Whether a relationship is professional, personal, or something a little more unusual such as a doctor – patient relationship, communication is key. Many people make the mistake of believing that words are enough or all that matters. However, sometimes what is not said can provide more information than the words spoken.
For example, I was surprised to see the look of fear on a doctor’s face. The first time I saw it on a doctor’s face occurred during my pregnancy with Charlie. I had the miserable experience of having a cold while I was pregnant. A few days into the cold, I woke up and felt more tightness in my chest than usual. The feeling steadily increased throughout the day. I sent a text to my husband that read, “I must be really sick. Can you take me to the doctor? I’m having a hard time breathing.” By the time he hurried home, I found it difficult to talk.
There was no way we could have made it to the nearest hospital through northern Virginia rush hour traffic. We opted to go to the urgent care center a block away. We needed a doctor quickly and had no idea what was wrong with me. After arriving at the urgent care center, I was taken back immediately. The doctor hurried in and started treatment. I remember seeing the look on his face. His wide eyes and panicked expression conveyed his fear. He called out to the nurse, “Call 911!”
The ambulance came quickly and had everything necessary on board. I was treated on the way to the hospital. It was the first time I had a life threatening asthma attack. Up until then, my asthma had been more of a seasonal allergy nuisance.
Next, I received ambiguous answers on a few occasions. This way of saying something without actually saying anything is the most frustrating to me. The morning Charlie was delivered, the nurse told me to call my husband. I asked the nurse, “Are we having the baby today?” while my husband was on the phone. She answered, “If it were me, I would want my husband here.” I wanted to yell, “What the hell does that mean?”
As it turns out, that morning we were dealing with reversed end diastolic flow (more was coming out of Charlie than was going in) in the umbilical artery. The situation has a respectable perinatal mortality percentage. I am not sure what I would have wanted to hear but being told a lot of nothing was not helpful.
Now, I grow suspicious and wonder what I’m not being told whenever a health professional avoids answering a question. The words “I don’t know” are perfectly acceptable for me to hear. I need it to be followed by who does know or how it will be figured out. I am more at ease with information… even unpleasant information. Bad outcomes are easier for me to deal with if I know it is a possibility. It is better than being blind sided with bad news.
Similarly, I find the look of quiet concern to be distressing. I saw this look many times when I first knew Charlie was significantly delayed. She had trouble moving, was rigid, and missed every motor milestone. Each time she had an appointment with a medical professional I voiced my concerns and asked questions. I had no idea what was wrong but I knew something was not right.
Each time, a doctor wore the same expression after examining her. Invariably, the expression was a mix of thought and concern with a slight narrowing of the eyes. I knew they were seeing what I was seeing. Yet, they did not say anything helpful to address it. Repeatedly seeing this expression is one reason why I did not stop asking questions until I found a doctor who could talk about it and guide me in how to help my baby.
Additionally, nervous habits can be equally as revealing. When I was hospitalized on the high risk perinatal floor, I noticed a pattern in my OB/GYN’s behavior. If there was no news, he would flutter around my room while fidgeting with his coffee and occasionally glance out the window as he spoke. If there was bad news, he pulled a chair up to my bedside and sat down to deliver it. I loathed seeing that chair approach my bedside. However, I was able to gauge the seriousness of my situation moment by moment via his nervous habits.
Finally, I’ve learned to communicate through indirect phrasing. For example, Charlie had an amazing nurse she regularly saw during her first year. As a first time mom, I had many questions. When I had questions concerning Charlie’s delays, issues, or developmental concerns, the nurse would answer with the phrase “If it were my child, I would…”. From one mother to another, it was code for “This is what you should do…”
Her responses were precious pieces of guidance during a time when so few people were willing to provide definitive answers. While I respect the option of self determination, sometimes I really just want to be told what I should do to help my child. Despite the wealth of health information available on the web, I need the expertise of health professionals to guide me and educate me.
To all the health professionals, I want you to know that sometimes what you don’t say resonates louder than what is said. To all the parents, ask direct questions if you feel you are receiving mixed signals. Information is power.