iPhone app iPad app Android phone app Android tablet app More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
Bernie Siegel, M.D.

GET UPDATES FROM Bernie Siegel, M.D.
 

The Power of Words: Revising the Doctor-Patient Relationship

Posted: 06/23/10 09:00 AM ET

As doctors, we are not trained to communicate and understand the power of our words as they relate to a patient's ability and desire to survive. It is also not only doctors but all the authority figures in our patient's lives that affect their ability to survive and the outcome of their disease. Parents, teachers, clergy and physicians change lives with their words. It is hypnotic for a child or patient to hear an authority figure's words. As I am always sharing, wordswordswords can become swordswordswords and we can kill or cure with either words or swords.

Up to the age of six a child's brain wave pattern is similar to that of a hypnotized individual. To quote a woman whose mother only gave her failure messages and dressed her in dark colors, and who as an adult has more trouble with her mother's words than she does with cancer: "My mother's words were eating away at me and maybe gave me cancer." We know from recent studies that loneliness affects the genes which control the immune system. So as doctors we need to ask the right questions and know what a patient has experienced and is experiencing in their lives. Can you imagine treating Christopher Reeve's wife for cancer without knowing her family history?

I recently received two emails: one from a woman who had a recurrence of her cancer and has decided to not undergo chemotherapy again. Her doctor said, "Then you might as well go home and commit suicide." The other email came from a woman who asked her doctor if they could become a team as she had just finished reading my book. He told her no and that he was the doctor and in charge of her care. She packed her belongings and walked out of the hospital and has found a caring oncologist to work with. She is a survivor and not a submissive sufferer -- or, from the doctor's perspective, a so-called good patient.

We need to listen to our patient's words and treat their experience. Helen Keller said it very well when she said, "Deafness is darker by far than blindness." We also need to understand that patients do not live a disease they live an experience and we need to ask how a patient would describe their experience and then treat them accordingly. The words they use, like draining, failure, denial, pressure, gift and wake-up call are always about what is happening in their life. So we can help them to heal their lives and improve the chances of curing their disease.

I did a great deal of children's surgery and I meet many of these children today, as young adults, and am amazed at how vivid their memories are. It is obvious how important this event was to them and the details they recall. I learned how powerful my words were when I began to notice children falling asleep as we wheeled them into the operating room. One boy turned onto his stomach and fell asleep as we entered the O.R. I turned him over on the operating table and he said, "What are you doing? You told me I would go to sleep in the operating room and I sleep on my stomach." I told him I needed to operate on his stomach to get to his appendix, so we reached a compromise.

I would rub an alcohol sponge on a child's arm and tell them it would numb their skin and a third would not feel the needle and ask why other doctors didn't do that. I called it deceiving people into health. Give someone who has faith in you a placebo and call it a hair growing pill, anti-nausea pill or whatever and you will be amazed at how many respond to your therapy.

Years ago psychologist Bruno Klopfer was involved with a cancer patient involved in a study to determine the effectiveness of Krebiozen. His patient responded dramatically until the initial report came out saying it didn't seem effective. Then Klopfer told him the problem was that he hadn't received the super refined Krebiozen and it was coming next week. He purposely told him that to build up the intensity of the situation. A week later he told him it came and gave him an injection of a placebo and his cancer melted away. He remained well until six months later when the final report was published declaring the drug was of no use in the treatment of cancer. He died within the week.

Doctor Milton Erickson, from his childhood experience with polio and hearing his doctor's dire predictions to his mother that he wouldn't see the sun rise, knew how important words were. As a child his anger led him to defy the doctor's predictions. As a psychiatrist, and hypnotherapist, he knew how to talk to patients to achieve the best outcome. There are many books about his work. One by Dr. Sidney Rosen is entitled My Voice Will Go With You. And our voices do. At the conclusion of an operation, while patients were still under anesthesia, a time when they hear their surgeon's words, I would say, "You will awaken comfortable, thirsty and hungry." I did that until I noticed many of my patients were gaining weight and so I added these words, "But you won't finish everything on your plate."

One last story. (It is hard for me to stop because there is only one thing truer than the truth: a story.) Stories change people while statistics give them something to argue about. Erickson would write in a patient's chart and then excuse himself and leave the room. Of course he expected the patient would get up and go look at what he had written and he wrote, "Doing well." So be give your family mottoes to live by like, "Do what makes you happy," so they pay attention to their feelings, and "Difficulties are God's redirections," so they keep an open mind about the future. And remind your doctor that their words can become swords and, like a scalpel, kill or cure.

