Monday, March 12, 2007

Terminology, Failure and the Patient

v. failed, fail·ing, fails
v. intr.
  1. To prove deficient or lacking; perform ineffectively or inadequately: failed to fulfill their promises; failed in their attempt to reach the summit.

  2. To be unsuccessful: an experiment that failed.
  3. To receive an academic grade below the acceptable minimum.
  4. To prove insufficient in quantity or duration; give out: The water supply failed during the drought.
  5. To decline, as in strength or effectiveness: The light began to fail.
  6. To cease functioning properly: The engine failed.
  7. To give way or be made otherwise useless as a result of excessive strain: The rusted girders failed and caused the bridge to collapse.
  8. To become bankrupt or insolvent: Their business failed during the last recession.

You hear it all too often in the realm of chronic illness and disability. You failed a medication--or a few or several. You failed to recover after physical therapy. You failed whatever treatment the medical establishment decided would work best for you.

As a newbie to the whole disability studies arena, I had never really thought about the implications of medical professionals using the language of failure in describing patients' responses. I didn't realize there was such a thing as a social and a medical model of disability. It never really sunk in just how much the usage of the word "failed" had impacted my persona, my hope and my outlook on the future.

I know that, as time passes, I will only get worse. There will be good times and bad. Not all standard treatments will work for me. I get that. I had pretty good hopes for my future and my ability to at least attempt to do some of the things I used to love like dance or play tennis. My hope and optimism have faded, and I believe much of it has to do with the manner in which doctors medical professionals talk to me.
Well, you've failed Enbrel/Plaqeunil/Azulfidine/standard medical treatments for inflammatory arthritis. You're starting to run out of options.

In reality, those treatments failed me. The important part of that conversation is the person, not the treatment. I have to remind myself that a treatment not working is not my fault. It just wasn't the right treatment option for me at that time. Much like the people first conventions of the social model of disability, the lack of response to a treatment should be phrased so as the fault does not lie with the person. The whole point of treatment is to improve the quality of life of the person; saying they failed defeats the purpose.

1 comment:

Anonymous said...

Well, of course you're right. I'm a pediatrician and have several friends who have rheumatoid arthritis; I don't think I've told a patient that they've "failed" a treatment (although certainly I've heard that phrasing), but if something I say causes someone to feel discouraged or disrespected, I'd rather know. The blogosphere is very educational in this regard.