Part 3: Confirm a diagnosis
After seeing the doctor in the emergency department, an appointment was made for me to see a specialist doctor (Consultant) at my local hospital. I needed to see him to confirm a diagnosis and plan my care. I waited two weeks for this appointment. When I arrived at the outpatient department, I had another x-ray of my lungs. The doctor wanted to compare this x-ray with the one I had taken in the emergency department a couple of weeks earlier. This would help him confirm a diagnosis.
I can’t remember how I felt. I think I just felt relieved to be seeing a Consultant. I hoped that we would get some answers to our questions, find out exactly what was wrong with me, and leave with a plan of action.
The Consultation – setting
Picture this if you will:
- A medical student (sat at the back of the room)
- A senior nurse sat in the middle of the room (in front of me)
- The Consultant sat to my left (in front of his desk)
- My partner sat near the door (away from me and everyone else)
I remember feeling a bit annoyed because I wanted my partner by my side as we were in this together. He had been by my side for the past two weeks. Consequently, in this room, we were parted. As a result, I felt alone. So, if I had a tip here, it would be to sit where you feel most comfortable. If you need to move a chair, do so.
Exploring my understanding
The Consultant introduced himself and then asked me to describe what I understood so far about my illness. As well as checking our level of understanding, doctors should listen to the words we use so that they can use similar language. Otherwise, they might pitch their delivery of information incorrectly. Consequently, we are in danger of not understanding each other.
Furthermore, we know that patients don’t always tell doctors if they don’t understand them, and they don’t seek clarification. There are many reasons for this including,
- not wanting to look stupid,
- not wanting to appear as though they are challenging the doctor and
- fear of taking up the doctor’s time.
A look of sympathy
When I answered the Consultant, I was mindful that he sat looking at my notes. The nurse was also looking at me with a sympathetic look on her face. I got the impression that she felt sad or sorry for me. Consequently, this just made me feel worried about what they were going to tell me. Plus, to be honest, I don’t like people feeling sorry for me, so it didn’t help my mood. I started to feel twitchy.
Confirm a diagnosis: It didn’t go quite as I planned
To summarise, my anxiety was increasing because of the way people were interacting with me. I desperately wanted the Consultant to confirm a diagnosis and give me a plan of care. He tells me that he has compared my two chest x-rays and shows them to me on his computer screen. The x-ray I had today was clear and, he could find nothing wrong with it. I feel stunned and somewhat confused. It transpires that the original x-ray I had didn’t show cancer at all. What it did show was two objects from the x-ray trolley.
Rather than feel relieved by this news, I was annoyed and not for the reasons you might expect.
a) The atmosphere in the consulting room was one of sadness and sympathy. Because of this, I was prepared to hear more bad news. It needn’t have been like this because they knew they were going to give me good news.
b) Consequently, the Consultant could have confirmed my diagnosis as soon as we walked into the consulting room. This would have put our minds at rest sooner. It might have also saved him some time in the consultation.
If he had, taken the time to think of the impact the good news would have on me, I would have appreciated this so much more.
In fact, this is reflected in the experience my neighbours mum had this week. She has had investigations and went to see her Consultant for the results of her tests. As soon as she walked into the room her Consultant said that he wanted to alleviate her fears straight away and tell her she didn’t have cancer. This was before she had even sat down. He even gave her time to text her daughters to tell them the good news. How lovely. He recognised the stress she had been under and was sensitive to her need. She was then able to sit and listen to what he had to tell her.
Impact on me
Rather than be relieved I wasn’t dying I was annoyed at the way I had been treated, and told them so. I felt let down. I didn’t feel respected as a fellow human being who, let’s face it had gone through a testing time (to say the least). They didn’t once, acknowledge the mistake that had been made and how this might have impacted on me and my partner. The Consultant didn’t even appreciate why I was upset when I explained that I thought his communication skills had been poor. I didn’t want the medical student to think this was good practice, because it wasn’t.
It is so important to respect patients. And acknowledge their experiences and how this might have impacted on them. If we get this right, then it can reduce anxiety and increase a patient’s trust in us.