The Aword

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Patient

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Thoughts on being a patient

It’s no coincidence that people who are ill are called ‘patients’: because as those of us who have experience as patients know all too well, patience is a very necessary trait to have!

I was reading a very interesting article* this week about how Psychiatrists ‘silence’ their patients by translating their stories into medical jargon: which got me thinking that it isn’t only Psychiatrists who do that. As the author remarked, patients “on the more vulnerable side of the health care relationship” often show more distress than they might in less intimidating situations: “[doctors] have learned to pay attention to how the health care situation affects their patients. But they have been slow to turn a reflexive gaze on their descriptive practices – particularly on their habit of judging their own descriptions of their patients’ experiences to be more accurate than their patients’”.

The article included a quote by philosopher Naomi Scheman: “those in subordinated, marginalized, or closeted social locations” learn that, in order to be taken seriously, they must adopt “the privileged ‘view from nowhere,’” speaking as if they were outside themselves.

I must admit that at times I have had that sort of experience: in trying to explain complex and mysterious symptoms to doctors, I have resorted to a sort of detached account that minimizes rhetoric, suffering and in fact, much of the reality of dealing with my illness. In so doing, I am trying to ensure I don’t come across as neurotic, but the downside is it perhaps all sounds improbable, if not a little fake, because I’m churning out a sort of sanitized version of events.

On the other side, as a doctor, I also recognize that the dialogue between patient and doctor needs to be pragmatic at one level, in order to achieve an exchange of information that can lead to some useful intervention, but it also needs to make space to allow the patient’s story to be told. That takes time, which is something usually in short supply.

*Metaphors in Our Mouths: The Silencing of the Psychiatric Patient  K Steslow ( from the Hastings Center Report)