‘‘Screw-ups’’ 105
ten minutes—but some sign of awareness of the helplessness, de-
pendency, and questions.
These multiple sources of indignities accumulated, further reminding
patients of their relative powerlessness, and psychologically eroding them.
As suggested earlier, a hospital communicates to patients their rela-
tively low worth in various ways. Walter said, ‘‘When you’re the patient,
you feel that your life, your actual life, is going to be frittered away
because it didn’t matter enough to someone.’’
Doctors were surprised, too, at the extent to which seemingly small
positive alterations in the quality of their daily life now loomed large.
After procedures, even being able to eat a meal again can be a major ac-
complishment. Roxanne said, ‘‘The first time I was able to complete a
meal was big: a major step!’’
Clearly, doctors can be better trained to comprehend these aspects of
patient experiences. Patients can benefit from anticipating these obstacles
and aids as much as possible.
Silence and Codes: Communication Problems
Ill physicians became more aware of the importance, and yet the rarity, of
good communication, and the complexities of doctor-patient interactions.
These ill doctors now saw more fully how subtle cues and clues can either
facilitate or impede discourse. Many of these health professionals reported
indirect communication or noncommunication with their own providers,
particularly about socially taboo topics. Problems such as depression and
side effects were not only of concern in and of themselves, but also posed
substantial communication difficulties. Challenges arose not only in being
depressed, for instance, but also in being able to speak about it with one’s
physician.
A few ill doctors felt that medical information had been sensitively
presented to them. Nancy, the internist with breast cancer, said about her
physician, ‘‘She has a magical way of giving bad news. Nothing shocks or
alarms her. I can get the worst news ever, and am upset, but after talking to
her, I think ‘Wow, it’s not so bad. I can handle this.’ She has a great talent for
that.’’ Indeed, this ability constitutes a clear and important skill that some
possess more than others. Here, too, stylistic elements prove important.