Impolite Dinnertime Conversation

Patricia L. Raymond, MD, FACP, FACG

That’s my excuse for a dearth of second dates — my penchant for impolite dinnertime conversation (IDC). But really now, it’s not as if I purposefully timed your mouthful of fettuccine to my discourse on amoebic dysentery, right?

In fact, I was recently taken to task by a non-medico for my conversational skills. Really. She told me that everyone did not like to hear about bodily functions. But when 100 percent of our work hours are the stuff of dramatic theatre, we’re often egged on to share.

In fact, most all healthcare providers "talk shop" in public places. I have been recently at a barbecue overpopulated with radiology technicians (that’d be more than two), and their talk about their difficult patients or films, albeit less graphic than what goes on in the GI suite, was certainly graphic enough for the non-medical bystanders to "hold their breath," and widely bypass the grill where they congregated. And have you ever heard a dentist "opening wide" about a really graphic root canal?

So is this off-putting medical discourse wrong? I think not. I think IDC serves a greater societal purpose than simply grossing out the non-medical amongst us. How so?

Marital discourse strengthens the bonds.

Public discourse seeks to educate.

Patient discourse seeks to encourage.

Marital discourse: One of the nurses I work with is married to a dental husband. I wondered whether their varied oral fixations were discussed over intimate dinners. “Well, sometimes we decompress," she allowed. “After a stressful day, even though he doesn’t get all the details, he listens and cares.” And it’s sometimes entertaining. In her household, the last season of American Idol was all about debating the dental challenges of one of the finalists.

I believe that discussing your worklife challenges with your significant other, whether you are a plumber, a rocket scientist, or in the medical field, helps to strengthen the marital bonds by understanding. But then again, I’ve not nabbed a date with a strong enough stomach to test out this theory ... yet.

Public discourse: Journalists have noticed a change in our boundaries, our privacy — particularly as applies to "the change in life." This "New Menopause" is flaunted — we talk about our hot flashes as power surges, and exchange home remedies (unfermented soy, a small battery-operated fan slung around my neck during endo cases, and vitamin C, thanks for asking). Others advocate nasal lavage and colon cleansings with their buds. You’d be amazed at the graphic questions that emerge from my call-in audience during my lunchtime radio show — and I have yet to be told of anyone being put off their feed by our frank talk.

Why are these changes in taboo topics, especially amongst the non-medical, so gratifying? I judge this as move in the right direction in patient responsibility. We are seeking answers for our medical questions from our peers, taking responsibility for our own health. We are no longer insisting that conventional pills, tablets, or elixirs hold all the answers to life’s challenges; we are looking for answers ourselves. We are becoming free of medicine’s tyranny (cue the music from Les Misérables).

You see, medical literacy is frighteningly low in America. Although I assign partial blame to the loss of health class in high school, the sad truth is, according to the American Medical Association, that folks with limited health knowledge incur medical costs up to four times of savvy folks. IDC will help to fill the knowledge gap.

Patient discourse: The most gratifying of all IDC is the conversation of our patients themselves — patients telling their friends that a colonoscopy or a mammogram is nothing to be frightened of. Programs in which former cancer patients act as guides for new families coping with a new diagnosis and treatment plan. Patients sharing their stories of illness, so that others might learn and avoid a similar fate. Patients marching on Washington, D.C., insisting on better coverage, better pharmaceuticals, more research for their conditions. This trickle-down to the patient advocacy level is where IDC holds its power to change.

IDC, far from being a dietetic ruse, holds the potential to strengthen your marital bonds, enhance patient responsibility, and elevate the health of a nation (cue patriotic theme). Whether at a cookout or cocktail party this summer, do your part and use IDC to educate and inspire. I have no doubt that Miss Manners would approve. Just don’t serve fettuccine.

Patricia L. Raymond, MD, FACP, FACG, of Rx For Sanity, is always ready to discuss bodily functions with friends. Many of her musings and her unique medical humor may be enjoyed via a free subscription to her monthly e-zine Passionate HealthCare, which teaches us to "Love Caregiving, Just For the Health of It." Sign up today at www.RxForSanity.com.

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