Many years ago one of our children brought home a canvas he had decorated in his school art class. He had filled the entire canvas with the word “words”. As a surgeon, what immediately struck me was that, just as you could kill or cure with a scalpel, you could also kill or cure with words, when wordswordswords becomes swordswordswords.
Physicians are not taught how to communicate with patients and due to their fear of being sued, tell people all of the adverse side effects of therapy and never mention the benefits. Every time I hear a TV commercial mentioning how the pill being advertised can kill you, I wonder why anyone would try it.
I began to realize how important a patient’s beliefs were from my experience and their experience and not from their diagnosis. In a sense, it is summed up by an anecdote in which Dr. Milton Erickson wrote in a patient’s chart and then excused himself and stepped out of the office for a minute. When the patient peeked at the chart she saw, “Doing well” written there. How therapeutic.
I also learned to ask people how they would describe what they were experiencing versus their diagnosis. Then, I would ask how and what in their lives fit those words if they were negative words. The words they would share—like pressure describing their pain, or failure for their cancer experience—led me to help them eliminate the pressure in their life and what made them feel like a failure.
One day, prior to performing minor surgery in my office, the patient and I got into an intense and interesting discussion. I picked up the scalpel while we were talking and made an incision. I noticed my nurse waving frantically at me. When she caught my attention, she pointed at the syringe containing the local anesthetic, which I had not used. I asked the patient how he was feeling and he was fine so I completed the surgery, and then told him we were both hypnotized and that I had not used any local anesthetic to numb the area of surgery. Major surgery has been done under hypnosis, and I have used hypnotherapists in the operating room, too.
As I learned the power of words, I began to pay more attention to what was said in the operating room. Simple things like changing an injection from feeling like a “bee sting” to a “mosquito bite” changed the way patients felt about it. When an anesthesiologist talked to the patient about their “going out” I would ask the patient, “When was the last time you went out on a date?” I also started playing music in the O.R. decades ago, which was considered an explosion hazard, but when everyone felt better the staff stopped complaining. Today we have studies verifying the benefits of music in shortening the time of the surgery, requiring fewer drugs, and that patients experience less pain.
During surgery I would ask my patients not to bleed and divert the blood away from the area of surgery. I was not a normal surgeon but no one is against success, so if it worked it became hospital policy for which I received no credit. Before patients woke up from surgery I would say, “You will wake up comfortable, thirsty and hungry.” I had to add, “but you won’t finish what is on your plate” when my patients all began to gain weight. However, I couldn’t get the administrators to use the TV in patients’ rooms to prepare them for surgery with guided imagery, which would have…
But what really opened my mind to the power of words was my experience as a pediatric surgeon. To reassure children that they would not be in pain while they were undergoing surgery I would tell them, while in the emergency room, “You will go to sleep when you go into the operating room.” I was shocked to see children fall asleep while they were being wheeled into the O.R. on their stretcher. One boy flipped over and went to sleep as we entered the O.R; when I turned him over for his appendectomy he awakened and said, “You told me I would go to sleep and I sleep on my stomach.” We reached a compromise.
Then, I began deceiving more kids into health by rubbing them with an alcohol sponge prior to drawing blood and telling them, “This will numb your skin.” A third of them had “total anesthesia” while the others all had a less emotional experience and told me it didn’t work. I apologized and blamed the defective alcohol sponge.
Labeling vitamin pills, with the parent’s cooperation, reduced side effects of chemotherapy and other treatments. We relabeled the vitamins as “anti-nausea,” or “hair-growing” or “pain pills,” and the kids responded because of the faith they had in their authority figures. One woman I know was feeling nauseated after her chemo. She asked her daughter to get her a Compazine pill, because she wasn’t wearing her glasses. Her daughter gave her the pill and she felt fine. Hours later, while wearing her glasses, she asked for another pill. When she saw her daughter reach for the wrong bottle she told her, “That’s not my Compazine. That’s my anti-coagulant Coumadin.” Her daughter replied, “Well Mom, it worked fine the last time I gave it you.” They both were impressed and enjoyed the experience.
The most dramatic experiences I’ve learned from were medical errors due to technical mistakes.
One of my patients had no side effects from radiation, and the radiation therapist thought his machine was malfunctioning until he saw my name in her chart and then realized, “This is one of Siegel’s crazy patients.” When he asked her why she had no side effects she replied, “I get out of the way and let it go to my tumor.”
