Rev. Gordon Putnam on asking medical questions on behalf of patients

Asking Questions May Be the Answer

She was pregnant and tears were running down her face. Her mother had gone into surgery for a brain aneurism and then had a stroke on the right side of her brain. Now her mother lay in bed, part of her skull missing, on a ventilator, not moving. In the staff’s opinion she was going to die.

What is my role as chaplain in this situation? That night I listened, I offered support, and I prayed. And there was one more role I played which chaplains and nurses tend to shy away from. That role was to empathize and help the doctor clarify the diagnosis and prognoses of the patient with the daughter.

When the doctor finished his guarded explanation that night, using medical terms interspersed with common words and a lot of “ums” and “ahs,” I asked a few questions:

• “Doctor, how will the stroke affect her left side?”
• “Do you think she will be able to walk?”
• “You said we are going to watch for signs of recovery. What will that look like?”

Simple questions helped the doctor explain the effects of the stroke, clarify much that was wrong, give a more accurate prognosis, and show the daughter signs to look for, both good and bad. When the doctor finished, the daughter thanked me for my questions and the doctor seemed relieved.

Another day, I was with a family as the doctor explained the patient’s situation. I asked a simple question that the doctor answered easily. The nurse commented to me later that she was surprised I had asked such a simple question. She thought I would have known the answer. Sure, I knew the answer, I told her, but the family did not.

Every case that was brought to the Ethics Consult Team in the last nine months involved communication, not ethics. Studies have shown that many doctors are unskilled communicators, especially in end-of-life situations. I do not believe trying to train doctors to be better communicators is the answer. I believe, however, we can help them communicate better. Chaplains have the unique opportunity to be "outside" the situation and can use reason, caring and empathy to help all concerned. By asking a few simple questions to clarify diagnosis and prognosis we can help communication among patients, family, staff and doctors.

Do you have thoughts about advocacy you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.