Helpful, Not Helpful: Words Have a Lot of Power

Thoughtless words can send you into a tailspin that lasts long after that person who spoke them has moved on to something else. Other words can have the opposite effect and can help calm you down. I had both experiences with words in one day. Unfortunately for me, the calming words came first; if it had been the other way around, perhaps I would have slept better.

Concerned about my spots

I had a lot of stuff going on. My hands were, in my opinion, a mess. I also had strange, scaly, oval shapes on each calf. I sent photos to my dermatologist’s office. The spots on my calves came through clearly, but the photos of my hands needed to be redone.

A cyclical problem

My hands cycle back and forth, from looking ok to being covered with red spots and flakey areas. I treat them with chemo cream, or the doctor zaps spots that look especially suspicious for squamous cell carcinoma. They tend to look clear for a while until they start to act up again.

How good bedside manner helps

The nurse said they needed a photo of each complete hand, not just of the spots, so I asked my boyfriend to do it. I lightened the mood by joking, “this is not what you thought you would be getting into when you put together your dating profile, eh?” After we sent the photos back, the nurse called to say they came through clearly. “They look gross, don’t they?” I asked. “I’ve seen worse,” she said. Her words had the same effect on me as saying “don’t worry,” and perhaps even better, because it made me smile. Her dry sense of humor had calmed me down; I felt like it was no big deal.

Treating myself

As for the large areas on each calf, it was noted that they had a darker outside and lighter inside. They also itched and burned. I had treated my calves with a combination of Efudex and calcipotriene about a month before. The large ovals had started out as little flakey spots. I thought maybe I had missed something, so I thought it was ok to treat them again. I always ask first, but it didn’t seem like it would be a problem to just do it in this case, so I did.

Self diagnosis

The ovals got larger and larger, like those sponges that are flat and expand when you put water on them. I turned to Google, which is usually not a good idea, but many of us know that and do it anyway. With the internet's help, I diagnosed myself with… drumroll… ringworm!

How bad bedside manner can cause stress

The dermatologist who called later that night to follow up about my calves was on call and not any of the doctors that I usually talk to. Unlike the nurse I spoke with earlier in the day, the doctor exemplified the other end of the spectrum by using words that harm. He sounded annoyed that I had treated myself and said that what I had was not ringworm but maybe a reaction to being over-treated. He got me so agitated that I actually took a little sliver of Ativan (lorazepam) before bed.

The doctor sounded very annoyed

“I don’t want you to hurt yourself,” he said. “How much cream do you have left?” I said about half a tube of both Efudex and calcipotriene. The dermatologist's tone led me to believe that he wanted someone to come and take the medicine away from me. He said he would email one of my regular dermatologists and see if she could see me the next day. Meanwhile, I also wrote her through our patient portal. I said the doctor on call sounded very annoyed.

My spots were irritated

The next morning, while I was doing my favorite Zoom yoga class, I got a call from my regular dermatologist’s scheduler. She asked if I could come right in and, even though their office is 90 miles from my home, I jumped up went right away. When I got there, the dermatologist said I could re-treat my hands. As for the spots on my legs, it was just a good reaction to the cream. Since they were irritated, she said I could apply a steroid cream like fluocinonide, which I already had on hand.

The photos didn't tell the whole story

I know that it’s hard to tell from a photo, but I wondered why the other doctor hadn’t suggested the irritation could have been due to a good reaction instead of making me worry that I had a flesh-eating bacteria or something. I told her the doctor on call sounded annoyed, and she said she could imagine him sounding like that.

That night, the angry dermatologist called back. He said he'd heard I had said he had sounded annoyed. Now I felt like I was getting into a mess! He said he wasn’t ever annoyed and was just concerned. In the end, I followed my doctor’s instructions, and in a few days, the spots on my calves flaked and cleared. The treatment of my hands also proceeded as it normally would. Both problem areas have resolved…for now.

Has good or bad bedside manner affected your experience in a healthcare setting? Share with us in the comments.