The examples, which I found to be more impressive, were when people who thought they were receiving chemotherapy were not due to an error preparing the medication and people who thought they were being radiated were not due to no radioactive material being replaced after the machine was repaired. The doctors involved felt terrible. The radiation therapy doctor said to me he had not treated anyone for a month and only discovered the problem when the radiation therapy machine underwent its monthly inspection. I told him he didn’t realize what he was telling me. He repeated how terrible he felt. I said, “You’d have to be an idiot to not know you weren’t treating anyone. You obviously had people experiencing side effects and shrinking tumors.” His eyes bulged and he said, “Oh my God, you’re right.”
So believe in the mind-body unity and words. Our body responds to our beliefs, and I’d rather lie therapeutically to a patient than give them a list of side effects of a treatment and induce all of those effects because of what they hear from an authority figure. When I do have to share some negative side effects, I add that they don’t happen to everyone, like how everyone isn’t allergic to peanuts.
Let me close with some of my favorite stories (and I don’t make any of them up).
The cousin of my father-in-law’s nurse’s aide was told she was terminal with leukemia and that it would be a waste of time to receive chemotherapy, which would only make her feel worse. When the aide heard this, she called her cousin in North Carolina and told her to come because, “Doctor Siegel makes people well all the time.” They told me about it when she arrived, so I admitted her to the hospital. I sat on her bed and explained that leukemia was not something I could treat but that I would ask an oncologist friend to come and see her. Then, I gave her a big hug and went to call the oncologist. The oncologists I used had learned about “Siegel’s crazy patients” and had no problem working with them.
My oncologist friend told me he agreed with her doctor about the likely outcome but would give her treatment to make her feel there was hope. His letters to me began with “doing well” and ended with, “in complete remission.” She went home to drive her doctor nuts. I heard later that she told her cousin, “When Doctor Siegel hugged me I knew I would get well.” I also know patients who left their troubles to God had their cancer disappear. That is called self-induced healing and not a “spontaneous remission.” So I’ve learned from exceptional patients about survival behavior. Ask them why they didn’t die rather than saying what doctors tend to say—which is, “You are doing very well. Whatever you’re doing keep it up”—then they learn nothing from their patient. Personality characteristics and survival are inseparable.
Another story: You are vomiting after chemotherapy and your husband puts bags in the car so that you can throw up into the bag on the way home. One day you are feeling nauseated and ask your husband for a bag. He hands it to you; you open it and find a dozen roses from your husband. You never vomit again after receiving chemotherapy.
Last, but not least, remind patients of their potential. Our Creator has built survival mechanisms into all living things so we can heal wounds, alter our genes and overcome various diseases. Love your life and your body and amazing things can happen. As Ernest Holmes said, “What if Jesus was the only normal person who ever lived?” Our Creator has built survival mechanisms into all living things so we can heal wounds, alter our genes and overcome various diseases.
Love your life and your body, and amazing things can happen. We have the potential built into us; we just need to show up for practice, have faith and not fear failing.
As I learned about the power of words, they became my therapeutic tools. With paradox and humor I was able to readjust people’s thoughts and feelings.
A woman I was about to operate on was in total panic before her surgery. I spent a long time trying to calm her down, but nothing I said or did made a difference. So I stopped trying and wheeled her into the operating room where—with a look of fear on her face—she said, “Thank God all these wonderful people will be taking care of me.” I knew agreeing with her wouldn’t accomplish anything so I said, “I know these people. I have worked with them for years. They are not wonderful people.” For a second she looked bewildered, but then burst out laughing, as did everyone in the O.R. We all became family in that moment. Fear cannot exist in the presence of love and laughter.
I was the police surgeon in New Haven, Connecticut for many years. One day a policeman I knew called my office. When I picked up the phone he said, “Doctor Siegel, I am going to commit suicide.”
I answered, “Jimmy, if you commit suicide I will never talk to you again.” He hung up the phone and 15 minutes later was in my office mad as hell, shouting that he was holding a gun in his mouth and how insensitive and uncaring I was.
I said, “Jimmy, did you notice you’re not dead?”
Then he laughed, and realized I had decided to say that and it had worked. We became buddies after that.