01 March 2006

Things Not to Say

Things you can say which will reliably discomfit your patients:

For patients who will need surgery:

  • "There's no cure for what ails ya except cold hard steel."

For patients upon whom you are performing a procedure:
  • "Oops"
  • "What the hell is that?"
  • "Hold still, I'm going to try something."
  • [To Nurse] "How does this gadget work?"
  • "I've never done this before, but I'm pretty sure I can pull it off."
  • "Now this may hurt a little . . . actually it's going to hurt rather a lot."

For patients with a medical diagnosis:
  • "There's Good News and Bad News. The Bad news is you have [X]. The Good news is that it's you and not me."
  • "Everybody's got to die sometime."

Now, I've never said (most) anything on this list, but I have a wicked mind and have thought about it on many occasion. I'm sure you have thought about it, too. Feel free to add suggestions in the comments.


  1. I had knee surgery many years ago. The doctor made a pulling motion at one point and kind of shook his head quizically and said, "That wasn't it."

    I said, "That's going to hurt, isn't it?"

    He said "Yeah."

    I'm not kidding, this was verbatim.

  2. And then there are just the little procedural things that can drive a patient/parent crazy. Like, for instance, leaving a message with the Nuclear Medicine receptionist to tell you "They need to see your son back at the Pediatric Day Hospital when you are done" when you had a CT scan the previous day. Boy it sure would have been nice if the message read, "They need to see you upstairs after this because they forgot to draw blood for a test" so my brain didn't jump immediately to, "They saw something bad on the CT that they need to tell us about", which, thank God, they didn't.

  3. Oh, that's so frustrating. I learned a long time ago that you can't leave a voice mail for your mom that says, "Mom, it's Matt. What's your insurance card number?"

    You have to say, "Hi, Mom, it's Matt. I'm doing great today, the sun is shining, I'm feeling great. By the way, a *clerical* problem with the University Health Care accounting department was brought to my attention and they need a number from one of your documents."

  4. My dad taught me you don't say "oops", you say "there" instead.

  5. Geez, one time after having a surgical consult for a nissen fundoplication, the surgeon told me "OK, we just did your EGD and biopsies this morning, we know you have Barrett's esophagus and low-grade dysplasia (have had that for years) so unless anything new or different shows up in the path. report and your coronary clearance (was having in 2 days) is ok then I will see you in the OR room." The next afternoon while I was getting things ready for my coronary clearance test (this hospital was 3.5 hrs. away.) I received a call from my surgeons receptionist that said..."Dr. X wanted me to call you because he received the path report from your EGD and he wants you to come to our office as soon as you are finished with your coronary exam tomorrow.." "It makes no difference what time you finish we will wait for you."

    My God, this had to mean I had high grade dysplasia show up (not good at all) or worse they found EC in there...I lost the whole nights sleep, was a nervous wreck, my BP was so high that the coronary Dr. ended up resceduling my Echo for a later date, which in turn meant my surgery would have to be postponed.

    I finally saw my surgeon, he walked in the room, sat down and said, "My dear you have Barrett's esophagus and some low-grade dysplasia!" He couldn't understand why I was just looking at him like he was nuts...Of course I had barretts and LGD, we all knew that for years...The prior conversation we had must have totally slipped his mind...


  6. "Hey everyone come look what this guy has!"

    "You know what you need? More Cow Bell... But it won't cure that Cancer"

  7. My personal favourite was a Surgical registrar (= to your resident) with incomplete mastery of English, who said to a patient:

    "Look, we got no idea what going on... So we cut you open, OK?"


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