A few days ago my flatmate, was surprised to discover that I didn't know where the Byzantine Empire used to be. In the ensuing¹ conversation I was surprised to discover that my flatmate didn't know where his spleen still is. We agreed that this surprising difference in knowledge could be due to the fact that he's a classics student and I'm a medical student.

I can't remember learning what my spleen is. I know that it removes my old red blood cells when they are worn out; it also helps my body fight infection because it's one of the places where the white blood cells talk to each other. I know where it is and what blood vessel supplies it. I know that much. I can remember when I was about 16 not knowing what it did, and now I know. It's much the same as knowing that the capital of Peru is Lima. I don't know how I know that, I just know it.

Apart from the occasional pub quiz, I'm never going to need to know that the city of Byzantium became Constantinople, and is now Istanbul the capital of Turkey. If I do need to know this, perhaps because I am planning a trip to Turkey and wish to do some sightseeing it will be fairly easy to find out.

One day my flatmate might need to know what his spleen is for. These circumstances might be slightly more dramatic. If he was crossing a road, was hit by a proverbial bus, and his spleen was ruptured, it might need to be removed urgently. To give consent to an operation you need to understand why you need it, and what would happen if you didn't have it. Until I had this conversation I would have assumed that he knew what a spleen did.

People often complain that their doctor hasn't explained something properly, that he skimmed over it, and used long words. Some people think that he did it because he wants to remain the knowledgeable one in control of the situation, and that he doesn't like informed patients. Perhaps there is another explanation. Perhaps the doctor used jargon because he'd forgotten whether he learnt that particular piece of jargon at school or in the early years of medical school. He might not have known that you didn't know.

If my flatmate tries to explain something about Latin to me, he can safely assume that I don't know anything about it. I went to a comprehensive school, we didn't even know what our school motto meant². But if I was to try and explain something medical to him, he would have a basic knowledge, it might have been in GCSE biology, he might have read about it in the paper, or seen something about it on TV. It's difficult to know what other people know so far about medicine. If I assume people don't know anything then I'm patronising them, if I'm assuming that they know more than they do then I'm confusing them on purpose.

Explaining things to people is a skill, and it's one that takes practice; part of the skill is learning to explain things at the right level. Sometimes doctors get it wrong. Whilst there may be some Doctors who do go out to confuse you, the chances are that they just didn't know that you didn't know – if that happens, there's one very simple solution – tell them.

A Baby Doctor Writes -
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