Heart Language

There is a great post “A Rant on Terminology” at the GeriPal blog (link below). The post from the authors list some of their least favorite terminology used in the Palliative Care field. This hit a chord with a lot of people including myself. There are 23 responses and the comments are great. There were different comments about how we say things such as “Allow Natural Death,” “Heroic Measures,” “Lost the battle with cancer” etc. It got me thinking in how I talk to patients. In my comments I stated …”I think that the words we use are dependent on the person giving them (training, experience, mentorship etc.). I find that we can say most anything as long as you are sincere and compassionate. Patients and families pick up on your “heart” language more than what “exact” words you actually use…” For several weeks I had a medical student shadowing me and we went in to see a consult for pain. This patient was labeled as a “drug seeker” because she was requesting her pain medication every 2 hours on the dot. She had a history of rectal cancer and was >1 week post op without improvement of her pain. The nurses were concerned because she looked “comfortable” but continued to request the pain medication. After reviewing the chart and talking with the patient it was evident that the patient had a history of depression and psychosocial issues that went beyond our scope of practice. It was clear that she was using the pain medication to treat her depression/psychosocial issues. I sat next to her and I was genuinely concerned about her as I did my consultation. I spoke sincerely and directly to her and pointed out that she was self-medicating to mask her problems. She actually agreed with me and stated that she needed help. The patient knew I was speaking from my heart and therefore my “Heart Language” was loud and clear. The lesson that day for the medical student was that we need not be so concerned about the exact words or phrases we use but how we say the words and what body language we are portraying. If we show that we really care, this will be louder and clearer than anything we can say.