OPINION
DOCTORS' Lounge
the fears of the patients we have cared for,
and perhaps lost, before this one.
Reading any chemo informed consent is
an exercise in progressive misery. Yet some
people have less intense side effects, and
some people have all of them in spades. How
much to tell people first, when the truth lies
squarely in “bad road ahead” territory, is an
exercise in caution, but also a duty to warn.
We do not want the patient to be blindsid-
ed, but saddling them with overwhelming
fear might cause them to refuse tests and
treatment that we think could really help in
the end. So we speak carefully yet honestly,
answer questions thoroughly, and hope that
the intended message got through clearly.
But, doctors lie too. We might lie by
omission; we too might lie on purpose, to
cover up a mistake if we can; we might hate
to make ourselves look uninformed or out
of date, and lie by guessing. We lie and say
we are fine when we are so angry with the
world we can barely walk, or we share our
feelings with the patient, which is helpful
at times. After all, it’s a partnership. If a
patient lies to you and that lie makes you
angry, stop and think: why? What did that
mean to me, and to him? Then ask: “Why
is it important for you to see it this way?”
How often do our patients lie to us, or
just not tell the truth, the whole truth, so
help them God? According to psychiatrists
who study such things, people lie to their
doctors fairly often. Humans do this to
avoid looking bad in some way; to make
someone else look bad; to avoid shame; to
avoid criticism; to avoid losing respect; to
cover up something else; to get something
we want; to self-aggrandize; and to get some
kind of praise or attention that is lacking
in our lives. Some people lie all the time,
to themselves and to others, as a matter of
course. Some people invent alternate lives
and to them, these things really happened.
Patients who have lost touch with reality
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House Calls
WE KNOW YOU ARE BUSY SO LET US
COME TO YOU!
are not lying so much as describing their
current worlds.
As for our current world: telling the
truth as we see it is how we will survive.
Telling the truth is living with your real self.
Telling the truth can be hard in the moment,
but easy in the long run. Telling the truth
is how you avoid self-pity and enjoy being
grateful.
Telling the truth is, simply, the difference
between honor and disgrace. As Aleksandr
Solzhenitsyn said, “Violence can only be
concealed by a lie, and the lie can only be
maintained by violence.”
Dr. Barry practices Internal Medicine with
Norton Community Medical Associates-Bar-
ret. She is a clinical associate professor at the
University of Louisville School of Medicine,
Department of Medicine.
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NOVEMBER 2018
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