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Doctor says, "stop whining"

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By Wendy Harpham, M.D.

icarewendy.JPGWendy Harpham, M.D., a physician and cancer survivor, talks about side effects and how to discuss them with your doctor. She talks from the wisdom of her own cancer experience and also that of treating patients in her practice.

Wendy is featured in this video created by the Interpersonal Communication And Relationship Enhancement (iCare) program at MD Anderson "Talking about side effects".

Slouched on the exam table, I take a quick breath and sit up as the door squeaks open. My oncologist smiles and asks, "How are you, Wendy?"

This is a routine check-up. My cancer is in remission. The last thing I want to do is complain.

My oncologist sits down and looks at me expectantly. I hesitate before telling him about the persistent pain we've talked about at past visits. As for my new symptom, I'm almost too embarrassed to bring it up. But I do.

Why did I choose to talk about a symptom so strange that my Google search yielded no links to reputable sites? Why did I bring up a minor problem after we'd achieved our main goal and my cancer was in remission?

Because as a physician I knew intellectually that talking about side effects was the right thing to do. I believed -- I hoped -- that talking about my side effects could help my recovery.

Still, finding the courage to speak up took time and effort. Like many patients, I feared annoying my oncologist with too many complaints. I worried about disappointing him with my menagerie of symptoms, none of which were life-threatening.

As a doctor it fascinated me to watch myself hesitate to talk about my symptoms. Most of my feelings -- fear, embarrassment, desire to avoid more tests, worry about annoying him -- were subconscious.

An aphorism came to mind: Physician, heal thyself. So I thought back to my own medical practice, remembering how patients who put up a brave front instead of confiding their symptoms frustrated me.

After all, I was working diligently to address their problems, and they were hampering my efforts by leaving out clues -- sometimes vital tidbits of information I needed to help them feel better and get better.

Problem-solving meetings
What did I say to help my patients relax and trust me with their symptoms? I reassured them that doctor visits are not social visits. Rather, they are problem-solving meetings. In this setting, talking about side effects is not complaining.

Dictionaries define "complaining" as expressing dissatisfaction, pain, uneasiness and so on. However, in everyday use "complaining" carries negative connotations associated with talking about problems with no intention of working to solve them, like when people whine about a lazy coworker or grumble about taxes. 

In contrast, as I told my patients, talking about side effects at doctor visits is not complaining, but reporting important information.

What helped me overcome my reluctance as a patient to report symptoms was the realization that more than I wanted to avoid embarrassing myself, I wanted to get better.

When I had that unusual symptom it helped me to say, half laughing, "Doctor, I'm embarrassed to tell you this, because I know it sounds wacko ... " Then I got serious and reported my strange symptom.

A way to say it
Try it. If emotions make it difficult for you to report side effects, preface what you need to say by telling your doctor how you feel about reporting them.

For example, "I'm afraid you'll find something bad, but ..." or "I feel like this is too minor to report, but I want to tell you ..." You'll save face. Your doctor will better understand your discomfort. Then, together, you can address the symptom.

Whatever your condition or prognosis, you have the right to feel as well as possible today, tomorrow and every day. The only way for this to happen is by finding healthy ways to talk with your health care team about side effects.

Click here to view a 12-minute video "Talking About Side Effects"
Click here to view a pocket guide to "Talking About Side Effects"

Resources

www.wendyharpham.com (website)
www.wendyharpham.typepad.com (blog)

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