BACKTRACKING

I had two appointments back to back with two very good doctors yesterday.  But only one great communicator.  What was the single difference?  Backtracking.  One did.  One didn’t.  And what a difference.  Try to be patient and read through both versions.

Your baby is sitting on its bottom, inside.  This means the body may come out just fine, but the head could get stuck.  There is also a small risk that your uterus could rupture during labor, because you have scars from your other cesarean. And since you want your tubes tied, that could be done during a cesarean.  Knowing all this, which do you prefer?  Would you like to come in to Labor and Delivery and have us try to change the baby’s position next week?  And then try for a vaginal delivery?  Or would you like to just skip that and schedule a cesarean?  Up to you.  For today, I would like to take a quick swab for Strep to see if you may need antibiotics during the birth process.

Or:

So your baby is sitting, well, bottom down, bum down, I mean not head down – and that is an indicator, well not always but usually we would do a cesarean, I mean it is up to you, but you know the head, the head could get stuck. Then again I mean the baby can still change so it may end up head down.   And you had already, I mean, you had a cesarean, right?  Yeah so oh shoot, what was I saying?  Just a sec, I have to remember to swab you for strep, but anyway, your uterus could rupture and start bleeding, well, you could bleed out and the baby could – well we’d have to do a cesarean, I mean, it is high risk, but um you want your tubes tied so we could do that during the surgery, but I don’t want, I am not saying you have to have surgery, just that, oh, here is paperwork for the swab, I mean, we do it routinely, so anyway we can do an external cephalic inversion where we kind of move the baby um but you can bleed during that or well it depends on the location of the placenta and they might not be able to do it, but you don’t have to have it so you can sign and then not do it or change your mind but we should do it next week but the baby can still change back, I mean it can still move, so we don’t really know.  They do that at Labor and Delivery, not here in clinic.  I’m gonna let you change clothes so I can do the swab but oh! you can just schedule a cesarean and that is lower risk but then there are always risks to any surgery, right?  But if you try for vaginal you might have a cesarean anyway and the baby can still move – and the version doesn’t always work, and plus we can’t be sure they can do it, right?  But right now, well, just get changed and I’ll be right back and we can talk more, oh, did you already sign for the cesarean, just a sec – let me check in the file, so do you have any questions?

As a professional communicator with a mind like a steel trap, well, haha, I am using humor here, but no, let me – I mean, uh, yeah, so.  If it is hard for me, a really gifted, or say truly gifted, yeah, truly gifted is better, let me start over: If it is hard for a professional interpreter to process and utter what you are saying, dear doctor, please consider thinking before you speak, and staying on track so your patient can follow along an easy and logical succession of ideas.  No false starts.  No false stops.  No retractions.  This is my advice to you, with or without an interpreter.  Think before you speak, and serve up your valuable medical advice in a digestible form.