Here is the full text of physician Leana Wen’s talk titled “What Your Doctor Won’t Disclose” at TED Talk conference.
Leana Wen – TED Talk TRANSCRIPT
They told me that I’m a traitor to my own profession, that I should be fired, have my medical license taken away, that I should go back to my own country.
My email got hacked. In a discussion forum for other doctors, someone took credit for “Twitter-bombing” my account.
Now, I didn’t know if this was a good or bad thing, but then came the response: “Too bad it wasn’t a real bomb.”
I never thought that I would do something that would provoke this level of anger among other doctors.
Becoming a doctor was my dream. I grew up in China, and my earliest memories are of being rushed to the hospital because I had such bad asthma that I was there nearly every week.
I had this one doctor, Dr. Sam, who always took care of me. She was about the same age as my mother. She had this wild, curly hair, and she always wore these bright yellow flowery dresses.
She was one of those doctors who, if you fell and you broke your arm, she would ask you why you weren’t laughing because it’s your humerus. Get it?
See, you’d groan, but she’d always make you feel better after having seen her. Well, we all have that childhood hero that we want to grow up to be just like, right? Well, I wanted to be just like Dr. Sam.
When I was eight, my parents and I moved to the U.S., and ours became the typical immigrant narrative. My parents cleaned hotel rooms and washed dishes and pumped gas so that I could pursue my dream.
Well, eventually I learned enough English, and my parents were so happy the day that I got into medical school and took my oath of healing and service.
But then one day, everything changed. My mother called me to tell me that she wasn’t feeling well. She had a cough that wouldn’t go away, she was short of breath and tired.
Well, I knew that my mother was someone who never complained about anything. For her to tell me that something was the matter, I knew something had to be really wrong.
And it was: We found out that she had stage IV breast cancer… cancer that by then had spread to her lungs, her bones, and her brain. My mother was brave, though, and she had hope.
She went through surgery and radiation, and was on her third round of chemotherapy when she lost her address book. She tried to look up her oncologist’s phone number on the Internet and she found it, but she found something else too.
On several websites, he was listed as a highly paid speaker to a drug company, and in fact often spoke on behalf of the same chemo regimen that he had prescribed her.
She called me in a panic, and I didn’t know what to believe. Maybe this was the right chemo regimen for her, but maybe it wasn’t. It made her scared and it made her doubt.
When it comes to medicine, having that trust is a must, and when that trust is gone, then all that’s left is fear.
There’s another side to this fear. As a medical student, I was taking care of this 19-year-old who was biking back to his dorm when he got struck and hit, run over by an SUV. He had seven broken ribs, shattered hip bones, and he was bleeding inside his belly and inside his brain.
Now, imagine being his parents who flew in from Seattle, 2,000 miles away, to find their son in a coma. I mean, you’d want to find out what’s going on with him, right?
They asked to attend our bedside rounds where we discussed his condition and his plan, which I thought was a reasonable request, and also would give us a chance to show them how much we were trying and how much we cared.
The head doctor, though, said no. He gave all kinds of reasons. Maybe they’ll get in the nurse’s way. Maybe they’ll stop students from asking questions. He even said, “What if they see mistakes and sue us?”
What I saw behind every excuse was deep fear, and what I learned was that to become a doctor, we have to put on our white coats, put up a wall, and hide behind it.
There’s a hidden epidemic in medicine. Of course, patients are scared when they come to the doctor. Imagine you wake up with this terrible bellyache, you go to the hospital, you’re lying in this strange place, you’re on this hospital gurney, you’re wearing this flimsy gown, strangers are coming to poke and prod at you.
You don’t know what’s going to happen. You don’t even know if you’re going to get the blanket you asked for 30 minutes ago.
But it’s not just patients who are scared; doctors are scared too. We’re scared of patients finding out who we are and what medicine is all about.
And so what do we do? We put on our white coats and we hide behind them. Of course, the more we hide, the more people want to know what it is that we’re hiding. The more fear then spirals into mistrust and poor medical care.
We don’t just have a fear of sickness, we have a sickness of fear. Can we bridge this disconnect between what patients need and what doctors do? Can we overcome the sickness of fear?
Let me ask you differently: If hiding isn’t the answer, what if we did the opposite? What if doctors were to become totally transparent with their patients?
Last fall, I conducted a research study to find out what it is that people want to know about their healthcare. I didn’t just want to study patients in a hospital, but everyday people.
So my two medical students, Suhavi Tucker and Laura Johns, literally took their research to the streets. They went to banks, coffee shops, senior centers, Chinese restaurants and train stations. What did they find?
Well, when we asked people, “What do you want to know about your healthcare?” people responded with what they want to know about their doctors, because people understand health care to be the individual interaction between them and their doctors.
When we asked, “What do you want to know about your doctors?” people gave three different answers. Some want to know that their doctor is competent and certified to practice medicine.
Some want to be sure that their doctor is unbiased and is making decisions based on evidence and science, not on who pays them.
Surprisingly to us, many people want to know something else about their doctors. Jonathan, a 28-year-old law student, says he wants to find someone who is comfortable with LGBTQ patients and specializes in LGBT health.
Serena, a 32-year-old accountant, says that it’s important to her for her doctor to share her values when it comes to reproductive choice and women’s rights.
Frank, a 59-year-old hardware store owner, doesn’t even like going to the doctor and wants to find someone who believes in prevention first, but who is comfortable with alternative treatments.
One after another, our respondents told us that that doctor-patient relationship is a deeply intimate one — that to show their doctors their bodies and tell them their deepest secrets, they want to first understand their doctor’s values.
Just because doctors have to see every patient doesn’t mean that patients have to see every doctor. People want to know about their doctors first so that they can make an informed choice.