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Speaking to Your Doctor

The key to health may be knowing when to listen, when to talk.
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WebMD: You write about your spiritual life and belief in the unexpected. What did you learn from your patient who had a melanoma and lost a lottery to participate in the clinical trial of a drug you were researching? The patient ended up miraculously curedon a drug you felt might only hold him for a few months.

Groopman: As I said in the book, my colleague called me Pygmalion and said I was deeply in love with my own work. The drug we were so excited about ended up having no meaningful effect on human cancer. Men were not mice. I was intoxicated by laboratory science, when I should have scrutinized the research with humility.

WebMD: What do you do with the patient who has seen an alternative provider who's told him he doesn't need the established treatment you feel is necessary?

Groopman: I respond honestly. I'm open-minded. There are certain things like acupuncture which have been shown to be helpful. ... Alternative providers look in the patient's eyes and hold his hand and ask how stress is affecting this or that symptom. The doctors [working in managed care settings] don't ask about the patient's family and feelings and the social context in which the illness occurs. The patient feels he's a disease, a case. What we find is that people who flee traditional medicine do so because they feel they're not being listened to.

WebMD: Is there a "diagnostic test" to determine when your doctor is not listening?

Groopman: I go back to the story of my infant son. We had been driving cross-country on the July Fourth weekend and had already seen one doctor in Connecticut who dismissed my wife's concerns that Steve was seriously ill. Then when we got to the emergency room in Boston, the surgical resident seemed so tired and anxious to get some sleep. My wife [also a physician], who is a very organized thinker, gave a crisp and complete recitation of the last 24 hours. But when the resident started examining our son, he began asking, "When did you last nurse? When was his diaper changed?" -- all the things we had just told him. We knew he wasn't listening and that we had to go around him to save our son.

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