{"id":36064,"date":"2016-01-26T14:56:34","date_gmt":"2016-01-26T13:56:34","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=36064"},"modified":"2016-02-03T17:07:33","modified_gmt":"2016-02-03T16:07:33","slug":"elizabeth-wortley-please-refrain-from-using-that-kind-of-language","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2016\/01\/26\/elizabeth-wortley-please-refrain-from-using-that-kind-of-language\/","title":{"rendered":"Elizabeth Wortley: Please refrain from using that kind of language"},"content":{"rendered":"<p>We talk a lot about communication in medicine and try to teach the right skills to students, such as the importance of body language and simplifying medical terminology. But how often do we look at non-medical language and the effect it has?<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/2015\/12\/07\/suzanne-gordon-medicines-f-word-fail\/\">Suzanne Gordon\u2019s BMJ blog \u201cMedicine\u2019s F word\u2014Fail\u201d<\/a> in early December reminded me to do better with our population of somataform\/psychological\/recurrent disorders (what is the correct term?) whilst also battling my fear of them. In paediatrics we don\u2019t often talk of our patients \u201cfailing,\u201d but we do have our own language problems. As a registrar, I\u2019ve had multiple approaches to the recurrent patient &#8220;problem&#8221; explained and demonstrated, and perfectly nice people (myself included) find themselves ranting behind closed doors, only to then attempt their best \u201ccomms skills scenario\u201d face in the clinic room. I can\u2019t say I believe this is a successful tactic, and the only times I\u2019ve seen it done well are by the small and select group who understand the impact their baseline attitudes have towards these encounters.<!--more--><\/p>\n<p>It strikes me we do ourselves, our colleagues, and our patients, a huge disservice in this. Firstly, what impression do we give to our junior colleagues about approaching patients? Of course in medicine, we have black humour, but this isn\u2019t laughing at death, it\u2019s instead a frustration\u2014people wasting our services when they are not &#8220;sick.&#8221; We may laugh along, but we\u2019re telling each other that these patients aren\u2019t worth our time and are a burden on the NHS. But from now on I think, surely they are worth some attention? Aren\u2019t they? For whatever reason they are missing school, being brought to the doctor a lot, worrying, and having tests done\u2014by us, by doctors. And then, once we\u2019ve satisfied ourselves, we tell them it\u2019s &#8220;stress induced,&#8221; &#8220;the gut is very sensitive to change,&#8221; &#8220;it\u2019s not serious,&#8221; and then follow it up with &#8220;so we would recommend some relaxation techniques, but can discharge you.\u201d What are we really telling our patients?<\/p>\n<p>To us there is not a serious life threatening cause of the pain looming over them, but this has taken over their lives, everything about it is serious to the patient and their family. Have we treated ourselves or the patient? Serious\u2014what a word, what does it mean? To us? To them?<\/p>\n<p>These patients are hard to treat, most of us aren\u2019t experts or any good at it. Instead of embracing the challenge\u2014who has time?\u2014we hide behind our words. Can we not listen a little more closely, think a little more deeply, tread a little more carefully, and bring our best holistic selves into the room to give them the service we would want our teenage selves to have?<\/p>\n<p>The problem is, I am\u00a0due to start an A&amp;E shift, where there is a high likelihood that in amongst the bronchs, wheezers, and kids in resus, I will see a child with a similar background. And I will somehow not give them the kindness, attention and care they deserve as their parents panic about why they are in so much pain if &#8220;there is nothing wrong with them.&#8221; The cycle begins again and I tell myself I will try harder the next time. I try to picture the mother from &#8220;<a href=\"http:\/\/www.amazon.co.uk\/Nhs-Experience-Ladders-Patients-Professionals\/dp\/0415336716\/ref=sr_1_fkmr0_1?ie=UTF8&amp;qid=1451933536&amp;sr=8-1-fkmr0&amp;keywords=snakes+and+ladders+jilary+cass\"><em>Snakes and Ladders<\/em>&#8221; by Hilary Cass<\/a> and remember the tenth consultation for me is the one and only consultation for them. Perhaps I am hoping that writing this will be the catalyst I need for my new years resolution.<\/p>\n<p><em><strong>Lizzie <span class=\"il\">Wortley<\/span><\/strong> is a paediatric registrar working in Northwest London who is interested in quality improvement, acute care, and particularly enjoys debating the psychology of doctors and patients.<\/em><\/p>\n<p><em><strong>Competing interests:<\/strong> None declared.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>We talk a lot about communication in medicine and try to teach the right skills to students, such as the importance of body language and simplifying medical terminology. But how [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2016\/01\/26\/elizabeth-wortley-please-refrain-from-using-that-kind-of-language\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-36064","post","type-post","status-publish","format-standard","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Elizabeth Wortley: Please refrain from using that kind of language - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2016\/01\/26\/elizabeth-wortley-please-refrain-from-using-that-kind-of-language\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Elizabeth Wortley: Please refrain from using that kind of language - The BMJ\" \/>\n<meta property=\"og:description\" content=\"We talk a lot about communication in medicine and try to teach the right skills to students, such as the importance of body language and simplifying medical terminology. 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