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Balancing appropriateness with total honesty

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Posted 5/19/2013 10:37 PM (GMT 0)
In another thread, a poster mentioned he was having night sweats after surgery and asked for input.

I did mention some causes, such as leukemia, lymphoma, multiple myeloma, and organ failure.

I also mentioned that I (and others mentioned this too) had briefly experienced some post-surgery night sweats and that while these other causes are scary there is a 99% probability that it is not due to anything scary.

I was called to task, pointing out that mentioning these possibilities was not too helpful. Upon reflection, I think the criticism is valid. I should have said that while there are, of course, some very serious causes, the probability is 99% that it is due to a benign cause, as indicated by other responses.

I guess I'm curious about what you all think in terms of dealing with the more general question. If someone asks about the causes of some symptoms, and there could be some dire causes, should one even allude to that? I know we always try to be positive. If someone says they have just been dx. with a G10, we can rightly look at the positive side in that many folks can knock it down for a long time.

Another example: someone has a G9 and says he is having significant bone pain. Well, it could be arthritis. But in this case, I would be doing a disservice by at least not suggesting he do scans (assuming this hasn't been done for awhile) to at least rule out the spread of PC. This is different than the first case mentioned, where the probability of a dire cause is extremely remote.

So, what do you think?

Mel

Posted 5/19/2013 10:54 PM (GMT 0)
Your second thought mentioned above was probably the way to have responded, IMO. I do agree that a G9 and bone pain is a whole different issue.
Posted 5/19/2013 11:09 PM (GMT 0)
I have to be honest. I think I answer posts that I really have no expertise on, yet I want to help. And I may not even have a clue I goofed on a reply unless called out. Trying to be helpful and straightforward can get me in trouble if I misread the question. And my answers may not be helpful at all. I`m pretty positive it happens to us all here.
Posted 5/19/2013 11:16 PM (GMT 0)
Mel,
We are all given a death sentence the day we are born. Most of us don't like to think that way.
Over the years we learn to not say things that offend even when asked. It's how we play our part in civil society. We accentuate the positive, eliminate the negative and don't mess with Mr. In-between.

Mathematicians and Engineers read your statement and think "He's right! What's wrong with that?" Philosophers and Poets will jump at the chance to tell you what's wrong with it.

We're all big boys here and unless you are outright lying, your answer should be taken with the intent it was given: honest advice and opinion.

Jeff

And "Yes" those Jeans do make your butt look big. ;-)
Posted 5/19/2013 11:23 PM (GMT 0)
Jeff:

One can answer in a totally honest fashion, with wonderful intentions, but it can still be inappropriate (or perhaps not prudent would be a better way of saying it).

I'm not sure if my original answer fit into that category, but perhaps, as BB said, the second answer would have been better.

In fact, I suspect many of the real feuds on HW stemmed from how something is said/approached rather than the actual substance of the statement.

Why do I keep thinking of Dr. Stockmann (Ibsen's "An Enemy of the People.")

Mel

Posted 5/19/2013 11:43 PM (GMT 0)
How to offer some hope but at the same time be realistic and honest? Though question that I don't have a complete answer for. I've attended week long classes on pastoral care that try to your question and even after all the discussions, case studies and role play - I still don't have a good answer.

But I tend to deal with it through my policy of "less than full disclosure." Something like, "The most common cause is: xxx" and your doctor can run tests to rule out the more rare causes." Don't hide the fact that there are other possibilities, just don't list them until the obvious causes have been ruled out by the poster.

Of course, if you really think someone might be mistaking the cause of a symptom, it's perfectly good to say something like, "but that could also be caused by xxx. You should get that checked out too."

Sorry I don't have a better answer but sometime just ask the question is helpful.

All the best,
Andrew
Posted 5/19/2013 11:48 PM (GMT 0)
Compiler!
I'm the poster you gave the advice too: Here's the rest of the story. Asoutler who chastised you for you comment is my fiancé and very protective of me! I have put her thru hell with my grief and depression! Please forgive her for getting a little upset over your response which was in no way inappropriate! I can tell from your new thread that you are a good man and secure enough to examine delivery! I'm x military and LEO and understand your straight forward delivery! U see, she is still trying to manage my stress and anxiety! So, brother all is good! If I have it in my bones or something else... So be it! In fact, I did research and came to the same conclusion as u regarding the night sweats!
Posted 5/19/2013 11:50 PM (GMT 0)
Comp, I just read your post in the night sweats thread . . . I thought it was totally appropriate. Like you mentioned here as an example, I am A G9 with both OA and Osteoporosis and I would thank the poster that replied with these possibilities whether I knew I had the syndromes or not. You are also right about the feud thing . . . so many pointless arguments over tact and/ or lack of it. I don't read this site to be comforted, I read it to be informed. Now, is that a tactless statement or simple honesty? I think it's just plain old Q.
Posted 5/20/2013 12:12 AM (GMT 0)
49:

Yeah, I am glad you understood.

