Doctor, I've got this thing in my ... but it might not be a thing ...
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Version 0 of 1. Many of us are rubbish at talking about problems in our nether regions. And the linguistic barrier can preclude our seeking the right help. If I tear a muscle, or incur a less-than-ordinary-sized cut or bruise, I’m brilliant at talking to my GP. I’ll sit down, inquire about their day, and springboard confidently into a lengthy colloquy about, well, everything. From what I did to what I’d like done about it, to what’s oozing out of where and which colours have so far made up my injury’s gaudy trajectory, I leave nothing to the imagination. But when it comes to talking about things “down there”, you’ll no doubt have already guessed that my descriptive accounts are reduced to mere code. In fact, it’s worse than that. Sometimes I just leave things to gesture and insinuation. In a manner redolent of the painfully uncomfortable Simon Amstell in Grandma’s House, I tell my doctor – my daft upward-inflecting tone making everything sound more like a question than a statement – that I’ve got this thing, but it might not be a thing, you know ... in my, you know ... I mean, is this normal? Help me? To be reasonable, though, that kind of dilly-dallying isn’t entirely my fault. As products of our learning, we are constantly modifying our behaviour in response to even the slightest whiff of disapprobation, and in the past, sometimes using anything less than the Latin term for something “down there” has garnered frowning, mild laughter or indirect correction on my doctor’s part. I’ve had some fantastic doctors over the years, but in an environment where sex becomes “intercourse”, contraception is “birth control” and poo is translated as “stools”, we as patients are aware of a linguistic distance between the terms we are familiar with and those deployed in leaflets, on websites and by some GPs. It surely isn’t surprising, then, that we feel a distance from the nether areas themselves, the very term connoting a hinterland of unspeakable filth. I’m not suggesting that there is a direct link between our inability to find the right words and our discomfort around – and perhaps delaying of – seeing our GP when we present with unusual symptoms. But talking to doctors about our private areas can be embarrassing at the best of times. In terms of a solution, there is no antidote to our feeling awkward about certain body parts, but as part of their pastoral role GPs ought to mirror the tone and language of their patient. If a patient says “sex”, for example, a doctor’s referring to it as “relations” immediately afterwards can feel corrective and intimidating, and may discourage the person from talking about it in the future. There is a line to be drawn – bantering about a patient’s “wonky womb” would be inappropriate – but, where possible, doctors should let patients lead when it comes to the language they are comfortable with in their surgery. There is a wider point to be made here: not only can medical language feel distancing, it can also close down discussion. Whether we’re referring to the areas we are less comfortable with or otherwise, medical jargon – specifically acronyms, Latin terms and difficult scientific explanations delivered at a rate of knots – can leave patients feeling less than fully informed about their condition. In a 12-minute timeslot, GPs are hard-pressed to deliver complex information swiftly and in easily digestible form, a skill that must be extremely challenging to hone. What we need, therefore, are well-disseminated standards set collaboratively by patients and doctors – local patient participation groups could provide a vehicle for this – that include guidance on appropriate language and a requirement for doctors to check a patient’s understanding of the information given. The internet is the go-to resource for most people wanting extra information about their diagnosis, but we cannot assume that this is always as available or as reliable as a GP. Feeling embarrassed when it comes to certain parts of our body is a natural part of the human experience. It becomes a problem when these areas may need urgent medical attention. GPs must take the lead in putting patients at ease, and support them to discuss their symptoms using words that are familiar and uncomplicated. |