Sometimes when a doctor talks to you about your health, they might talk a lot and give a lot of details. I call this “monologuing.” It might seem like they are just trying to be helpful, but sometimes they do this because they have bad news to tell you.
The reality is that despite all those years medical training, many doctors are never taught the framework to break bad news in a patient-centered way. So, not knowing how to tell you, they do this monologuing thing where they lay out piece by piece the workup that they’ve done with the hope that you connect the dots on your own. And if you don’t speak “medical,” you may not realize this is happening.
So what should you do to figure out whether or not your monologuing doctor is trying to break bad news? I would recommend this line:
“Hey doc, can you give me the headline here?”
What are you doing by asking for a headline? You are giving your doctor the specific imagery of a newspaper headline to guide them away from their monologue and towards explaining things in a better way. Because everyone knows what a newspaper headline looks like, right? A newspaper headline uses just a few words to tell you two important things:
- What is happening
- Why you should care
A medical headline from your doctor should should be able to distill into one short sentence what is happening with your health and why it really matters. Most doctors I’ve taught to give headlines to patients can pretty quickly grasp the first half – what is happening? For example, if you’ve been getting treatment for stage 4 cancer and the latest scans show new spots in your liver the first half of a headline might sound like, “The cancer is getting worse.” And yes that alone is horrible news, but that doesn’t give you the full picture. The second half of the headline is often where the hardest news is buried, news like “There aren’t any more treatments at this point” or “I worry your time is getting short now.”
Because this part of the news is so hard to give, a lot of docs will dance around it (everyone hates giving bad news, and doctors are human too). So even if you ask for the headline and receive news, you may need to specifically ask, “What does this really mean for me?” And while what you hear in response may be devastating, how on earth are you supposed to make the right decisions for you or someone you’re caring for if you aren’t getting the whole context?
So again if you find your doc going into long winded explanations of things – if they are monologuing – ask for a headline. I hope by doing so you find the conversation with your doctor opens up in a newer and more meaningful way.