Still, it engendered a good point, worthy of discussion. Here at HW, we want to give complete, accurate answers, but sometimes it is a balancing act in terms of tact and how much to say.

Mel

Posted 5/20/2013 12:24 AM (GMT 0)
I've been there many times! Again, the paranoia, anxiety and depression has taken its toll on people close to me! They want to protect me from any more emotional distress! Most of the men and ladies here have been there!
Posted 5/20/2013 11:17 AM (GMT 0)
Mel,

I thought your comment was OK. The lady overreacted. That's also OK. She has worries and gets to vent a bit if that's what she needs.

My only critique if you still want one would be that there's a difference between being totally honest and passing along information that one oneself does not totally understand. Totally honest would be to say "I Googled for 'night sweats' and some of the possible causes sounded worrisome: I'd talk to your doctor."
Posted 5/20/2013 12:31 PM (GMT 0)
I surely didnt mean for my post to come across as brash.. 49 is right.. he has been worried sick about this diagnosis and I have been trying to get him to live in the moment and not think.. what could happen or what it could be.. but for now celebrate the fact that his lymph node tested was negative.. his scans all came up clear.. AND his first PSA was ZERO! I know I am not the one with the affliction. It is because we spouses, partners, or girlfriends feel your pain more that you know and we feel helpless because we want to take your pain and fear away. We lay at night worrying sick about the one we love more than you know.
Posted 5/20/2013 2:15 PM (GMT 0)
Asout:

No problem whatsoever from my end.

Knowing what to say and how much to say is always problematic.

Mel

Posted 5/20/2013 2:49 PM (GMT 0)
I read what you wrote and don't think you said or did anything wrong or out of line.

However, i find in life in those situations, that sometimes, saying less, or nothing at all, is more appropriate. It's easy to be misunderstood in a situation like that.

david
Posted 5/20/2013 9:08 PM (GMT 0)
Mel -- they call it "brutal honesty" for a reason :-)!
Posted 5/20/2013 10:36 PM (GMT 0)
F8 - sometimes brutal honesty, or saying what you think, isn't the most appropriate course of action, not if its only accomplishing hurt to the receiver.
Posted 5/20/2013 11:17 PM (GMT 0)
Another alternative. Put the 'disclaimer' and positive first, but still include the possibilities! I think that covers it all. (Personally, I prefer knowing the possibilities. I'd rather be armed with knowledge that I don't need than the other way around).
Maybe something like this: " It is 99% certain that you are simply having some reaction to the surgery and the medications you are taking. But you might want to know that there are some other causes that you can look into with your doctor if this continues and is still bothersome. These are......"
Posted 5/20/2013 11:59 PM (GMT 0)
As someone whos first language is not English, I sometimes find myself in situation where what I said is misinterpreted as mean spirited. So I try to put extra care into words.

I have been a member here for a few years and the compassion, care and careful delivery of advice has always impressed me very much. We have wonderful members and this discussion is yet another example.

Thank you all who goes out of their way to comfort the others and balance it with full disclosure. My hat off to you guys and gals. And if sometimes our words don't come out exactly right - it's the same brothers and sisters who are on reviving end and they sure understand.
Posted 5/21/2013 1:25 AM (GMT 0)
Purg. No crap.
Posted 5/21/2013 1:28 AM (GMT 0)

Geebra said...
As someone whos first language is not English, I sometimes find myself in situation where what I said is misinterpreted as mean spirited. So I try to put extra care into words.

that's how I interpret almost all emails coming from my French speaking clients. I think that thinking in French while writing in English results in disaster most often in the work setting.
Posted 5/21/2013 1:37 AM (GMT 0)
Always tell the truth no matter how difficult. If your knowledge is thorough, spare no detail and let the person's rationality square the stuff that might be difficult to hear or digest. Do it as delicately as the situation dictates, but be completely honest. Comfort when necessary. It's very difficult sometimes.
Posted 5/21/2013 1:43 AM (GMT 0)
F8, I will use my 86 year old mother as a prime example. For most of the time that I can remember, she has always boasted about, "I don't care what people think, I am just speaking my mind". And for years, I have seen the hurt that has been inflicted upon family, friends, and even strangers, by her attitude. Sometimes, its just plain rudeness and bad manners in play, and at others, its just expressions of ill feelings and hatred. I sure wouldn't want to say out loud everything that was on my mind at a given time, lol. Sometimes silence is golden.

david
Posted 5/21/2013 4:11 AM (GMT 0)
A former employee (30+ years ago) called "brutal honesty" the "fist forward" approach.

Put your fist forward, and see who beats the crap out of you.

Posted 5/21/2013 7:48 AM (GMT 0)
Personally, I rather the total honesty... if one knows what they are talking about. :)

I think back on my first postings here and as time went by, I thought about a how a few members leaned towards telling me that the news was not good news at all and others totally tip-toed around it.

I wanted to hear more from those telling me it was not good news. I wanted to know what they saw that triggered their reply.

Actually, I wish I knew how to find those first posts to see just how uninformed I was. Seems like a lifetime ago.
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