By Michael Kalinosky
People come from different backgrounds. Regardless of differences, be they economic, educational or cultural, people everywhere come to the doctor with some of the same hopes and fears. A mother with a coughing child is fairly certain it is nothing life threatening, but wants reassurance. A middle aged woman who has survived cancer has her radar up for any sign it may be returning. A man with nagging back pain is hoping it will one day get better. There is always someone with a worry who wants to be sure he’s not crazy. Emotional hurt can be found everywhere.
Most people aren’t looking for a magic pill. They want to know what is making them feel badly, and if they will eventually feel better. Most are accepting of a plan that requires their participation. Everyone wants respect. A corollary is that they will think more of you if you admit when you don’t know what is making them sick, but you are not giving up on finding out.
Giving reassurance to people who will get better is a huge part of medicine. Though it is essentially giving good news, it can take as much skill as giving bad news. The patient mustn’t go away thinking you trivialized her pain; that you were dismissive. What can safely be ignored by the physician is still important to the patient. Cultural differences have to be considered when giving reassurance, too. The several times I’ve seen patients at Wanblee has made me more aware of the need to be in tune with a patient’s sensitivities. This is doubly so with emotional pain and mental illness. It is all about respect.