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What Doctors Cannot Tell You: Clarity, Confidence and Uncertainty in Medicine
Kevin B. Jones, M.D.
By
Published: Aug 08, 2012
Category:
Non Fiction
A friend was about to get a heart transplant.
I asked his wife, “Does the surgeon think he’s God?”
“Father and Son,” she said.
She smiled. I smiled. In surgery involving the heart and brain, you don’t want Dr. Ambivalent. My friend is now on year six of his new heart.
Kevin B. Jones, M.D. is an orthopaedic surgeon and scientist at the Huntsman Cancer Institute and Primary Children’s Medical Center at the University of Utah.
Translation: bone surgeon.
Here’s the first sentence of his book: “I have only been fired by a patient once.”
Stunning. And also just what you want in a bone surgeon — and in the author of a book called “What Doctors Cannot Tell You: Clarity, Confidence and Uncertainty in Medicine.”
Jones, who did time as an English major at Harvard, is that rare doctor who knows what he knows and is honest about what he doesn’t. He sees nothing wrong with sharing uncertainty to a patient. He has a higher priority: clear communication. Because it’s not about what the patient wants to hear but what he/she needs to hear.
Like this:
A patient came to me for surgery to remove a tumor that had recurred after surgery by another specialist. The patient and her husband had celebrated with champagne and a big dinner out after hearing from the first surgeon that his surgery had been successful, that he had gotten it all. The only problem was that he had not gotten it all. It came back in a matter of weeks. When I discussed with them — much more cautiously, with much less apparent confidence — that I felt I had on a second surgery gotten it all, but that there remained many uncertainties, they lifted no champagne glasses. They trusted me, but it was a different kind of confidence. It was confidence based on their assessment of my honesty, rather than my bravado.
“What Doctors Cannot Tell You: Clarity, Confidence and Uncertainty in Medicine” is not a book about the kind of cases you see on “House.” Most patients don’t present such one-offs. And the brand of “differential diagnostics” as practiced by Hugh Laurie requires a genius/jerk at the head of the team. On the strength of this book, given the choice between Hugh Laurie’s character on “House” and Kevin Jones, I’d take Jones every time. [To buy the book from Amazon, click here. For the Kindle download, click here.]
The point of the case histories in his book, Jones writes, “isn’t to encourage you to marvel at the skill of the people in the white coats. It’s to help you learn to talk to your physician, how to understand what she or he says. And then it’s to help you to ask your physician to invite you more fully into that privileged space, not as subject alone, but as the interested party.”
The stories are vivid and dramatic, but always human-scaled. The outcomes are not all happy. The doctor is, however, invariably honest, forthcoming, and — on the topic of his colleagues — occasionally withering. [To read an excerpt, click here.]
If you or a loved one are contemplating surgery, this is required reading. If you’re just getting a jump on a future that might include surgery, it’s almost more valuable — in matters this serious, you don’t want to make a decision on a firm handshake and an explanation you couldn’t possibly understand.
