Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Seite 198

Double Lens 187
Patients read the PDR, and if they find ‘‘thrombocytopenia’’ and
look it up, it doesn’t convey anything to them. They know it means
low platelets. But what that implies, what the risks are, don’t mean
anything. They don’t have any gut feeling about it. A doctor knows
what thrombocytopenia is and can do. He has much more knowl-
edge, and leaves aside his emotions. He can be much more rational
in appraising risks. Patients are concerned over what their best friend
thought she heard.
These physicians are more critical of purported treatment benefits that
may in fact prove elusive. They felt they were more wary than nonphy-
sician patients of ‘‘hype’’ about medications. These doctor-patients were
able to critique reports of medical findings in several ways: for example,
how much the data actually supported the conclusions. Peter, the med-
ical student, said:
When they put something out in the media, I don’t take it at face
value. A lot of people do, but I have more knowledge. I investi-
gate things. I look at it from more of a medical viewpoint than just
an Average Joe.
Still a trainee, he was proud to possess these skills.
Relative to doctors, lay patients have difficulty, in part because of the
mass of information available on the Internet and elsewhere. This morass
of details may make it hard even to know where to start or what ques-
tions to pose. Rochelle, a surgeon with breast cancer, said:
A friend had just been diagnosed with cancer, and clearly had no
idea what the big picture was. He was bright, but going to Internet
sites. It was too much information. He was talking about levels of
chemo protocols, which was just not on track. Some pieces were
missing. I was explaining what kind of cancer this was. He was
asking, ‘‘What does ‘-oma’ mean?’’
Contexts are needed for optimal comprehension of information, but may
not be provided by Internet searches, or even journal articles. In contrast,
medical trainees learned not only from books, but also from clinical ex-
periences, providing structures and ways to make sense of isolated facts.
Lay patients lacked this education, scaffolding, and context, built over
years of experience, that allowed these facts to be optimally weighed and
applied.