Yesterday I was hospital visiting to a couple of elderly folk, a now familiar routine almost every week it seems.
I went first to see my 95 year old who had been admitted, initially overnight for a follow-up to her oesophageal botox treatment ("making beautiful on the inside" as she put it). It transpired that this had not been successful (I did a quick web trawl, the success rate is evidently only around 30%) and as she was dehydrated she'd been kept in for a few days to rectify matters. She said that a doctor had been to see her and explained that there were only two treatments for her condition - the botox, which had failed, and a dilatation procedure which (in her words) "would kill me." A second doctor had then been to see her and suggested that the dilatation procedure might be the best way forward. Needless to say she was confused and frightened. Having done my bit of web trawling, the suggestion is that the procedure is not dangerous so I can only assume the first doctor was concerned about more general risks of invasive procedures on very elderly patients.
The second person has dysphasia following a stroke, so her ability to communicate verbally is very limited, despite her brain being as acute as ever. She has no way beyond yes/no answers of expressing anything she needs, wants or feels, and is clearly not too well as present. I dread to think what she might fear and be unable to explore if she is given equally blunt information.
I know we live in an age where patients are entitled to know the truth (for which I am grateful) but, if what I was told is accurate, and there's no reason to think it wasn't, then the mode of delivery was at best insensitive and more probably careless. Having been with a patient a year ago on a Saturday afternoon when she was called in to see a doctor alone to be given a diagnosis of terminal cancer, I fear the latter is more likely. I know medical staff are very busy and get very tired, and I know they have a tough job to do, but just sometimes I wonder if a little more attention could be given to training them in how to talk to patients.