says. Early detection is curable, she assures.

    Take care, Manju.

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  6. He must have been trying to be helpful, but sadly, it went the other way. If only he had thought of how the young woman would have felt hearing all that, he might have been far more careful.

    Yes, what to say to patients is indeed very important, as the last thing any body would want is for a patient to give up, hearing about the pain associated with the treatments.

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  7. While I absolutely condemn the person who kept traumatising the patient with the alarming descriptions, I am surprised that there was no one from the family with the patient. 31 years ago, I was in hospital after a caesarian surgery , and it was then the done thing for folks to come visiting and see the baby etc etc. A particular relative came in and started off on one post-surgery horror story after another, even though she had never undergone any such surgery. My folks noticed that , and the person was promptly called outside under the pretext of the doctor coming on a visit. I guess some people are like that. Thoughtless communicators. They just want to put it on record that they came and visited. The person you saw must have been that category……

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  8. Sandhya– Yes, there is greater posibility of a cure nowadays than there was earlier. So I agree- early detection is desirable.

    Smitha– Yes, it did cross my mind, that such a description of side-effects may make a patient hesitate to continue the treatment.

    Suranga– Actually there was a family member with my room-mate. What I have related still happened.
    In the day-ward where chemo treatment is given, the atmosphere is not so strict, as patients are not really ‘admitted’ for an illness. The nurses don’t pay much attention to visitors. People come and go…..

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  9. You are so right about creating awareness in a visitor about how to speak to a patient. Any kind of ‘me too’ story should be nipped in the bud by either the patient herself or her family member with her, unless it is positive. In their misguided notion that they are preparing the patient, these visitors can otherwise shatter the confidence or positivity of the patient.

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  10. This happens quite often, unfortunately. My father was a doctor and he once told my mother, who was suffering from cold and flu that it would take three days to subside anyway.

    On hearing this, my mother called my father’s friend, also another doctor, and asked him to prescribe medicine!

    Vivek

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  11. sm– You’re welcome!

    zephyr– Yes, as you say, such visitors think that they are helping the patient prepare for what is in store for them. Unfortunately, the patient may end up getting scared!

    Vivekji– Interesting incident!

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  12. I can so see this happening. Empathy is lacking in a lot of people. I remember a woman (and a mother of two to boot) who came to the hospital while I was in labor pain and insisted on talking of difficult pregnancies and deliveries not to mention keeping close family occupied with incessant chatter while all I wanted was a bit of peace.

    I am going to share this post with my sister who recently had to go through chemotheraphy.

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  13. So awful, what a patient needs is posivitity. When my dad was in the ICU hanging onto life by a thread, a couple of doctor friends came and told me and my mom ICU stories, all of which ended in death. I wanted to throw something at them. But I kept countering them with positive statements and skilfully changing the topic.

    Good post!

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  14. I so hear u, During 4th month of my pregnancy I had heavy bleeding and was hospitalised for about 10 days and one day one distant relative came and started on the horror stories of how people lost their babies and some were born with problems etc, hubby kept on telling her to stop it but she didnt and than after she had told 2-3 stories inspite of hubby telling her not too, hubby just asked her to leave. She hasnt spoken to us ever after that and tells every person on this earth how rude we were to her when she came to help us in our time of need.

    Well we are happy without her around… people so need to learn empathy

    great post

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  15. Phoenixritu– Yes, I could see that she was very troubled by the way he related his experiences of chemotherapy.

    Indian Homemaker– Yes, we should indeed!

    Anrosh– Very apt description- ‘toxic people’!

    starsinmeyes– What insensitive people!
    Good for you for not getting rattled by them!

    monikamanchanda– Such thoughtless behaviour on the part of your relative!
    Thanks!

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  16. It is lack of understanding and sensitivity. There are people who believe they are helping but create such a tangle that it takes weeks to clear. The damage, many times, leaves a permanent mark.

    My brother-in-law succumbed to cancer a week back, after a year long battle. Initially, I was all at sea and just could not figure out how to handle the situation and kept quiet.

    Soon we learned and glum serious faces were out and it was laughter, jokes and normal behaviour. Infact, soon they wanted us visit more frequently and each visit had to be sufficiently long…sad he just could not keep the fight beyond a point.

    Guess it must have given him some relief and hope.

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    1. Mavin, I am so sorry to read about your brother-in-law. Please accept my sincere condolences.

      I am sure he must have appreciated you and your family behaving normally and in a positive manner, during a time which was undoubtedly extremely stressful for all concerned.

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  17. Somehow missed this post of yours.. the Google reader has stopped helping wordpress..
    Even I think some people lack the sensitivity while some just dont know how to behave in such situations. All they want is to be heard. But it can be a cause of alarm and some may even refuse to be treated.
    My FIL has been diagnosed with cancer (was operated) but he is yet to be told.. since he is 83 yrs old, we thought it is best to let him enjoy/live life without this knowledge. One doctor told us that it is better to tell the patient and is now the new policy.. but somehow we just cant bring ourselves to do it since he seems fine and happy.
    All the best to you too in your own fight for good health.

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    1. Considering his age, you are probably right in not telling your FIL the truth about his condition. I hope he remains in good health for a long time.

      And thank you!

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