With a title like “You Will Feel A Pinch“, I couldn’t help but read Marylyn Grigas’ poem in the Bellevue Literary Review. Whenever I’m doing an injection with a numbing medication for a procedure, I say exactly this: “You will feel a pinch, then a burn.” This is just how she begins.
There are so many phrases that I use automatically and repetitively with patients on a daily basis. Leaving the room for the patient to change for a physical exam, I inform: “The gown opens in the back, the paper drape unfolds over your legs.” Performing a Pap smear and gynecologic exam, I explain I’m going to “use my other hand to feel your uterus and ovaries and make sure I don’t feel any masses or anything abnormal.” I listen to the lungs on the back and ask the patient to “take deep breaths through your mouth”, then as I move to auscultate the lub-dub of the heart on the chest I ask them to “breathe normally.” I once had a patient laugh and reply, “What does that mean?” These phrases come out of our mouths, rote habit, without thought as to what a patient, who might be hearing those words for the first time, might perceive.
After much trial and error you discover what tends to work to communicate with patients in a way they can understand. You begin to anticipate the questions they’ll ask, such as if the gown opens in the back or the front, and preempt with answers. But I think over time, over years, it becomes such second nature that the words fall out without pausing to think about the meaning.
Two years ago I had a skin lesion on my back that was bothering me and I asked my doctor to “burn” it off with liquid nitrogen. This type of so-called cryotherapy is a treatment I perform on others regularly. I always warn “this may sting” and have had incredibly varied responses, ranging from people barely flinching to crying out in pain. When my own turn came I was acutely surprised at how painful it was, much more than just a “sting”, both during the application and for several days after. I developed a new empathy for the recipients of my cryotherapy treatment going forward. I shudder when I think of all the coaching phrases confidently uttered to my patients in labor a decade before I experienced labor pains myself.
Why do you think Grigas opens her poem with this oft used warning? What does this phrase seem to make her think of? How does her poem evolve and what do you think it’s about?
Writing Prompt: Think about something you say regularly to patients, almost automatically. Unpack the phrase. Imagine yourself in the patient’s position hearing this for the first time and write from their perspective. What other things might come to mind when a patient hears this phrase? If you’re not a medical professional, can you think of sentences you’ve heard from doctors or nurses that were confusing or funny or easily misunderstood? Write about this for 10 minutes.