Want A Better Relationship With Your Patient? Make It Personal.

“Doctors are people too,” I once was told, by a patient no less. Sarcasm colored her choice of words, implying we doctors ought to descend from the heavens above and relate to patients like … well … people. Not a bad idea, one that humanizes the incomprehensible doctor-speak we unwittingly projectile-vomit onto our patients. Hmmm … talk to patients like one normal person to another?

Easier said than done. A doctor’s life comes with lots of time-consuming frustrations, patient-care-related or not. Among these are chronic, non-life-threatening conditions having no cure or satisfying means to allay the symptoms, leaving you at a loss. So what then? Shrug, fill in the void with incoherent medical jargon and leave the poor soul dumbfounded and wondering whether the time and money spent on the visit would’ve served a better purpose — like a case of beer and an hour watching grass grow?

Often it’s not “what” is told but “how” it’s told, making the difference between someone who’ll curse your name in vain to anyone within earshot versus one who’ll come away with a more positive outlook. And sometimes sharing a personal story helps.

As an example, a frequent ailment seen by ENT docs like me is tinnitus — ringing in the ears, resulting from a constant sound generated by the inner ear due to impairment from any number of causes. With very few exceptions, the condition is benign. Unfortunately for the majority, there is no cure.

People may believe the sound is external, but upon discovering no one else hears it, they may conclude the worse — it’s a mental disorder, a brain tumor, or something invading their head. Tinnitus plagues millions of people, so I reassure patients they’re not alone. This often is not enough though, and I don’t have the heart to shrug my shoulders and ride off into the sunset.

So I often share my personal story, for I too have tinnitus; my ears have been ringing 24/7, since I was a kid. In fact, I thought everyone heard this. I believe this resulted after lighting firecrackers, entire packs at a time (along with 50-60 other crazy people) during Chinese New Year’s one day. After that, my ears rang and haven’t stopped since. I tell patients I’ve adapted well to this; I don’t “suffer” from tinnitus. However, this was not always the case for I certainly suffered considerably, going through a very tough period at the ripe age of 11.

Following is my “Tinnitus Tale,” modified in various ways to suit the conditions of the moment:

One day, I was hanging out with three friends and asked, “Hey dudes, ever hear that ringing in your ears? Man, it can be really loud!”

They all thought I was crazy and had nary a clue to what I was describing.

“Just shut-up and listen and you’ll hear it. I can hear it right now — a high-pitched ‘eeeeeee’ sound. C’mon guys! You hear that, don’t you?” I tried to keep my cool, since decompensating in front of a bunch of eleven-year-olds would’ve started a tease-fest I didn’t need at the time. They still thought I was crazy.

Then one guy concluded, “It’s all in your head! You’re possessed, man!”

“What? Possessed? Is that bad?”

“Yeah, really bad! You know that movie that just came out — The Exorcist?” he explained. “It’s about a kid that gets possessed!”

Another said it was the scariest movie ever made in history and though he hadn’t seen it, he knew “a friend of a friend whose Uncle Ernie saw the movie and he peed in his pants ‘cause it was THAT freakin’ scary!”

The third guy put the icing on the cake, “Yeah! I heard some people DIED — of heart attacks! They DIED in the theater, dudes!”

“Holy crap!” the other two said.

Holy crap, indeed.

A few weeks later, I’d forgotten about the tinnitus, when surprisingly my parents, in their infinite wisdom, took us all —me and my younger brother and two younger sisters — to The Exorcist at a drive-in theater.

To make a long story short, the movie was that freakin’ scary. Even my dad, an ex-paratrooper, was scared out of his boots. I couldn’t sleep the entire weekend. Visions of the devil-possessed-girl flashed every time I closed my eyes. And in that twilight of near-sleep, I’d hear her scream, “It burns! It burns!” when doused with holy water. Watching that movie between my trembling fingers was one of the most traumatic events of my young life.

The following Monday at school, I tell my friends that I “saw the freaking scariest movie in the entire world!” They were all quite impressed.

“Man, I’m glad you’re still alive!” one kid declared.

“So what about your ear ringing?” another asked.

“What about it?”

“Don’t you remember? The ringing in your ears? It’s actually in your head, dude!”

I honestly forgot that. I had trouble enough purging my head of Linda Blair spinning her head to be worried about my tinnitus.

“Hey, yeah,” the other kid recalled. “Didn’t I tell you? Fong, you’re possessed! That’s really cool!”

Good God, I was possessed by Satan! I ran home, rushed through the door, screaming “Mom! Mom! I’m possessed! We gotta see one of those priest-guys NOW! I need some holy water or something!”

Mom, a small Japanese woman barely five feet tall, just looked at me while preparing dinner.

After I unveiled my tale of woe, my constant ear ringing, that my three best friends told me I was possessed by Satan and was going to burn in hell forever … well, she continued chopping vegetables until I exhausted myself out.

“What are you talking about?” she finally said after I plopped into a chair. “My ears ring too,” she said matter-of-factly. “They have been for years. A lot of people have it, and they live with it. It doesn’t mean you’re possessed. Now go do your homework.”

“Really?” She convinced me I was going to be OK. Afterward, I’ve given little thought to my tinnitus, though now and then thinking about The Exorcist still gives me the creeps.

“So that’s my story,” I tell my patients, who often laugh. “My ears ring non-stop. But I’ve learned to live with it and so can you. And oh, by the way, you don’t need an exorcism.”

This frequently softens things as does most sage advice coming from moms. Surprisingly many people understand medicine does not have the answer for every health problem out there. But patients want you to treat them as people, not as slabs of tissue to poke and prod, ready to exercise our medical magic. And often relating on a more personal level enhances the experience for both patient and doctor.

Randall S. Fong is an otolaryngologist



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