Book Publications The Columbia Presbyterian Guide to Surgery

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But what if I get the sense that I'm bothering the doctor if I come back with more questions or ask to hear something over again?

If you are not comfortable enough with the responses from the physician and staff you are consulting with, you have a couple of options.

One is to confront the physician with your feeling that your concerns are being rebuffed. Most will respond to that. You can press the doctor in a direct and firm way. "So, you are telling me my only surgical option is a mastectomy? What if I refuse to have a mastectomy? What other options are available to me?"

Of course a doctor can be a skilled surgeon, yet may have difficulty talking to his patients. Or he may be a world-renowned specialist with time restrictions even greater than the average doctor's. In those cases, your concerns still should not be ignored. You can say, "I am not happy with how unavailable you are for my questions but I don't want to switch doctors. Can we work out a way I can get my questions answered?" The doctor should understand your need to know more and connect you to a medical professional on his staff who is qualified to answer all your questions in his stead.

If you still don't think the doctor is being responsive enough, you can go to another doctor. Consider whether you want to put yourself in the hands of a person who can't communicate adequately with you, and who, when you express your concerns, still resists giving you appropriate information about your condition.

How am I going to remember all the information I'm getting?

Estimates show that within twenty-four hours, about 75 percent of what a doctor discusses with a patient is usually lost. Without a doubt, there is a great deal you have to absorb and consider. You may be feeling ill or anxious, and in any case, hearing the risks of disease and surgery are not part of your normal routine.

There are several ways to overcome that loss of information. Remember what works for you when learning something challenging. What would you do in your job, for example, when you're taking on a new task? You can apply the same techniques here.

• Simply listen. For some people, that's all it takes.
• Repetition. The first discussion you have with a physician is not likely to be your last. He expects to repeat information to you; you will also hear the information again from staff, such as the PA. And you can read about the topic in the materials you've gathered. Redundancy here is not a waste of time; it reinforces your learning.
• Bring someone with you. A friend or a family member can help you remember and discuss what was said. It is an invaluable asset to have a "lay consultant" with you when you visit the doctor. Since your companion is not personally on the line in the same way you are, he is likely to hear the information more clearly.
• Take notes. If you're comfortable doing so, bring a pen and paper and write down key points during your visit.
• Tape the discussion. You can play it back in the quiet of your home later, as well as share the information directly with family members. Some doctors also make a tape, especially when they are confirming your informed consent to a procedure. You can ask for a copy of that tape.

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