Lesson #4 Your Words Matter

Young doctors sometimes fear that their patients don’t take them seriously enough. Take my word for it, YOUR WORDS MATTER, more than you might think.
When I was a young med student I met a man I will call Joe. He was 70ish, frail, malnourished and tremulous. He was in the hospital with pneumonia and when I met with him to explain his diagnosis and treatment; he exhibited the most bizarre behavior. When I spoke, his lips moved. When I stopped speaking, his lips stopped moving. I repeated the exercise multiple times.
Perhaps it was a habit or a form of synesthesia where 2 senses are interconnected and blurred but it taught me how my words could impact another person.
I learned this lesson another time and felt amazingly empowered. A 60 year old man came into our office with a lacerated finger from work. He smelled of tobacco and I listened to his lungs and remarked that his lungs did not sound too good. I asked if he smoked.
“2 packs a day for 40 years”, he said.
“You should quit” I shot back, “That would be the best thing you could do for your health”
I sewed up his finger and sent him on his way.
3 months later he came back in for another unrelated injury. We chatted some more and I asked him about the smoking.
“I quit”! He said.
“That is great”, I remarked. “When did you quit”?
“Right after you told me to. No doctor had ever told me to quit before”.
I congratulated him and smiled to myself, not quite believing what my words had accomplished.
To this day, getting people to quit smoking is one of my favorite doctoring things to do and usually it is not nearly this easy. But sometime people are ready for the message.

Several years later, I learned a similar but less happy lesson in the power of my words.

Malka was a 70ish, heavy smoker with emphysema who lived at a local nursing home. She was a bit cranky and refused to give up smoking even though her lungs were slowly failing. I watched her getting weaker and weaker and decided to have a discussion with her about Advanced Directives. It was my view that people should think about these things ahead of time so we can be sure their wishes are honored.
Malka listened to me explain that her emphysema was getting worse and that I wanted to know what she wanted us to do if her heart should stop. We had a nice detailed discussion and I came away feeling better that I knew who her durable power of attorney for health care would be and that she wanted to be resuscitated in case her heart should stop but she did not want to linger on a respirator. Pretty reasonable discussion leading to pretty reasonable decisions, or so I thought.
I was surprised when I overheard her say to one of her friends,
“My doctor told me I am going to die today”.
Malka was a bit dramatic, a bit of a complainer, so I did not pay much attention to her remark.
I was shocked to learn that later that day she suddenly did die, just as she had predicted.
Of course, I don’t know for sure that my words were the thing that made the difference and brought on an earlier demise for Malka. I am sure her emphysema and endless smoking had a lot to do with it too. But I learned the lesson again that day that my words were powerful and needed to be handled with the greatest of care.
So, whether you are a doctor, or a parent, or a friend, don’t underestimate the power of your words to lift up or tear down, to inspire or to discourage, to heal or to love. It is a power that is within each of us.