Doctors’ Lounge
Failure To Communicate
Waqar C. Aziz, MD
T
he phrase “What we’ve got here is a
failure to communicate” is a quotation from the 1967 film Cool Hand
Luke, with Paul Newman memorializing
these lines as a young prisoner. It is a strange
opening for a medical journal article, but
will help put things in perspective for us as
physicians. We often fail to communicate
openly and compassionately with our patients. This fact was brought home to me
in the story of my son, Haroon.
When Haroon was six months old, we
found out that what had appeared to be
cute stretches and a hot temper were, in
fact, Grand Mal Seizures. A subsequent
MRI showed brain malformations of his
right occipital and parietal lobes. Thus began an endless journey into some of the
country’s foremost institutions and their
most prominent doctors. Tests were done
and more followed along with multiple invasive procedures. The list of the procedures,
especially those under general anesthesia, is
too long to remember. No medication could
control his seizures, resulting in sleepless
nights leaving us feeling utterly helpless, as
we could do nothing to console him. My
wife would take him for long drives several
times past midnight, as the motion and hum
of the van with changing scenery would
pacify him for a while. He was finally put
on a medication still not approved by the
FDA in this country, which we have to get
from Canada.
This improved the situation to some
degree. Although, the seizure burden was
significantly lower, the insult to his growing
brain left him with many handicaps. Haroon
is a fighter with an indomitable spirit. His
resilience and patience as he endures all
the probing, poking, and multiple surgical
interventions has proven to be an inspiration to all who know him. For me he is my
hero and taught me priceless lessons as a
human being and a physician. Although
he has yet to verbally communicate, he has
communicated much more with us in his
own special way than some of his doctors
ever could.
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LOUISVILLE MEDICINE
I will try not to generalize and put everyone in the same category, but too often, not
communicating was the case. We liked his
neurologist at Cincinnati Children’s Hospital from the beginning not only because he
was expert in his field and was always guardedly optimistic, but more importantly because he always listened and explained. This
quality I have found to be a rarity amongst
our ilk. Seven and a half years later Haroon
still sees the same neurologist and my wife
has logged thousands of miles in his follow
up care with him and a few other specialists
there. Waiting hours for them has never irritated us. These are people who distinguish
themselves in their patience as listeners and
examiners of an admittedly difficult patient.
Sadly, we have discovered how rare these
qualities are in the medical culture. Many
physicians were writing prescriptions while
we were still explaining Haroon’s problems.
We waited in doctors’ offices, who were
chronically late sometimes by hours and this
after travelling long distances with special
needs kids making multiple pit stops! The
very least we expected was time with the
doctor when we finally saw him! Sometimes
the only provider we saw was the Nurse
Practitioner. Although not questioning his
or her ability, we travelled to an academic
center for a complex problem with questions
for the actual physician.
We would research on our own and asked
pertinent, succinct questions in an attempt
to save time and not prolong the visit. However, this uniformly annoys busy doctors for
now they are sensing this may take longer
than five minutes. Apparently an educated
patient is an annoyance rather than an informed consumer, taking ownership of his
disease. The gist of conversation overheard
in multiple crowded waiting areas boiled
down to how little time the doctor spends
with them and that physicians never listen. Since we were simultaneously visiting
four of the country’s foremost centers, our
expe