Engaging Patient Communication

I was speaking with Dr. James Stubbs: one of our great “thinkers”.

He uses a whiteboard to puts up ideas to talk with patients about.

We were discussing the concept of framing things from a “Vitalistic” versus mechanistic perspective.

We were talking about putting up questions like, “Fever: good or bad?” (If you would like a great discussion on Vitalism vs. Mechanism just click here)

That would lead to discussions like:

If you were camping and knew that the stream water was bad and full of bacteria, what would you do before you drank it?

Of course, you would boil it.

Why?

You would boil it to kill off the bacteria and bad things in the water.

Did you know that bacteria can only live to a certain temperature and that is why innate wisdom or innate intelligence (not innate stupidity) causes a fever?

James and I were talking about putting up a poster with these three basic tenets (which are from the Five Branches of Philosophy that we learn from Pat Gentempo)

1. 1. What do you believe to be true?

1. 1. How do you know it is true?

1. How do you act or behave because of what you know to be true?

Then we could have discussions such as: “Do you believe that fevers are good or bad?” Odds are they will say “bad”. That would be their basic premise or belief, (what you believe to be true?).

We could then have a discussion like this story above which would “poke a hole” in their belief system or “B.S.” causing them to reevaluate what they believe to be true. Realize if you argue with step three, or how they behave (I take aspirin to reduce the fever) because of what they believe to be true (their B.S.)  you will only find resistance!

But if you poke a hole in their belief system first they will realize that if their belief system (B.S.) is not true. Then we can install a new belief system which of course would lead to new behaviors.

Obviously if they now realize that innate intelligence (not innate stupidity) causes a fever to get rid of the bad stuff so we can heal, then what they choose to do when they get a fever would be different than if they believe that the fever was bad.

We were looking at other concepts we could bring up like this. Such as, “Swelling: good or bad?”

The downside to swelling is it hurts, it limits our range of motion, and it may take longer before we can go do the thing we want to do, like play basketball.

The upside, again from a “Vitalistic” perspective, would be to ask the question, “Why would innate intelligence do such a thing?” The swelling does several different good things.

• • First it is a natural brace and keeps us from moving the injured area.

• • Second it brings white blood cells to the area to initiate healing.

• Third it brings blood and nourishment to the area so it can heal.

I think these are great conversations to have with our patients that could really shift their paradigm and consciousness leading to long lasting change.

Here is another good example: Why do we see lipping and spurring on X-rays and are they good or bad?

You would discuss the downsides to lipping and spurring AND from a VITALISTIC perspective why would innate intelligence (NOT innate stupidity) start to lay down calcium and eventually bridge the areas? Clearly to brace the area and stabilize the area. Mom nature is ALWAYS choosing the lesser of two evils. “Hmmm, I could just let this area continue to degenerate eventually severing my spinal cord, not a good thing! Or I could lay down calcium and brace the area. Yes I will have limited range of motion and pain but at least I won’t be paralyzed or die!” Do you start to get the idea?

I sent out an email and posted this on FB and got some really great other metaphors and stories.  I’ll be sharing them over the next few weeks, to spur along the conversation. if you have any you would like to add would you please add them in the “Comment” section of this blog? 

Here’s the first one:

From Dr. Lance Cotteril

Vomit, cough, sneeze, diarrhea…

Hi Russ. Back at school we used the examples of sneezing and vomiting as the base for the question of expressing health or expressing sickness. We had great debates in philosophy class on this. The question can be asked that when the body sneezes: “Is it expressing health or illness?” Our initial answers were that sneezing was a symptom of disease. However if the body was working well and in a healthy state and detected that there was something present in the body that would stop the body from expressing full health, then it would be in the body’s best interest to remove it. If there is a particle or irritant in the nose or throat then the body’s response is to expel it by sneezing. The exact same is true when thinking about vomiting, diarrhea and coughing; although it would be different toxins and irritants that the body is trying to expel. The more pertinent question can then be asked would it be more concerning if the body wasn’t sneezing, coughing or vomiting when there are toxins and/or irritants present in the body? (Dr. Cotteril, I agree 100%! Remember it is innate INTELLIGENCE not innate STUPIDITY! Innate wisdom is ALWAYS making choices that will lead to survival even if it does not look that way. It is ALWAYS choosing the lesser of two evils… until it cannot… – Russ)