Medicine has come a long way since 1942, when this was taken,
but what about communication between doctor and patient?
I work in an academic medical library, but at a public institution, so while our main mission is serving our students, faculty, and staff, we do also serve the general public to the extent that we can. This means that occasionally, a patient will come in or call the reference desk and want to talk to us in detail about their medical condition. Mostly I think they just need to talk; it’s not even so much about looking for information as it is just getting someone to listen.
Now that I don’t work out at the reference desk, I don’t deal as much with these patrons, but there has been one recently who was becoming too much for my student desk staff to handle, so they referred her to me twice. The first time, she called while I was at a conference, and I got back to a screaming message about why did I never answer my phone, why don’t my staff even know where I am (they totally did and told her more than once I was away and when I’d be back), and how she was elderly and dying of cancer and didn’t have internet access and I HAD to help her. When I called her, I got some more screaming and then we got down to the question. With all the urgency she’d had when she left the message and the demands she’d made on my staff, I expected it to be something like “I need more information about this potentially life-saving cancer treatment that could bring me back from the brink of death!” No. In fact, it had to do with what doctors would have written in medical records in the 1950s and how certain diseases of infants were diagnosed at that time.
I told her that was going to be extremely difficult information to find and that I would need a few days, if I could get it at all. She said she needed it right then. I told her I’d call her back in a few days and that was the best I could do. When I did finally get it, I called her and left several messages saying I’d found the information, but she never called back. That was kind of annoying, after I’d gone to the trouble of finding all of this out for her, but what really struck me was how desperate she was to find this information that, as far as I could tell, didn’t really matter. I could be wrong, but I’m guessing she had gotten a hold of her own medical records and was trying to place some sort of blame on a doctor all these years later for something that he missed. I’m sure the statute of limitations for a malpractice suit would be up by now, not to mention I doubt the doctor would still be practicing or even alive. So why was she so desperate for this information?
This was back in November. For awhile, I actually kind of worried that she had been as close to the brink of death as she claimed and that she had passed away before I could get the information to her. I felt really bad about it. However, she called back again this week and my staff referred her to me again. She had more questions about medical records and basically wanted to read me her entire medical record and have me decipher it for her. I told her that I couldn’t do that and that she should talk to her doctor. Then she would say, “but what about this one thing – what does this mean?” and I’d tell her again, please, ask your doctor. I ended up giving her a few definitions, but told her I wasn’t comfortable doing more than that, as I’m a librarian, not a doctor. She seemed somewhat satisfied when we hung up, which is good, but I wonder how long it will be before I hear from her again. When I think about this consuming need she has to find out what these records mean, I feel bad for her, and I wonder what will change for her if she finds out the answers to her questions.
What really strikes me here, and the reason I’m writing this post, is how strange people’s interactions with doctors are. I’m not sure what this woman’s reasons were, but many of the patient patrons I’ve dealt with seem unwilling to “bother” their doctor with questions and instead come to the library for answers. That’s part of the doctor’s job! Doctors are of course very busy and pressed for time, but if a patient leaves a doctor’s office with questions, I feel like the doctor hasn’t fully done their job. Of course the onus is also on the patient to ask questions, as doctors are not mind-readers, but I think there are many doctors who discourage that either outright or through their demeanor. That’s not to say that I don’t think people should educate themselves and seek out information about their health, and as a medical librarian, I’m more than happy to point them to some good sources for doing that. However, people should leave the office with fewer, not more, questions than they had when they came in, in my opinion.
I think part of this comes from the fact that we as a society seem to hold doctors in such a high esteem, as though they’re not people but some sort of minor gods. They’re not. The more I work with doctors, the more I see that they are just as fallible as the rest of us. They say stuff with certainty – pronouncements on diagnoses and treatments seem like 100% fact, but more often than you’d think, it’s all really sort of a best guess. For all that we know about medicine today, there’s still so much that we just don’t understand, and I don’t think patients realize that. If you want a book that exemplifies this beautifully and is also quite a pleasure to read, I recommend Atul Gawande’s Complications: A Surgeon’s Notes on an Imperfect Science.
I don’t think the mystique of the doctor will fade anytime soon, but I think in an ideal world, patients would have more of an open relationship with their doctors. Sure, they’re smart and very educated and have worked very hard, but they’re not gods. If you aren’t comfortable asking your doctor questions about your care, you might want to think about finding a new doctor with whom you have a better relationship. In the meantime, the medical librarians (well, speaking for myself at least) are here to help.