Lies, Lies and More Lies

Lies. Let’s talk about them. I recently read a great essay in the New York Times by a physician talking about all of the different kinds of lies that are told in health care.

Of course, it’s easy to think about the lies that patients tell their physicians. Often these lies are told out of fear –fear of being judged by the health care provider. Other lies are told out of embarrassment –a patient may not want to admit that they’ve been incontinent, for example. Yet other lies may be told out of shame –someone may not want to admit that they’ve had unprotected sex outside of marriage, for example.

Some lies are full-out falsehoods. Others are half-truths that patients tell to still convey some information but to not appear as guilty/embarrassed/ashamed. For someone who smokes a pack of cigarettes a day, an example of these lies might be:
“No, I don’t smoke.” (full lie)
“I only smoke a couple cigarettes a day.” (partial lie)

We all know the hazards of patients who lie: at worst, a patient may not be accurately diagnosed and/or treated, and at best, the doctor-patient relationship is undermined. But what about lies that doctors tell?

What are you talking about?! you might be thinking. Doctors don’t lie. The physician in the New York Times piece talked about how physicians may lie to hide errors and medical mistakes or how they may order unnecessary tests to boost revenue, or how they might present their treatment recommendations as more evidence-based than they may actually be.

Finally, the physician describes a patient who he couldn’t let go even when it became apparent that the treatment he was offering was futile. The lie he told was to himself and some of his colleagues in order to pursue further treatment. This lie, I think, came out of denial; denial that this patient wasn’t going to get better and his difficulty accepting this. And, while I appreciate that he said that he was lying to himself, I can’t find much fault with him. He clearly seemed attached to this patient, which speaks volumes to me. I could only hope that my physician is that attached and devoted to me.