What’s Unsaid

“I am pleased to inform you that your manuscript ‘Art Informs Medicine’ has been accepted for publication in the Art of Oncology section,” the editor noted. I was well aware that this meant that my work was going to appear in an issue of the Journal of Clinical Oncology (April 20, 2010). I was thrilled. The essay was based upon my experience as a medical humanist at a cancer center. Although it was published 12 years ago, I am still amused by the reviewer’s comments about a submission to a professional journal from someone with no medical credentials.


One reviewer said, “I like the way the article gets several of the communication difficulties and the ‘unsaid’ or obtusely phrased pieces of conversations” while another noted, “I think voices that one does not understand or clearly support should be heard.”


My writing style did not stop a reviewer from saying, “It is different and thoughtful (even though I have no idea what it means to ‘explore the landscape of the lived world of illness’). The writing is a bit staccato with all of the short quotations. But I think it works!”


And another reviewer stated, “Hmm. Very artistic, I recommend publishing it in the choppiness of the writing. I find the choppiness of these kinds of conversations in the challenge of staying with the patient’s point of view.”


Reluctantly, another said, “I guess, overall, I favor using this one with editing. I think it will raise questions and thought among many.”


The reviewers’ comments about the content and style of my essay made me think about the language divide between doctors and patients. This disconnect between a physician’s linear thinking and reliance on medical terms and a patient’s ability to understand the meaning of a foreign language can lead to misunderstandings. For me, these comments reflect a need for a shared responsibility of both patient and doctor to recognize how the “choppiness” in their conversations can hinder an understanding of medical information.   Acknowledging this language divide can be a good start to building a healthcare partnership.