The Doctor and His Patient: Explaining Illness

Abstract

To explain illness adequately and sensitively is not an easy matter. To tell patients brusquely just the name of their illness, or to lecture to them pedantically may be as bad as to tell them nothing, and only slightly better than to lie to them. To inform patients, to clarify their ideas, to interpret their apprehensions, requires the ability to listen with empathy and to appraise the patient's capacity to understand and “take it.” It requires patience and proper timing—as opposed to a rigid technique—and sticking with one's patients for better and for worse. It demands maturity and control of one's own emotions as a physician. This may be much harder for the physician than the traditional authoritative approach of protecting the patient from the truth. The gifted physician will use the newer techniques intuitively. Most others will have to learn through practice and precept. I believe that these principles and attitudes can be taught today quite well by sensitivity training in groups and, less economically, in an individual preceptorship. The “soft” approach can be effectively combined with the hard approach of a computerized information-gathering technique. I am convinced that the new “hard” and “soft” techniques will enable us to practice better medicine and help us to approximate Nathaniel Hawthorne's ideal of a good physician.