You Can’t Always Get What You Want

Recently, I was thinking about the Rolling Stones lyric “You can’t always get what you want but if you try sometimes, you might find you get what you need” and found myself checking the dictionary for the definitions of “want” and “need.” I discovered that “want” is a desire for something that you could live without while “need” is defined as something necessary for survival. It wasn’t much of a leap for me to imagine what these words could mean to patients facing serious illness.


So, please bear with me as I’m not trying to sound clever by saying the obvious – no one “wants” to become seriously ill and, if one does, there will always be a “need” to survive.


To explain where I’m heading with this, let me take you back to my role as a medical humanist on a cancer care team. I observed that patients were frequently overwhelmed by their diagnosis and the medical information being directed at them. In most instances, patients did not know what questions to ask, which indicated they were unprepared to make informed decisions about care. So, when I met with patients, I would ask a series of questions aimed at exploring what they understood about their diagnosis, treatment plan and prognosis, which helped bring into focus what may have been misunderstood or was unspoken at the doctor’s visit. This exercise identified questions that patients “needed” to ask, especially when treatments failed and options might be limited. For those facing serious illness, this was about survival.


Even though today’s healthcare delivery system is complex and a challenge to navigate, patients “need “to recognize their responsibility in asking questions. With this in mind, I used what I learned as a medical humanist to develop SpeakSooner: A Patient’s Guide to Difficult Conversations, a tool to help patients prepare to ask questions about their health status, options for care and resources for support.


Although I like the phrase “You can’t always get what you want but if you try sometimes, you might find you get what you need,” it’s a bit too abstract a message to remind patients to ask questions about healthcare issues. I would suggest using the Guide, which offers a straight forward route to identifying and communicating questions and concerns. I’d leave Rolling Stones songs for dance music.