My brother’s recovery from a car crash became a lesson in how to talk to doctors and nurses | Expert Opinion
Communication is part of healing.
Shortly before Thanksgiving 2022, my brother, Elliott, was driving on a two-lane highway in New York when another car hit him head-on.
The other vehicle’s driver was critically injured, its two passengers dead. Paramedics rushed Elliott — disoriented, in pain, unable to contact anyone, and hundreds of miles from home — to the nearest Level I trauma center.
At the time of the accident, he had been on his way to visit friends. When Elliott did not arrive and could not be reached, those friends called local emergency departments until they found him.
They found my email address on the University of Pennsylvania’s website and sent word of the accident. They couldn’t provide me with any details because the hospital had only confirmed to his friends that Elliott was there — legally, the hospital wasn’t able to share more.
I study patient-doctor communication at Penn. The aftermath of Elliott’s accident underscored in personal ways what I know professionally: Communication is part of healing. Here are lessons you can draw from our experience.
Ask for the headline
I called the hospital as soon as I got the email about Elliott’s accident. The doctor who answered enumerated Elliott’s many broken bones. I wanted those details, but first I needed key facts. I had to ask the doctor directly to learn that Elliott was alive, alert, and in stable condition.
When delivering news, particularly bad news, clinicians are trained to quickly share “the headline,” the one or two most important pieces of information the patient or family should take away. Unfortunately, this doesn’t always happen, so be sure to ask.
If you don’t understand something, ask
Elliott didn’t understand when a doctor said he’d “sustained an acetabular fracture.” This unfamiliar language increased Elliott’s anxiety and made him feel he didn’t understand his injuries well enough to participate in his own care. Research has found that patients who understand their medical condition feel more empowered, make better decisions about their care, and, ultimately, experience better outcomes.
When team members used jargon, I drew from my nursing background to translate for Elliott: “Your hip socket is broken.” But I also encouraged him to speak up.
Talk about your needs and expectations
Before the surgeries on Elliott’s shattered ankle and arm, I told the surgeons that Elliott was an enthusiastic athlete and musician. I shared our hopes for what he could do after his limbs healed.
The patient and their family are important sources of information about the patient’s needs, preferences, and values. I learned as a nurse that knowing the patient helps the care team improve and personalize their care.
For Elliott, this meant that the doctors suggested a more aggressive surgical approach that offered the best chance of fully restoring function.
Involve trusted others in making decisions
In the aftermath of the accident, Elliott had to make several decisions about his care. He was scared and uncertain, so he asked me for help talking to doctors and weighing options.
Elliott did this intuitively, but there is evidence that involving trusted others helps patients. For example, I sometimes asked questions Elliott hadn’t thought of. Family and friends often play a vital role in helping the patient access or coordinate care, adhere to treatment plans, and stay motivated.
Despite these benefits, I experienced what many others do: Family members are not always included in decisions and may need to advocate to be involved.
Elliott has achieved a new normal and is back to biking around FDR Park and playing bluegrass guitar. He has not always heard what he wanted to hear along the way, but clear communication has doubtlessly contributed to his recovery.
Emily Largent is a senior fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania and professor of medical ethics at the Perelman School of Medicine. Elliott Largent is a quantitative specialist in Philadelphia.