Fighting, battling, and beating: combat metaphors in medicine are just wrong

 

Articolo di Carolyn Thomas su MyHeartSisters.org

These wartime references are metaphors as described by Dr. Jack Coulehan, a physician, an award-winning poet, and editor of the 5th edition of The Medical Interview: Mastering Skills for Clinical Practice, a best-selling textbook on the doctor-patient relationship. Dr. C explains that there are several basic metaphors used in medicine that to a large extent generate the vocabulary of doctor-patient communication – but can also unintentionally objectify and dehumanize the patient.

Here are three of the most prominent metaphors you’re likely to encounter in health care:

 

Parental (paternalistic) metaphor

Disease is a threat or danger  (“She’s too sick to know the truth”)

Physician is a loving parent/ patient is a child  (“We don’t want him to lose hope”)

Engineering metaphor

Disease is malfunction   (“He’s in for a tune-up”)

Physician is an engineer or technician  (“Something’s wrong, doc – you fix it”)

Patient is a machine  (“We need to ream out your plumbing”)

War metaphor

Disease is the enemy  (“I treat all my patients aggressively”)

Physician is a warrior captain  (“She’s a good fighter”)

Patient is a battleground  (“The war on cancer”)

Dr. Coulehan believes that contemporary medicine has now largely abandoned the parental (or paternalistic) metaphor, perhaps the most prevalent way of thinking about the patient-physician relationship in the good old days.

But try breaking that news to the Emergency Department physician who misdiagnosed me despite my textbook heart attack symptoms in 2008, and – just as alarming! – the ER nurse who returned to my bedside and sternly warned me after the doc had left my cubicle:

“You’ll have to stop questioning the doctor. He is a very good doctor and he does not like to be questioned.” continua a leggere