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1/
#HumanismAlways, Day 1
Right of refusal.
Him: “I’m shook about this spinal tap.”
Me: “Yeah?”
Him: “For real, for real. I don’t know, man.”
*silence*
Me: “What has you most scared?”
Him: *shaking head* “I don’t know, man.”
Trepidation was all over his face.
#HumanismAlways, Day 1
Right of refusal.
Him: “I’m shook about this spinal tap.”
Me: “Yeah?”
Him: “For real, for real. I don’t know, man.”
*silence*
Me: “What has you most scared?”
Him: *shaking head* “I don’t know, man.”
Trepidation was all over his face.
2/
Me: “I get it. A lot of people feel nervous about needles.”
Him: “I don’t even be tripping on needles like that.”
Me: “No?”
Him: “I mean nah, not really.”
*silence*
Him: “You know what it is?”
Me: *listening*
Him: “It’s WHERE you sticking me.”
He shook his head again. Hard.
Me: “I get it. A lot of people feel nervous about needles.”
Him: “I don’t even be tripping on needles like that.”
Me: “No?”
Him: “I mean nah, not really.”
*silence*
Him: “You know what it is?”
Me: *listening*
Him: “It’s WHERE you sticking me.”
He shook his head again. Hard.
3/
Me: *still listening*
Him: “You sticking me in my BACK. Where I can’t see.”
*silence*
Him: “How I’m s’posed to know what’s going on when I can’t see?” *mumbling* “Hell naw.”
*silence*
Me: “I could tell you.”
Him: *looking up*
Me: “Like. . . tell you what is happening.”
Me: *still listening*
Him: “You sticking me in my BACK. Where I can’t see.”
*silence*
Him: “How I’m s’posed to know what’s going on when I can’t see?” *mumbling* “Hell naw.”
*silence*
Me: “I could tell you.”
Him: *looking up*
Me: “Like. . . tell you what is happening.”
4/
Him: “Yeah but what if you not being straight up?”
Me: *listening*
Him: “Y’all might tell me anything.”
*silence*
Me: “I want you to feel safe. What would make you feel more safe?”
Him: “I think I just need a minute, man. To think on it.”
Me: “That’s fair.”
And so he did.
Him: “Yeah but what if you not being straight up?”
Me: *listening*
Him: “Y’all might tell me anything.”
*silence*
Me: “I want you to feel safe. What would make you feel more safe?”
Him: “I think I just need a minute, man. To think on it.”
Me: “That’s fair.”
And so he did.
5/
At first I chalked it up to medical mistrust rooted in historical disses and amplified by current racial injustice. And while some of that might have been a part of it, I thought about what I could have done differently.
Hmmm.
At first I chalked it up to medical mistrust rooted in historical disses and amplified by current racial injustice. And while some of that might have been a part of it, I thought about what I could have done differently.
Hmmm.
6/
My explanation of WHY he needed the tap seemed robust. But the actual process and procedure? I’d scooted over that part rather quickly.
I’d said:
“A needle in your back to sample the fluid that bathes your brain and spine. . .”
Which, on second thought, sounds hella scary.
My explanation of WHY he needed the tap seemed robust. But the actual process and procedure? I’d scooted over that part rather quickly.
I’d said:
“A needle in your back to sample the fluid that bathes your brain and spine. . .”
Which, on second thought, sounds hella scary.
7/
I recalled the fear I felt about my first colonoscopy. Even as a doctor, I was nervous.
But.
My doctor sensed that. She described more of it in fine detail—the what that would actually happen and the how. Not just the why. Which made me feel better.
Yup.
I recalled the fear I felt about my first colonoscopy. Even as a doctor, I was nervous.
But.
My doctor sensed that. She described more of it in fine detail—the what that would actually happen and the how. Not just the why. Which made me feel better.
Yup.
8/
So I got my little whiteboard and went back to him. And drew some pictures and broke down the what that would be happening behind his back.
He asked some damn good questions. Which I answered best I could.
And it made him feel better. Which made me feel better, too.
So I got my little whiteboard and went back to him. And drew some pictures and broke down the what that would be happening behind his back.
He asked some damn good questions. Which I answered best I could.
And it made him feel better. Which made me feel better, too.
9/
The tap was uneventful. And fortunately the problem he had did not involve the CNS.
When I came back to talk to him about it, it was light. He thanked me for “slowing it down” so that he could “get his mind right.”
And I thanked him for making me.
The tap was uneventful. And fortunately the problem he had did not involve the CNS.
When I came back to talk to him about it, it was light. He thanked me for “slowing it down” so that he could “get his mind right.”
And I thanked him for making me.
10/
I’m realizing that a lot of forces are at play when patients say no. While long-standing factors that cause mistrust are real, sometimes it’s just us—the healthcare team.
Rushing.
Fast-talking.
Or just not explaining every part as fully as we could or should.
I’m realizing that a lot of forces are at play when patients say no. While long-standing factors that cause mistrust are real, sometimes it’s just us—the healthcare team.
Rushing.
Fast-talking.
Or just not explaining every part as fully as we could or should.
11/
Or not recognizing that a no might be an opportunity to double down on humanism.
Or respecting it as a right.
Sometimes it’s complex. But you know? Sometimes maybe all a pt needs is for us to slow it down so they can get their mind right.
Yeah. That.
#7daysofHumanism
Or not recognizing that a no might be an opportunity to double down on humanism.
Or respecting it as a right.
Sometimes it’s complex. But you know? Sometimes maybe all a pt needs is for us to slow it down so they can get their mind right.
Yeah. That.
#7daysofHumanism
