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    “Doctor, what would you do?”

    Choosing your words wisely

     

    Dr. Afshar is a third-year resident in the Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center in Los Angeles, CA. 

    In the last week, I have had two patients look me straight in the eye and ask: “Doctor, what would you do if you were in my place?” The first patient was a 39-year-old G4P0 with IVF di-di twins at 22+0 weeks with preterm premature rupture of membranes. The second patient was a 69-year-old with recurrent Stage IIIC papillary serous ovarian carcinoma coming in for her third bowel obstruction in 12 months.

    As a disclaimer, I am not one who is generally shy or short of opinion. And yes, I do have opinions in both patient cases. But that is not the real question the patients asked me. I remind myself that in that moment, patients do not really want to know what I would do; rather, they need help making informed decisions for themselves. These straightforward and raw conversations have become some of the most difficult challenges for me to tackle as a resident. Though residency trains us to answer questions confidentially and directly, these patient queries require a mastery of precise diction that, for physicians in training, sometimes is lost in the deluge of new information. I watch one of my brilliant attendings coordinate an eloquent dialogue of calculated word choice with continuous teach-back with her patients and it gives me something to strive for.

     

    Yalda Afshar, MD, PhD
    Dr. Afshar is a Maternal-Fetal Medicine Fellow in the Department of Obstetrics and Gynecology, University of California, Los Angeles

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