 
As doctors, we are not trained to communicate and understand the power of our words as they relate to a patient's ability and desire to survive. It is also not only doctors but all the authority figur...
As doctors, we are not trained to communicate and understand the power of our words as they relate to a patient's ability and desire to survive. It is also not only doctors but all the authority figur...
 
 
  • Comments
  • 18
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Bloggers
Recency  | 
Popularity
This user has chosen to opt out of the Badges program
nikanj
free the fnords
03:36 AM on 06/26/2010
It's not just the words, it's the vibrational quality of their delivery.
All ancient cultures understood and made use of the vibrational power of the human voice.
This user has chosen to opt out of the Badges program
01:22 AM on 06/24/2010
My doctor missed something once, something important. The next time I saw him I told him, "look, I don't like coming here, so if I come here, there is something wrong with me." He didn't say a word.
photo
HUFFPOST SUPER USER
Cynthia Occelli
Author with a Law Degree & a Blackbelt in Shopping
07:43 PM on 06/23/2010
Hi Bernie:

I love your stories and could read them all afternoon. There is so much power in treating patients as people first. Bravo and I love you.

Cynthia
07:33 PM on 06/23/2010
I have a super internist who listens and explains everything very well. We evaluate meds on a regular basis so thats great too. Here's the problem though. I was in an a auto accident and have to go to specialists and sometimes don't come up to the standards I am now used to. Especially surgeons. So I am less trustful of those who are less communicative and come bearing knives. I would live Bernie to help us communicate our needs to these physicians.
thanks
photo
HUFFPOST SUPER USER
Daoine
Ever hopeful...
05:57 PM on 06/23/2010
Within the last year, the physician I had been seeing for over 20 years passed away. He was a wonderful man who rarely had a dent in his smile, even when he was battling cancer himself. I trusted him so implicitly that I find myself still wondering what I am going to do without him. The relationship I have begun with another gentleman in his practice, while medically sound, lacks the personalized (feigned or otherwise) involvement that I found so important.
This user has chosen to opt out of the Badges program
photo
Trilby
Like candy for dinner.
04:00 PM on 06/23/2010
Yes, most doctors don't listen. My father is a very funny man, and quite old now. Doctors look at him and just see "old man" I guess. He likes to wrap up each visit, no matter how minor the complaint, by saying, "So, is there any hope for me, doctor?" And the doctors invariably reply brusquely, "There's always hope," usually without looking up from their notes. They never get that he's joking. I find that hysterical.
12:23 PM on 06/23/2010
Bernie:

You are as I remember you those many years ago when we used to speak on the phone: a genius with words (a poet, really), as well as a wonderful, compassionte doctor. Back then, I was writing a book on doctor/patient relations; you were the only doctor I interviewed who "got it" from the patient's point of view.

I smile as I read your words today:

"As I am always sharing, wordswordswords can become swordswordswords and we can kill or cure with either words or swords."

AND: "Up to the age of six a child's brain wave pattern is similar to that of a hypnotized individual."

AND: ". . . . there is only one thing truer than the truth: a story."

But I think one thing you said to me on the phone back then sticks with me even more: "There are no coincidences," you told me. "Only God-incidences."

I am writing another book now, about four lifesaving treatments that save lives but aren't produced by pharmaceutical companies -- so doctors often don't want to learn about them. (Sound familiar?) And the basis of this book is stories -- patients' stories.

Keep up the good work, Bernie. I'd love to talk with you again soon!
xoxo
Julia Schopick
http://www.honestmedicine.com/
12:09 PM on 06/23/2010
Great article. Thanks.

Doctors who understand the power of words and attitude are a select group of doctors who know how to think for themselves and do not outsource their thinking to the medical industry. Such great docs are the ones who think critically about conditions, their underlying causes and all potential cures. They are doctors who are cognizant of the influences of drug companies, hospitals and others that have a financial interest in directing (from the moment they enter med school) what they will think, predict, prescribe, etc.

"I recently received two emails: one from a woman who had a recurrence of her cancer and has decided to not undergo chemotherapy again. Her doctor said, 'Then you might as well go home and commit suicide.'"

That's an unprofessional, lazy response. I imagine the response of someone like Dr. Andrew Weil would be either take the time to make a more compelling argument on behalf of chemo or else give the patient an alternative approach ---without promises, but with great respect and keeping in mind the oath he took.
photo
HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
09:20 PM on 06/23/2010
Ideally, I want a competent doctor who is a great communicator. By competent, I mean a doctor who understands what works best, taking into account my personal issues that may require a modification of what works best.

