Making Decisions Together

Simmons bylineI love working with kids. It’s one of the reasons I got into this gig, and it makes the day fun. Now having kids of my own, I identify more and more with the parents bringing their kids in for surgery. A couple years ago, we had to take my oldest in for a procedure. I had done this procedure myself with other kids plenty of times, but when it’s your kid it makes you crazy.

Yesterday, I had a father come in with his young kids, and it was a very typical appointment for me. The two kids had audiograms and exams that told me they needed ear tubes, which I told him.

“Can’t we wait until they can tell us that there’s a problem?” he asked me. “Like, they’ll say that their ears feel full or can’t hear as well.”

I could relate, really. It’s hard to make a decision involving risk for someone else, whether it’s a kid or an aging parent. Surgeons have to make these types of decisions for patients quite a bit, and even when you have data on your side, it’s hard.

It comes down to each person’s evaluation of risk and benefit. While my colleagues and I try to enter into that decision with the patient and their families, we all hesitate to make a decision for you and yours. Given a hand of poker, each person will play his cards a little different.  One player can never fully fold, bet, or bluff like another.

As physicians, we can coach, and we can advise, and we should empathize.  It’s part of why I think of medicine in some ways (not all) as a priestly profession. That’s a vulnerable and tender place to enter into with a patient, and sometimes we can only sit there together, heads down and hands folded, thinking out loud about the problem together.

As people, I hope we can take the time more and more to do this for each other. I hope as a society we could come more and more to that place together as we talk about even larger problems.