What Does “I’m Fine” Mean for Cancer Patients?

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Why does the response “I’m fine” so easily roll off the tongue of patients when they are asked by their doctors how they are doing? Dr. Malcolm DeCamp explains how asking probing questions is the key for getting a more explicit answer. Tune in to learn more. 

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.  

Susan Leclair:    

Dr. DeCamp or Dr. Paik, if you want to shift to the visiting team on this one, if you were talking to my brother-in-law, and I wasn’t having my hand around his neck, what do you think of the word fine? I know a lot of guys, in particular, want to be the John Wayne type. They’re stoic. They’re fine.  How do you break through that? What advice do you give to them to say you can’t afford to tell me that?

Dr. DeCamp:       

I think you have to learn to ask the probing questions and read body language and hopefully connect with your patient on some sincere level. I’m a big believer in telling them to bring more ears into the room. I like it when they bring family—their spouse, their significant other, their children. Daughters are especially effective, because I can look at the daughter, and she’ll just be shaking her head. 

Susan Leclair:     

Busted.

Dr. DeCamp:       

I think that’s both on the receiving information side important that you have someone there who can corroborate it, because then the patient is sort of in a position where they can’t mislead you. And it’s also important when you deliver a message, because, you know, I think I’m as articulate as I can be, and the patient can listen and not hear any of it.

The more times that there are other ears in the room, I’m okay with it. If they want to bring the tape recorder in, I’m okay with that, except a third of the time it works. The iPhone now, it’s like conference calling the extended family is okay. But I think there’s nothing like having other ears in the room to validate the communication in both directions.  And I think you just have to probe. How much are they sleeping a day? How much pain medicine are they taking? How active are they? Oh, yeah, I’m walking a mile, and the family is all shaking their head no. 

How’s your war on tobacco going? It’s a teachable moment to reinforce the—often, they’re pretty good about quitting around the time of surgery but then use those post-op visits to reinforce that.  So again, when there are more people in the room, you know, then that—I’m sure they get berated on the ride home.

“I can’t believe you said that to him.”  You know, or they’ll say, “I can’t believe you ratted me out.”

Susan Leclair:     

Or that he never told me that.  Yes, he did. I have it down in writing. 

Dr. DeCamp:       

I think that give-and-take is good, because it’s like having any kind of meeting.  There needs to be some deliverables at the end of meeting like this is kind of what I expect you to do between now and the next time I see you, which is A) forget about us. Go out and live your life. But I want you to walk every day. I’m going to wean you off pain medicine over this period of time. It’s not about that day, but it’s about making progress.

And reminding them they’re going to get anxious by the time their next visit comes up, because we get into that surveillance mode, and they hopefully do forget about us.  But then, when that appointment is looming off there in the, you know, not-so-distant future, they start to worry about it.  And just reaffirming that that’s normal and that the longer you go in that survivor mode that hopefully those visits space out, and you’re feeling those feelings less often.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on October 14, 2015