Truth

When doctors speak casually to their patients, little do we realize our words mean an awful lot. Sometimes the truth hurts, and it pains me to say this, but there will be situations that challenge a prima facie duty for honesty. "A good speech isn't one where we can prove that we're telling the truth," Sir Humphrey Appleby once reminded James Hacker, "it's one where nobody else can prove we're lying."

Few, if any, moral philosophers would admonish us to always "tell the truth, the whole truth, and nothing but the truth." Telling a white lie might not do anybody harm. More often than not, it can do your patient a world of good.

Doctors are by no means having the monopoly to please their patients; the reverse also holds true.

Lately, I have been sharing a story about telling truth to doctor. It's a tale I wish didn't need telling. It all started when most of our team went to the States for a conference last week. I screened the referral letters to our specialist clinic for kidney problems. One of the patients had been seen in our clinic decade ago for the finding of heavy protein in her urine. She remained well after treatment but seemed to have the same problem coming back this month. I jotted down a note to expedite her care.

That patient was called back to see me yesterday. As she came into my room, she made a quick remark that she recognized me. "Indeed," I continued the conversation, rather superbly I thought, "I just realized that, after going through your case notes, I was the doctor who first saw you ten years ago." I was pleased to see her again, with pride written all over my face, because my patient remembers me after all these ten years.

"Yeah, yeah, you were young at that time," she replied.

I nodded reluctantly, as if my head was hanging over a guillotine. She is absolutely qualified, I know, to remind me I look older than ten years ago.