Doctors don’t really speak in code, no matter what you think. Sometimes we say the same things so many times that we forget that you don’t completely understand. Or your interpretation may be a little bit different than what we really meant.
So, when your doctor says: “This is only going to hurt a little bit.” He means that the pain will be short and intense. Usually this is in relation to a shot. Some doctors will say “this won’t hurt me at all.” Usually by the time you figured that one out, they’ve done whatever they were going to do. One of my doctor friends says, “My favorite is the blunt truth. ‘This is going to hurt like bloody Hell for a few seconds.’ Then when it’s over, they either agree or are relieved because it wasn’t as bad as they thought it would be.”
Then there is the phrase “You are going to feel a little pressure.” You know, like that guy in the movie who got his arm pinned under a boulder and it hurt so bad that he cut his own arm off kind of pressure. And we doctors have a long running debate over who invented the phrase “discomfort”. Was it the surgeons, the OBGYN’s or the dentists?
Interesting that there are so many different styles for the same issue!
“Take a deep breath.” She means either “I need you to relax” or “this is going to hurt a little bit”. “You need to relax” means that you are so stiff and tense that there is no way she can figure anything out except you have good muscle tone. If your muscles are really tight when examining your belly, for example, it is impossible to tell if there is a big mass in there, or where exactly the pain is.
“Please use inside voices” means that your children are giving everyone a major headache with their yelling. As a parent, you have probably used that one with your children on many occasions yourself. One of my Emergency Room doctor friends shared this one with me: “My, he seems to have a lot of energy.” This means: “If we can’t catch him to examine him, he’s not sick.”
When the doctor is listening to your chest, sometimes he is listening to your heart, and sometimes he is listening to your lungs. If he wants to listen to your lungs, he wants you to breathe deeply. If he is listening to your heart, breathing deeply will mask some of the heart sounds, so you need to “breathe regular” or “breathe softly”. Talking during this part of the exam makes anything hard to hear.
Some doctors will talk to you while doing something just to keep your mind off what is happening. Other doctors are quiet when they are stitching or looking in your eyes or something. If you want to know what they are doing or what they see, you can ask.
Lots of us have been giving speeches or instructions about the same things for a long time. Some of my doctor friends tell me that they tend to “zone out” when giving speeches that they have given a lot. I refer to that as “speech number 124” syndrome. My lips are moving, but only part of my brain is engaged, because I have said the same thing so many times before. We all have standard speeches, depending on our specialties. This is because so many people have needed to hear them before. We will probably have to give them again and again. My allergist friend’s examples are dust mite avoidance, pet allergen avoidance, difference between types of asthma meds, and immunotherapy risks/benefits. I’m sure he gives each of those at least once a day, if not more.
Doctors are concerned about your health. Your doctor will prescribe the medications that she feels is best for your condition. If she feels you have an infection that needs antibiotics, you will get a prescription. If, on the other hand, you have a virus, it is not a good idea to take antibiotics. We all get frustrated when people push for prescriptions that they don’t need. My expression is that, “A virus will get better in 7 days without an antibiotic and a week with one.” (That’s the same amount of time, in case you missed my joke). Your doctor will listen to your lungs or check your belly or whatever is indicated by your symptoms, and make a decision. Medications that aren’t needed can cause side effects. Plus, your bacteria get “smart” and develop immunity to the antibiotics. That’s how we got MRSA. Three different doctors begged me to put this in.
When a doctor says, “That’s a lot of things on your list. Which is the most important to address today in case we don’t have time to hit them all?” he is concerned about how many problems you want to deal with today. Most doctors have a limited amount of time scheduled for each patient. You need to pick the most important problem first. You may have time for two per visit and you have 10. Please pick and reschedule the others. It isn’t that the doc doesn’t care about your problems; he just doesn’t have time for all of them at this visit.
When it comes to changing lifestyle habits, what a doctor says, what we think you hear and what we really mean tend to be different things. Here are some examples from some of my doctor friends:
When your doctor tells you that you need to exercise more, you think, “Yeah, I’ll park a few spots farther away at McDonalds”. The doctor meant, “You need to hit the treadmill for 30 minutes, five days a week”.
When a doctor says, “I’m concerned about your drinking,” he/she really means, “Dude, you’re an alcoholic!”
When you are told by a physician, “I don’t really feel comfortable prescribing narcotics for this condition.” The doctor means, “You are an addict and drug-seeker and the answer is ‘No.'”
When your doctor says, “you need to lose some weight”, patients hear, “5-10 pounds would be enough”, when we really mean 50-200 pounds or so. Another doctor tells me that the basic principle of all diets is to “eat what you don’t like and don’t eat what you like”.
A friend of mine says that her spiel about smoking is, “When you have an upper respiratory infection, it is best if you stop smoking for a while, or cut way down…” Way down, like none at all, but she figures you know that and she doesn’t need to actually tell you how bad this is for you, “you moron”.
Another doctor gets a little upset when people tell him, “I know my own body, and I always get a Z pack and it always works.” He just sits there and cringes. He says he has often wanted to ask them, “Well if you know your own body so well, where is your hyoid bone?” He has never actually said this to a patient but wanted to often, just to see the expression on their face….
“You really need to find a primary doctor,” means that the doctors and staff are sick of seeing you once a week in the ED or the urgent care clinic. It might be better to get a pediatrician, family physician, internist, or whatever specialist you need for your care, and be seen in the office on a regular basis, instead of getting irregular care by a different doctor each time in the high cost emergency room.
“She might be a little bit anxious.” Means to one doctor that she’s hysterical and in the movies they’d slap her. I enjoyed that one.
And, of course, a long standing “joke” among doctors is that “all bleeding eventually stops…”
I would like to thank the many physicians who will (for obvious reasons) remain nameless who contributed their favorite phrases to this article.