I was thinking about the subject of my next blog when I was alerted that a new comment was awaiting approval. Mike H, who had just shared his thoughts on one of my recent blogs, was now posting a comment on one of my blogs from time passed titled -“It’s Treatable But Not Curable.” His disbelief that this particular blog had not been commented upon moved him to “step up” and respond to my question: What do patients understand these words to mean? And, I had also asked readers whether the order of the words impacts a patient’s understanding of their illness.
Mike H stated, “I understood (at the time of diagnosis) the word ‘treatable’ to mean a very prolonged, uncomfortable and complicated future. I understood ‘not curable’ to mean I very well may not see my then young children leave the nest.” He went on to note, “The order in which those phrases came is, and was at the time, irrelevant.”
A couple of years ago, when I asked the same question of Dr. John Hearst and the late Dr. Carol Tunney on their Bennington, VT radio show Natural Instincts, they offered insight into the difficult task doctors’ face in reconciling patients to incurable illness. “We give the good news first, it’s treatable,” Hearst said. Tunney, then a patient herself, explained, “All I heard was ‘not curable.’ Tell me it’s treatable and I’m open to hear more.”
We seem to be circling back – to the theme of hope and reality for which there is no standard dose. Who was it that said if you find yourself going full circle you know you are going in the right direction. Doctors often say they do not want to take away hope. Perhaps, asking patients what they understand the words treatable – not curable to mean can help define what they hope for – sooner rather than later.
So, who opens this conversation and when?