Serious illness demands honesty, not false reassurance from doctors

What you read in this column is mostly about health advice that relates to you as an individual. But as it’s often the case, your doctor tends to be on the other side of the equation. What your doctor ends up telling you about your health matters. Still, what the doctor shouldn’t be telling you may even matter more. Let’s look at what a recent publication highlighted on words and phrases your doctor should not be saying to you while navigating a serious illness.

Top on the list, doctors should speak less and listen to you more. As a patient you need to feel that you are being heard by your doctor, so that all your health goals can be incorporated into any treatment plans. A doctor who rarely listens to you, and appears to be in a rush to recommend one treatment or another, is likely to ignore your own wishes and desires. You may end up not getting individualised optimal treatment that would suit you best.

When facing a serious illness, your doctor should refrain from saying ‘everything is going to be okay. That’s never the case. The best your doctor should do is to be as forthright and as honest as your illness demands. Sugarcoating a serious diagnosis is uncalled for. You want to hear what the diagnosis appears to be, and what your prognosis might be. You want to get reassured on how your doctor will help you, and not to listen to condescending and meaningless statements.

Ditch judgment

If your long-gone habits have contributed to your current ailment, dwelling on that isn’t really helpful. Say you used to smoke, and that may have contributed to what you are now suffering from. Dwelling on that provokes the feelings of self-blame, guilt and shame. What matters clinically is the here and now. Your doctor should be concentrating on a treatment plan, and not berating you for your past life. You cannot undo the past, neither can your doctor.

No doctor should be telling you exactly how much more you are going to live. No doctor in this world, whatever the level of their specialisation, can tell you exactly when you will die. Regardless of your diagnosis and the sure path to death, any predictions on when you’ll die tend to be ill-advised and inaccurate. All that serves is to raise anxiety, when that is already at a heightened level. Instead, the doctor should concentrate on objective treatment options, all attuned to your wishes as your life fades away.

There are many other things that doctors shouldn’t be saying, but they keep saying all that anyway. Every doctor should continually review their communication skills, and strive to speak to patients with clinical clarity and purpose. Anything else is mumbo jumbo, and not useful to anyone.

Dr Murage is a Consultant Gynecologist and Fertility Specialist.