There. That got your attention. Now. This blog is about the language healthcare professionals and people with diabetes use when talking about the diabetes human condition.
Okay, maybe I’m not playing fair. If you feel cheated and only followed my blog-link looking for something a little more… well, prurient, then rest assured. I will attempt to satisfy you… …later… …when I’m good and ready.
See, I’m good at this. Maybe such power-trips come as second nature to healthcare professionals?
So to my thesis: The language spoken in diabetes care is often warlike, angry and designed to raise heckles. Aggressive targets. Tight control. Patient compliance. Medication adherence. Adjectives such as strict, rigid & intense. To those of us of a certain age, it might conjure up memories of Mrs Thatcher’s Cabinet ministers’ visits to Soho Miss Whiplash-types.
Realising the importance of the language we choose in building doctor-patient relationships, it was interesting to look back at presentations I made in the past, this extract is from a PowerPoint made in 2007.
Back then, I began to see that choosing the wrong kind of language can distance our patients and even worse, cause us to see them as blame-worthy & as scapegoats: “none of them take their tablets”, “they all say, ‘It’s not for what I eat’ “… just two examples of the attitudes I encounter from health care workers (I won’t say professionals).
Recently I’ve been spending time with the doc, diabetes online community. It’s been truly revealing, a window into the lives of people with diabetes. I feel a sense of privilege to be let in. Yet I was taken aback to find how commonly people with diabetes themselves use negative language to describe their feelings and behaviours. “On the naughty step”. “Sometimes I cheat”. “Follow the rules”. “Like a trip to the headmaster’s study”. What I have found especially surprising is how this jarrs with their otherwise confident, upbeat & engaged online persona.
Perhaps this becomes ingrained in people with diabetes by the attitudes of generations of healthcare professionals, grooves in a vinyl record that has become stuck?
I can remember vividly how my own personal attitude-adjustment occurred. I also remember it was very painful.
I was in my second year as a junior doctor, SHO on a kidney unit. I was just finishing up, taking a blood sample from a woman new to my ward. As I was going, she said we’d met before. I couldn’t place her, so she elaborated- we had met in the diabetes clinic. I must have said something like, ‘That’s nice’, but her next statement grabbed my full attention: ‘Yes,’ she said, ‘I remember it was you that made me cry.’
I can only describe the next ~30 minutes by saying that she took me to the cleaners.
I sat. I listened. I learned from her what a first rate a** hole I had been. She told me the brutal truth that resulted from of the way I had talked to her.
I had judged her. I had demoralised her. I had humiliated her. I had reduced her to tears.
It was my turn for tears and for humiliation.
Well, she stayed several days on my ward. We enjoyed many more conversations and developed a close doctor-patient relationship and perhaps for the first time in my career, I came to know what that phrase really means.
Okay, you have been very patient. I think it is time.
So, if you’ve read this and none of it cuts any ice, you might consider adopting the approach of Dr Kempner at Duke University in the USA.
For a more academic assessment see Robert Tattersall’s informative article. Register and login for free if you’re a healthcare professional, but if you do so and you are not a health care professional… well… that would be VERY naughty now, wouldn’t it? VERY, VERY NAUGHTY…