Maya Angelou famously once said, “ I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”
At our fertility clinic, and as a doctor who routinely has to deliver news that runs the gamut from happy to horrible, I know how true it is that words have the power to tear a person down but they also have the power to heal – in all situations.
A Doctor’s Obligation
At a recent patient-physician conference, I heard an interesting analogy: just as surgery is a practice that requires its own specific skillset, delivering news also demands expertise in things like empathy and tact. As experts in the human body, doctors must realize that our statements and advice carry significant power and weight, and it is our daily obligation to be as precise and careful as a surgeon when it comes to delivering news.
When I was a medical school student, it was a given that through our studies, lectures, labs and working with patients on the wards, we were to become more knowledgeable in our chosen field. Somewhere in the middle of all this – often essentially by osmosis – we learned the art of communication and how to convey facts vs. opinions to patients. If you’ve ever watched Grey’s Anatomy, you’ll know that of all the skills a doctor needs to master, being a thoughtful yet clear communicator can be one of the most challenging aspects of any resident’s early career. (And perhaps any seasoned doctor’s as well!)
Thankfully, medical school curriculum today includes time for specified training in interviewing and communication.
While I’m not an oncologist who regularly delivers news about life and death, in my field of fertility medicine, I am frequently the bearer of a mixed bag of news, from “you’re pregnant!” to “back to square one.” On top of that, much of the work I do in interpreting test results and what they mean for my patients is nuanced and also changes rapidly as new fertility diagnostic tests and treatments crop up all the time.
To complicate matters, thanks to that aforementioned rapidly changing pace of new fertility treatments, what was once an absolute diagnosis of infertility may have subsequently become treatable. For example, severe tubal blockage was once an insurmountable problem, but IVF changed that in 1978. Likewise, egg donation opened up the ability of prematurely menopausal women and even menopausal ones as well to carry a pregnancy. Surrogacy made it possible for a woman without a uterus to have her own genetically related baby. And ICSI (intracytoplasmic sperm injection) revolutionized treatments for male factor infertility. Keeping all of those historic developments in mind is helpful when it comes to breaking news that may seem helpless at the time.
Another thing I always keep in mind when counseling couples is that their concern is personal, and not just a population statistic. And while data is what we fertility doctors present so that our patients can better understand their problem and chances for success, I make a conscious effort not to speak in absolutes. However, I also understand that it is imperative not to offer false hope, either.
In the end, I always refer back to Hippocrates and the oath we physicians take – “above all else, do no harm”. In a nuanced field such as fertility, certain treatments may not physically harm the body, but they sure can take a toll on a couple’s emotions, finances and timeline of life.
The act of imparting difficult news to a patient is incredibly complex. It begins with empathy, followed by space to process the information. Patients have a right to their own emotions and reactions to news, and certainly with fertility, suggested treatments might be accepted or rejected, depending. My job is to ensure my patients accurately understand and hear what I say both verbally and nonverbally. I’m always conscious a gentle touch or other nonverbal way of communicating can be just a powerful when it comes to encouragement and/or comfort.
In fact, there are some studies that show empathy may be linked to positive health results. In treating women who have experience several pregnancy losses, one study showed that outcomes were improved by frequent visits to a patient’s doctor, with handholding and other reassurances that the pregnancy was progressing as expected. Science and medical technology continue to advance, and although we may not know what the future holds, the importance of a doctor always striving to be a compassionate human being that delivers accurate, real information in a clear yet empathic way will never change.
Together We’ll Find A Way
This is why in my daily practice I always remember the power words have to harm or heal, and make sure I always chose the latter. To learn more about our practice, please contact us at the West Coast Women’s Reproductive Center.