What I don't want is a doctor who is a great communicator, but doesn't understand what works best and merely goes with the alternative medicine flavour of the week.

If I find the doctor who is treating me is truly a lousy communicator, then I may look for another doctor who is better at it.
photo
HUFFPOST SUPER USER
TheIndependenceParty
Cranky yankee and a rehabilitated ex-Republican
11:30 AM on 06/23/2010
It has been my experience as an allied health professional since 1970, that many physicians assume the nurse or therapist will explain and explore to and with patients the parts the physician has left unsaid or untended. The patient's impression left by this approach is that the physician truly does not care what happens to the patient.

It seems that those selected to become physicians, ... often by other similar physicians, ... don't even know that this is an essential part of good patient care, or are simply incapable of delivering this essential aspect of the healing arts. Others are capable, but terrified they will get "sucked" into grief after grief, patient after patient, and protect themselves by distancing themselves. Others can be totally self-absorbed narcissists.

To all physicians I would offer this cogent advice, ... Those who offer the human consideration Dr. Segal describes, in addition to finely tuned diagnostic and therapeutic skills, ... are sued less often. So when you plead for reductions in your insurance premiums for malpractice, consider that you could have taken this simple step all along.

Your patients will love you for it, ... and so will your accountant!
photo
HUFFPOST BLOGGER
Alison Rose Levy
Connect the Dots www.healthjournalist.com
08:53 AM on 06/23/2010
Many in integrative medicine noted the absence of nutritional training in medical school-- after years of work by doctors like Dean Ornish, Andrew Weil, and more recently Mehmet Oz and Mark Hyman, at long last, some headway has been made-- although it has cost Americans tremendously to overlook that basic.

But a still ignored basic is emotional intelligence in health care-- which is what you are speaking of here, Bernie. On the one hand, we have an emphasis on physical science-- biochemicals and such. On the other, many integrative docs address stress management via meditation and other practices. But somehow, the social sciences, especially real skillfullness in caring, caring language, and in knowing how to deal with common psychological problems is completely absent from our health care view.

In my experience, spiritual practices, wonderful as they are, don't always address such issues. One can arise from the meditation mat with a momentary sense of peace -- but waste decades avoiding a persistent psychological issue. I'm sure we all know people who have-- perhaps even ourselves.

Obviously, this disconnect is compounded by physicians who deliver the instrumental side of a communication = here's what's happening-- without awareness that they are also delivering simultaneously a message that the person will feel subjectively== here's the difficult thing that is happening to you and I care about it.

You have always been the premiere model of the latter. Thank you

Alison
Health, insight, and social action via free ezine sign up at: www.healthjournalist.com
This user has chosen to opt out of the Badges program
photo
Midnightrain
Hume was the greatest!
05:30 PM on 06/23/2010
Great post. You touch upon two fundamental problems with modern medicine: (1) Its pedagogy is grounded in the objective, which requires physicians to be detached from their patients. (2) Attempts to integrate modern medicine with traditional or spiritual practices often lead to some sort of superficial exercise in healing.

Neither the modern approach, nor the integrative approach to medicine focusing on healing. And true healing is brought forth by self-study; the study of the total being of the being to find and locate the source of the dis-ease. Physicians are taught to manage disease, integrative medicine teaches how individuals can cope through the disease management process - neither focuses on healing.
photo
HUFFPOST BLOGGER
Alison Rose Levy
Connect the Dots www.healthjournalist.com
06:27 PM on 06/23/2010
Fanned. Sad but true. While I do feel that many integrative practices are a big improvement over drugs and surgery-- and support healthy nutrition and lifestyle.so that people aren't naively forced marched into painful and costly illness that proactive behavior could forestall, there is still more to true healing as you so clearly state.

However, what you point out is that self-study is involved. That means not just making ourselves feel better-- or congratulating ourselves-- but really taking a good look. I guess Bernie's writings gather the likeminded.

Thanks so much for engaging.

Alison
photo
HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
09:29 PM on 06/23/2010
Please explain how self-study will lead to the healing of the following conditions.
1. Ulcers. At one time, they were thought to be caused by stress. Now, it is recognized that they are mostly caused by bacteria that can be killed by anti-biotics.
2. ALS. My brother has ALS. Unlike me, he's long been attracted to the spiritual self-help movement. Since he was diagnosed with ALS, that intensified. He's no longer interested in this, perhaps because he's on a respirator.

I'm glad that doctors aren't taught 'healing.' It would be just as much a waste of time as the nursing schools that teach therapeutic touch --- which you should know was debunked by a child.