“Pranay, you’re too verbose when talking to patients.” This was the feedback I received after my first formal patient interview a few months ago. Being a neurotic medical student (there is no such thing as a non-neurotic medical student, by the way), I was totally crushed and saw it as a scathing indictment of my lack of clinical acumen.
I’ve always been proud of my vocabulary. I got it from reading entirely too many PG Wodehouse novels and developing an appreciation for the sound of words. I luxuriate in the ups and downs of words like behemothic and enjoy the etymology of words like asseverate (assert and veracity). All my life, I’ve received compliments about my eloquence.
This is why it was a huge shock for me to discover that my vocabulary was a curse in the clinical setting. I found myself drowning my patients in words that they didn’t understand. Even if they don’t openly say “What?”, “Pardon me.” or “Excuse me?”, you can always tell when someone is nodding along to the stuff you’re saying without understanding an iota of the argument you’re making or the concept you’re explaining. I have been lucky so far to have had extremely articulate patients and standardised patients, but, especially considering my interest in working with impoverished and the medically underserved regions of the world, it would be moronic to expect the trend to continue.
The point is, we don’t talk with patients to impress them with our knowledge or vocabulary. We talk with them to communicate and we must tailor our language accordingly. There’s no point in using the word hyperglycemia when you want to tell a not-very-highly-educated person that his blood sugar is high. Similarly, using acronyms like HCT, OGTT, SCIWORA is a scourge in the medical community and is a massive obstacle to effective communication unless the listener is a member of an elite cognoscenti. I currently struggle with my vocabulary and have been policing my vocabulary when I interact with people and am trying to tailor it such that I communicate, not talk.
One more thing. Vocabulary is one part of the equation, but we, as doctors, need to be able to make it easy for our patients to understand the extremely difficult science behind their diseases and their treatments. While teaching Chemistry recitation and tutoring in my undergraduate years I discovered the power of illustrations and analogies to make difficult explanations more digestible. I intend to use these tricks as a medical student as well as a doctor.
I definitely saw some of these issues crop up at the free Diabetes screening we had recently organized for the people of Charlottesville and was very impressed with the ability of my colleagues to explain the subtleties of a complex metabolic disease like diabetes to individuals who had not had the privilege of higher education. Experiences like these give me faith that physicians from our generation will be known for our accessibility and compassion.