Bedside Manner from Hell

Perhaps the doctor with the worst bedside manner ever was also thankfully fictional. Step forward Dr. Gregory House star of the long-running TV drama House. He was played by actor Hugh Laurie as a brilliant diagnostician with the bedside manner of Atilla the Hun. A drug addict, liar, and cheat, he cared nothing for the feelings of his patients or friends. No wonder the show was so fantastically popular.

How important is a good bedside manner?

On one end of the caring, or rather not-caring spectrum, you had House and at the other end was Dr. Wilson the touchy-feely oncologist. So, what kind of doctor do you require, and how important is a good bedside manner?

A House-like doc would undoubtedly terrify me, but he was famously skilled and might be the only one who could identify my rare condition; wasn’t it always something to do with Lupus? But I’m not sure about Dr. Wilson either. I don’t want a doctor to put his arm around my shoulder. My doctor isn’t my friend and anyway too much empathy would probably leave me sobbing into a tissue.

Most of the time I want a straight shooter...

I’m guessing like most people I want a straight shooter, who while not uncaring just tells it like it is and does a professional job.

But when you are about to receive some serious medical information, what the hell let’s say a diagnosis of prostate cancer, I want to hear it from a doctor. Let me explain.

Who broke the news to me?

After seeing blood in my urine, a digital rectal exam was followed by a PSA test (5.03) which was the precursor to an MRI scan. On the day my test results were in I was kept waiting for some considerable time. Finally, I was called through by a junior member of the hospital staff, to this day I’m not sure what his role was, perhaps a nurse, but he was a young kid and certainly not a doctor.

He pulled up my scans on the computer monitor and pointed out what he said was a 2mm tumor towards the bottom of my prostate. Obviously, I didn’t want to hear this information but just as importantly I didn’t want to hear it from him. This was a life changing event for me, and I wanted someone with the initials MD after their name to explain what kind of hell I was getting into.

Making decisions without all the information

The doctor arrived, rather out of breath, and said it certainly looked like cancer, but a biopsy was required for complete confirmation. By now, feeling a little faint I lay down to collect myself only to hear the kid suggesting to the doc how many samples would be taken from my prostate during a biopsy. The doctor slapped him down and decided for himself what form the biopsy would take as he was the one who was about to perform it.

Sitting in the waiting room, prior to the biopsy, I was approached by a researcher who wanted to put me on a prostate cancer trial to which I replied, "Yes sure, but it’s not been confirmed that I have prostate cancer yet unless you know more than I do."

Once again, I felt rattled, this was not a conversation I wanted to have unless and until the cancer was confirmed.

It's about putting people first

Hospital staff diagnose cancer in patients every day, it must be a commonplace, but it’s not commonplace to the patient. A cancer diagnosis is huge and how this information is delivered to the sufferer requires careful thought. It shouldn’t be a series of random messages coming from people who are barely qualified.

And one last thing, I see on this website in comments and elsewhere that some doctors still refer to hormone therapy as chemical castration. I don’t care how accurate that phrase is, it should never, ever be used by anyone in the medical profession to a patient. If you want a form of words that provide the perfect example of the worst kind of bedside manner, you need look no further.

Doctors need to step up

Doctors are likely to be with us at some of the most critical points in our life and they and those around them need to learn how to deliver difficult or life-changing information in a caring way. But above all, they need to show up and deliver it themselves and not outsource this responsibility.