Seeing a doctor can be nerve-racking, especially if you have a serious illness. In a new self-help book inspired by their own experiences with cancer and heart disease, Alice MacNaughton Hodge, ’75, and Mary Halsted Lonergan, MA ’70, argue that people get better care when they understand and take charge of their treatment. In the following excerpts, the authors offer tips for maintaining control in three very different situations.
The Doctor Visit
When you call to make your appointment, be clear about why you want to see the doctor and how much time you will need. Most doctors schedule appointments in 10- or 20-minute slots. If you will need more time, tell the nurse or receptionist when you call for the appointment. Sometimes, requesting the last appointment of the day will allow you more time to talk without distractions. If this is your first-ever appointment with the doctor, make certain the scheduler knows this. First appointments will take more than 10 minutes. Consider faxing a list of concerns, issues or questions ahead of time.
Come prepared with questions. Write down your questions and concerns. Don’t leave the doctor’s office until at least your most important questions are answered. Don’t hesitate to ask the same questions you have asked before -- there may be different answers this time. It’s also fair to ask your doctor, “What questions should I be asking that I’m not?”
Be completely honest. When your doctor asks how you are, don’t say, “Fine,” when you’re not. Air all your complaints, as silly as they may seem at the time. Also, be open with your doctor about any apprehensions you have about your diagnosis or treatment. If he prescribes treatment and you ignore it, hiding that information will do neither of you any good.
Bring a tape recorder. It is easy to forget what transpires during a visit. Bring a tape recorder and ask your doctor for permission to use it. Taping of sessions is becoming more common, and doctors are getting used to it. Some doctors may feel they are “on stage” and unable to be as frank, but others even provide tapes and recorders during appointments.
Bring a friend. It helps to have an extra set of ears and someone taking notes. You can discuss your visit afterward to make sure you thoroughly understand what the doctor said.
If there is a decision to be made, ask your doctor what he would do if you were a member of his family. Your ultimate decision will be based on many factors, including calculated odds, your own desires and those of the people around you. Still, it can help to know what your doctor would do in your shoes. Some doctors may not like to hear this question, but most will respond honestly.
Repeat back what you have heard. When we hear upsetting news, we tend to react with denial and may block out what is being said. Therefore, say to your doctor, “I would like to understand correctly what you said…” and then state in your own words what you believe was said. This may seem unnecessary or even embarrassing at first, but it can be very helpful by allowing the doctor to immediately correct any misunderstandings.
Second Opinions
When you are buying a house or a new car, do you buy the first one you see or do you shop around? Even when you and your doctor agree on your diagnosis, and even if you are comfortable with the recommended treatment protocol, we believe you should consider second opinions in order to fully explore the options available to you.
In most cases, your doctor will present only one or two choices for treatment. Using his best professional judgment, based on his own research and experience, he will describe what he believes is the best course for you, which is usually the one he feels most comfortable administering. His recommendation, however, may or may not be the best choice for you. Only you can make that decision, and then only after you have adequate information about the full range of available options.
You may ultimately choose your doctor’s original recommendation, but the important thing is to make the decision that is best for you after considering as many factors as you can.
When You Know You Are Dying
At some point in your illness, you may come to the realization that a cure is not possible and that you are going to die. This can be a frightening experience. Most of us never really prepare to die; therefore, we can find ourselves unprepared to deal with the emotions that envelop us and those around us. Here are some suggestions to ease the burdens associated with dying:
Acknowledge that you are dying. Get the subject out in the open. Talk about it with others. Don’t make yourself and everyone else go through the experience alone. Lift the cloud of unexpressed emotions that hangs over you and your situation.
Validate the emotions of those around you. You may be the one who is dying, but this is not just your ordeal. Everyone who shares time with you is going through his or her own emotional experience. Acknowledge their feelings.
Involve everyone who wants to be involved. Encourage loved ones to participate with you in the time you have left -- especially the children.
Decide how you want to be cared for, and share this information with your doctor and your family. Don’t put loved ones in the position of having to choose how you should die. Talk with your doctor about how you want to be treated, and clearly communicate your wishes to those close to you.
Seek help to express all the emotions you are feeling. Let a professional counselor help you frame how and what you want to say to those you dearly love.
Adapted from Taking Charge of Your Health by permission of Book Partners Inc., Wilsonville, Ore. Copyright 1999 by Alice Hodge and Mary Lonergan.
