Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Seite 294

Improving Education 283
Given that part of the problem communicating about certain symp-
toms, particularly psychiatric ones, is their inexpressible nature, indi-
viduals who have experienced these symptoms have sometimes found
ways of conveying them from which other practitioners can learn. Her
experiences led Suzanne to establish quick rapport:
I just say, ‘‘Does it feel like there’s a dark cloud in front of you, and
it’s hard to put one foot in front of the other? You can’t get where
you want because there’s this hump you can’t get over?’’ That’s
what depression feels like. Patients’ eyes light up: ‘‘That’s exactly
what it feels like. How did you know?’’ They feel so comforted that
somebody understands. We feel very connected—three sentences
into our conversation.
Patients feel gratified when physicians not only empathize but, more
specifically, ‘‘clarify or summarize’’ such states. Suzanne continued, about
panic attacks:
I say to patients: You’re somewhere and feel you just need to
get out, immediately. It doesn’t matter what you’re doing, you
just need to get to a safe place. Patients say, ‘‘Yeah, that’s exactly
what it feels like.’’ Or ‘‘You feel like you’re going to die. There’s
this load on your chest. All of a sudden it feels like you’re wear-
ing a tight turtleneck.’’ They say, ‘‘Oh my God, that’s exactly
it.’’ Or when people get antsy and can’t sleep, I’ll say, ‘‘Does
that anxiety sometimes get to the point where it’s more like
agitation, like people start to really bother you?’’ They say,
‘‘Yeah!’’
Suzanne’s realizations illustrated the degree to which physicians other-
wise have difficulty communicating and connecting with patients about
these disturbing but inchoate symptoms.
Physicians also drew on their own experiences of illness to teach pa-
tients quick ways to stymie symptoms. For example, based on his own
history, John, the public health official with HIV, taught patients tricks
to recognize and treat early herpes symptoms.
Since I’ve had a lot of herpes myself, I tell people how to recognize
it: that the first thing you get is tingling. I said, ‘‘Keep acyclovir in
your medicine cabinet. As soon as you feel that tingling, pop eight
capsules, and see if you can abort it!’’