lessons learned

You Gotta Give 'Em Hope

Be honest but when possible, describe the glass as half full.

JACK RUNNINGER, O.D.

"Your friend Phil Landerer is in bad shape," reported the emergency room physician to the two surgeons, one an optimist, and the other very much a pessimist. "He was visiting a Mrs. Sally Sexton, when her husband came home unexpectedly, and found them in bed together. The husband emptied his revolver into Mr. Landerer."

"Well, things could be worse," said the optimistic surgeon after they had examined their friend, Mr. Landerer.

"How can you say that?!" exclaimed his pessimistic partner. "Phil is going to suffer for about 24 hours, and then die. He has no insurance so his wife and their small children will be destitute. And they'll have to live with the shame of what happened. Just how could things be worse?"

"Well," said the optimist, "if it had happened last night instead of tonight, it would have been me!"

The power of optimism

According to communications experts, being an optimist and looking for the bright side of things is an important factor in building good patient relations and a successful and enjoyable practice.

"If people like you, they'll forgive just about anything you do wrong. If they don't you can hit everything right on target, and it won't help," once said communications consultant Roger Ailes. "It's hard to define what makes people likable, but those who try too hard, usually aren't. Optimism is the only trait we find that's important to being liked."

In addition, you owe it to your patients to give them hope. You must, of course, be honest with them, but try to be as positive as possible in discussing their diagnoses.

Devastated

"Dr. F (a local ophthalmologist) told me I have macular degeneration, and I'll be blind within two years," a retired librarian told me a number of years ago when she came to me for a second opinion. "It devastated me! I have no family, and books and reading are my entire life. I seriously contemplated suicide."

Dr. F had done an accurate job of diagnosis. But he forgot we're dealing with people, not just diagnoses. What he did to her was worse than a wrong diagnosis. First of all, her acuity never got worse than 20/60 in her better eye. With special lens correction, we were able to keep her reading for the remaining 12 years of her life.

Secondly, even if she had been destined to suffer more severe visual loss, he should have pointed out to her that she would retain peripheral vision, that there were visual aids that would help her, etc.

Half full or half empty?

We need to present problems to patients in their most favorable light. For example: Your patient has age related maculopathy. You've just reexamined him, and his vision has not improved. How do you tell him?

"Your problem seems stabilized, and is no worse than it was last year," is a lot better than, "Your problem is no better." It's the old "Is the glass half full, or half empty?" analogy.

On the other hand, many years ago I examined a lady who was extremely fearful of having cataracts. So instead I told her she had a few lens opacities.

"You completely misdiagnosed my mother's problem," her daughter later angrily phoned me. "We took her to another eye doctor, and he discovered that she has cataracts."

Life ain't always fair. OM