Therapeutic Dialogue
Therapeutic Dialogue
'You're a doctor. Can I ask you a medical question?' It isn't easy to refuse when someone asks, so I said yes and waited to hear what would follow. The questioner on this occasion was a Greek builder called Costas. We were standing in my back garden, where Costas and his team of eastern European labourers were doing some work. He said the question was a very simple one—at least in his view: 'What are the chances of dying after a stroke?' I took a deep breath and asked him to tell me more.
The story, as it turned out, wasn't related to Costas himself. It concerned one of his labourers, whose father was in hospital in Rumania and being kept on strict bed rest following a stroke. The doctors had told his family he would almost certainly die—a 99% chance of doing so. However, when I asked how severe the stroke was, Costas said the patient could apparently walk and talk normally. The only problem seemed to be partial vision in one eye. Cautiously, I explained to Costas that this didn't sound such a grave picture. In this country the doctors would get him out of bed and mobilise him quickly. They would regard his general outlook as pretty good. Costas beamed at me when I said this and he summoned his Rumanian worker over to join us. 'I told you so!' he said triumphantly. 'This doctor says your father will live! Your family must ignore the doctors and get him out of bed!' I squirmed at his version of what I had said, but I couldn't do much about it. I tried to have a conversation with the Rumanian man himself, but his English was poor. He understood enough to confirm the story Costas had told, but not enough for me to add any notes of caution to his boss's reassurance.
Later, I shared some concerns with Costas. Maybe we didn't know the full history, I explained. Perhaps there were other problems the doctors in Bucharest were worried about. Besides, I told Costas, traditions of treatment differ in other countries. So do medical outcomes. Costas would hear none of this. His own mother had died of a stroke, he told me, and she did so in exactly the same circumstances. 'They made her stay in bed', he explained. 'They kept feeding her. Day in and day out. She got bigger and bigger. I begged the doctors to give her an enema to get it all out. They refused. Then she exploded. I could kill them!'
Introduction
'You're a doctor. Can I ask you a medical question?' It isn't easy to refuse when someone asks, so I said yes and waited to hear what would follow. The questioner on this occasion was a Greek builder called Costas. We were standing in my back garden, where Costas and his team of eastern European labourers were doing some work. He said the question was a very simple one—at least in his view: 'What are the chances of dying after a stroke?' I took a deep breath and asked him to tell me more.
The story, as it turned out, wasn't related to Costas himself. It concerned one of his labourers, whose father was in hospital in Rumania and being kept on strict bed rest following a stroke. The doctors had told his family he would almost certainly die—a 99% chance of doing so. However, when I asked how severe the stroke was, Costas said the patient could apparently walk and talk normally. The only problem seemed to be partial vision in one eye. Cautiously, I explained to Costas that this didn't sound such a grave picture. In this country the doctors would get him out of bed and mobilise him quickly. They would regard his general outlook as pretty good. Costas beamed at me when I said this and he summoned his Rumanian worker over to join us. 'I told you so!' he said triumphantly. 'This doctor says your father will live! Your family must ignore the doctors and get him out of bed!' I squirmed at his version of what I had said, but I couldn't do much about it. I tried to have a conversation with the Rumanian man himself, but his English was poor. He understood enough to confirm the story Costas had told, but not enough for me to add any notes of caution to his boss's reassurance.
Later, I shared some concerns with Costas. Maybe we didn't know the full history, I explained. Perhaps there were other problems the doctors in Bucharest were worried about. Besides, I told Costas, traditions of treatment differ in other countries. So do medical outcomes. Costas would hear none of this. His own mother had died of a stroke, he told me, and she did so in exactly the same circumstances. 'They made her stay in bed', he explained. 'They kept feeding her. Day in and day out. She got bigger and bigger. I begged the doctors to give her an enema to get it all out. They refused. Then she exploded. I could kill them!'
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