Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

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B. Forman and B. Ramshaw
toms. Listening is crucial to the process of recognizing the mind-set of
the patient as he/she attempts to describe not only his/her condition but
also what he/she has encountered prior to this phase of care in attempting
to deal with the condition. The terminology that the patient uses will
probably not be medically correct, so listening to the complete story from
the patient involves getting into the patient’s mind and understanding
what he/she is trying to say and what he/she is feeling. By listening to
hundreds of chronic patients suffering after hernia repair, we have heard
of several patterns:
• The patient did not do research or think much about the decision
to have the repair. The surgeon said it was “no big deal.”
• The patient feels stupid for not doing more research.
• The patient expresses the wish that he/she had known more
about what was going into their body (e.g., that a mesh was
being placed and what type of mesh it would be).
• After surgery, the surgeon would not listen, refused to acknowledge
that the patient was in pain, said that the cause was not the
mesh or the operation and that the pain was “all in your head,”
and told the patient not to come back.
Understanding involves the process of leaving the caregiver’s medical
knowledge in the office and being able to put oneself into the position
of the patient. There are a wide variety of emotional and
psychological reactions on the part of most patients, as well as the physiological
reactions to their medical condition. Fear, confusion, intimidation,
uncertainty, and misinformation are some of the more obvious
characteristics of many patients. Being placed in a medical institution—
whether a doctor’s office, a medical clinic, an emergency room, or
hospital room—is very uncomfortable for many. For the caregiver, this
environment is their normal workday setting. For the patient, however,
it is like a foreign land. Not only is the setting uncomfortable, the language
they hear—words that they cannot pronounce, with meanings that
are either vague or completely unknown—further creates a sense of
mystery and increases the likelihood of confusion and intimidation. In
order for caregivers to be able to deal effectively with the patient and
center their care on the total needs of the patient, they must understand
where the patient is—in a strange place, surrounded by strange words,
and attempting to deal with a situation they may not understand at all.
The caregiver’s understanding of the patient involves much more than
recognizing and treating the medical symptoms; it involves relating to
them as their equal and not their superior.