Tag Archives: Dr. Jack Coulehan

Fighting, battling, and beating: combat metaphors in medicine are just wrong

29 Nov

by Carolyn Thomas    @HeartSisters

Are you “battling” heart disease”? Have you “beaten” cancer? Are you “fighting” a chronic illness? These wartime references are metaphors as described by Dr. Jack Coulehan, a physician, an award-winning poet, and editor of the 5th edition of The Medical Interview: Mastering Skills for Clinical Practice, a best-selling textbook on the doctor-patient relationship.(1)  Dr. C explains that there are several basic metaphors used in medicine that to a large extent generate the vocabulary of doctor-patient communication – but can also unintentionally objectify and dehumanize the patient.

Here are three of the most prominent metaphors you’re likely to encounter in health care:  Continue reading

Just not listening – or “narrative incompetence”?

22 Mar

by Carolyn Thomas  @HeartSisters

The Radical EarI’ve been reading lately about something called the patient’s narrative in medicine. Although it’s basically defined as patients telling the story of what originally brought them to see the doctor, it’s actually much more.

Doctors, for example, all too often may see “the story” as an unnecessarily lengthy distraction from getting swiftly to diagnosis and treatment.

But as U.K. physician Dr. Jeff Clark describes it, connecting with and understanding the patient requires a doctor to appreciate each person’s unique perspective. In the December 2008 issue of The British Journal of General Practice, he asked other doctors to consider how not listening to a patient’s story can be compared to his colleague’s golf game:  Continue reading

Empathy 101: how to sound like you give a damn

24 Feb

by Carolyn Thomas    @HeartSisters

During the first follow-up appointment with my (now former) family doctor a few weeks after surviving a heart attack, I noticed something unsettling right away. First, she seemed utterly preoccupied with her own possible part in missing some magical sign that I’d been at risk for this surprising cardiac event. She reviewed lab test after lab test while I sat there watching her claw through a thick file (no electronic charts there!) of my lipid and blood pressure results going back years. It struck me that this follow-up visit was somehow all about her – not about ME at all!

Hey! Remember me? The one who actually had the frickety-frackin’ heart attack?   Continue reading

“She’s a fighter!” and other metaphors in medicine

12 Feb

by Carolyn Thomas   @HeartSisters

Are you “battling” heart disease”? Have you “beaten” cancer? Are you “fighting” a chronic illness? These wartime references are metaphors as described by Dr. Jack Coulehan, a physician, an award-winning poet, and editor of the 5th edition of The Medical Interview: Mastering Skills for Clinical Practice, a best-selling textbook on the doctor-patient relationship. Dr. C explains that there are several of these basic metaphors used in medicine that to a large extent generate the vocabulary of doctor-patient communication.

Here are three of the most prominent metaphors encountered in health care:  Continue reading