What we say and what we mean

What we say and what we mean.
A patient’s relative was discussing treatment options for his patient. The patient had an advanced cancer for which most standard treatments had failed. We were discussing the feasibility of additional chemotherapy.
“This treatment can cause several side-effects. Also, the chances of benefit to the patient are quite low.” I told the relative.
“Low! How low is low Doctor?” the gentleman asked anxiously.
“About 10 percent.” I replied.
“That’s not bad Doctor. Considering the trouble my patient is going through, a 10 percent benefit would still help him.”
It took me a few minutes to comprehend that by 10 percent benefit he thought that the patient’s troubles would be relieved by 10 percent.
“That’s not how it works. When I say a 10% chance, it means that if I treat 100 patients with this treatment, 10 are likely to benefit and the remaining 90 are unlikely to benefit from it”
The gentleman left me thinking about how we phrase our answers and how the patient/relatives comprehend it. Most of our patients are scared, worried, anxious and at times, desperate. They are likely to latch on to the word ‘benefit’ of any magnitude. The thought behind the benefit is often unsaid. We, the treating doctors are so used to read and talk about percentages in our papers, books, meetings and talks that we often overlook the fact that for our patients’ any benefit is welcome. The `per cent’ part(meaning for every 100 people) is often not given a thought. For the relatives, there is only 1 patient, but we see that patient as a part of a group of 100 patients of similar problems.

- Oncologist in Pune | Cancer Specialist | Dr. Chetan Deshmukh