Truth is the best medication

Even if you’ve never seen the film, Some good menMost of us have heard the Jack Nicholson line,

“The truth? Do you want the truth? You cannot manage the truth! ”

A recent study has identified truth As one of the best needs of patients confronted at the end of life. For years, medicine has adopted Jack Nicholson’s approach and has been paternalistic. You cannot manage the truth, so we will continue to make treatments and hope you do not notice that you are weakening and more fragile.

To defend the doctors and caregivers who acted in this way, the reflection process was in fact that they did not want to remove the hope of a patient, so they continued to offer more and more treatments. It turns out that truth is a better option for many reasons.

Hope is a complex thing

Now hope is a complex thing. What we sometimes seem to think is that the only hope of a patient is for a complete healing, and if we evoking the subject of death, the patients abandon.

Families often buy in this state of mind, or even promoted it by asking the doctor not to tell them what is happening and not to tell the patient. Culturally, this can be appropriate for some, but more often than not, it is this conspiracy of silence, where the family thinks that patients do not know how sick they are, and the patient does not think that the family knows how sick he is, and until someone calls him, everyone goes against the other.

I even heard of patients who do not openly discuss being towards the end of life with their doctors by desire not to upset the doctor! As a patient told me when I announced that her doctor had referred to the hospice: “Well, it’s time for him to admit that I was dying!”

Treat me like a person and tell me the truth!

In the study I mentioned above, the two highest elements of spiritual needs were …

1. Be treated like a person
2. Be telling the truth.

Hope was there, but much further on the scale. People prefer to know the truth, and be able to face it and plan for that, rather than giving it hope in a lie. False hope is worse because it prevents us from dealing with things we would like to do if we only knew it.

The mentality of the “lottery”

I know doctors who tell me that patients all want each new treatment. They seek and ask, but really, they ask for this treatment, or an honest opinion on the fact that the doctor thinks that it could be something that could really work, or is it just a pipe dream?

Admittedly, there are patients who live on what I call the “lottery mentality”. To describe this scenario, think of the last time that the MEGA Millions lottery has reached a ridiculously large number. It seemed that everyone and their brother bought tickets.

Some people buy tickets whatever happens, and both seem to have the concept that “someone wins”. When you buy a ticket, you often dream of everything you will do if you win. However, unless you are totally blind and naive, you do not leave your job before the winning figures are drawn. You dream of winning, but you plan to win, which is by far the most likely scenario.

Sometimes, in medicine, those who have the “lottery mentality” leave their work, so to speak, by not focusing on the necessary and important aspects of their own lives, but by putting all their energy in this lottery.

Tragically, someone can win, but more likely that it will not be him. And when they realize it, they have lost a precious opportunity, which they can never recover. Shame on us to have allowed this to happen in the name of what is called hope. The real hope is for an honest doctor, an honest companion on the trip.

The bottom line

The main thing? An open discussion is the way to follow. Honest communication does not need to be dark and unhappiness, even if the perspectives are horrible. Honor the patients as people and give them the truth.

Jack Nicholson was wrong. We not only CAN Manage the truth … we REQUEST he.

Last update: November 5, 2018