A surgeon, speaking post-operatively, regarding a tumor resection, “We got it all.”

Routine screening tests ( EKG, chest x-ray, mammogram, cardiac stress test, colonoscopy, pap smear, PSA [for prostate cancer screening] ) the final reports stating, “NORMAL” or “NEGATIVE.”

A medical professional looking at a large, deep bed sore or looking at a post operative, open and infected wound, states, “Looks good!”

Before an injection to numb the area around an open laceration, the patient hears, ” This is going to pinch/ sting/ burn a bit.”

Instruction to someone who is chronically short of breath at rest, “Use this rescue inhaler only when you are short of breath, not all the time.”

While a medical professional is pressing on an already known to be a painful body site, she asks, “Now, does this hurt?”

After surgically removing a gall bladder or a portion of the colon, a patient is cautioned, “You will have a bit of diarrhea for a while.”

When a patient has a poor prognosis or a near-term terminal illness, the patient and the family may hear, “We want to shift our focus to comfort and achieving your goals.”

When a patient wants to know how a medicine is going to help, they may be told, “The mechanism of how this drug works and why it helps is….”

When a patient asks if this drug is expensive to purchase, she may be informed, “This drug is on your formulary.”

Patients should be reassured about a drug’s cost when the hear, “This drug is generic.”

A patient may feel that they have protected personal identifying information and healthcare data when he is told, “You need to sign this HIPAA form so that your doctors can talk to each other about you/your case/ your needs/your results.”

When a patient wants to have the most accurate and definitive test, occasionally they are told, “We ran a genetic test (or a send-out test) and it shows….”

When the patient still has symptoms they may be told, ” Since the ____ test is negative and your exam is negative, there is nothing else I can do / there is nothing else left to do / there is nothing wrong with you.”

When a patient is trying to do their own research regarding their symptoms, and presents their findings and questions to the medical professional, they may be told, “I know more than the internet.”

When a patient’s active disease treatment options are no longer helping / not helping enough for the side effects of treatment, the patient and family may be told, ” Estimates are that you have ____ ( a single number) weeks/months to live.”

A patient wanting guidance for treatment may be told, “Studies on thousands of patients show______. So this why we need to do ____ / need to start ____ / need to avoid doing _____.”

When a patient has an adverse event related to a medication, the perplexed medical practitioner my say, “In my ____ years of practice, I have never heard or seen your side effects due to this drug.”

A patient who has chronic shortness breath, falls and breaks her hip. Laying in bed for days, she starts having even more shortness of breath. Post operatively the orthopedic surgeon who inserts a pin to stabilize the hip comes to see her in the hospital room and states, ” The wound looks great and the hip X-ray shows the fracture and pin in good position. “The patient retorts, ” But what about my shortness of breath?” The surgeon reiterates, ” Your hip looks great.”

When a patient hears back about a test result and there is an abnormality, she may be told, ” We saw a little ______ on your x-ray/ mammogram/ CT scan / MRI / PET scan / EKG / colonoscopy.”

When a person is told a single number, in isolation of other factors, represents the risk or benefit of a treatment.

When a patient continues to have symptoms, so the medical professional performs a psychosocial review. The professional may state, “I think that your alcohol intake may be contributing to ______.”

When the patient is suffering a lot, they may be told, “Yours is the worst case of ______ that I have ever seen in my practice.”

When a patient is told a one time abnormal lab value result, in isolation from prior lab value results.

( Interpretations and explanations forthcoming.)

Charles Tadros, M.D.

May 24, 2021

Saint Louis, Missouri

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