When I was a preemie — all two-and-a-half pounds of me — my mom was understandably worried. She said her doctor wheeled her down the hall to the newborn nursery, and my mom could hear me screaming all the way down the hall. She said, “I’ve got to hand it to you. You let your voice be heard — you let your needs be known. I told her that at two-and-a-half hours old and two-and-a-half pounds, I don’t think I made a conscious effort to exercise my constitutional right of free speech. I think it was just instinct to speak up. Maybe we need to get back to that unfiltered and unpolished voice. We patients shouldn’t have to worry about speaking our minds, albeit politely, about our own health. I’m not talking about “PC” as in “political correctness. I’m talking about “PC” as in “patient communication.” As someone who has owned this body for quite some time now, I know when something isn’t right, and I value when a doctor listens to me.

If my gut tells me that a problem is with my tooth, and not with the gums or nerves surrounding it, someone needs to listen to me. It shouldn’t be like pulling teeth. After seeing seven dental professionals, someone finally listened to me. A picture, like an X-ray, is not always worth 1,000 words, as my X-rays proved. Not everything will show up on an X-ray. It was not my nerve — but my nerves that were the problem These people not listening to me was understandably getting on my nerves!

Speak up, especially when a dental technician misreads instruction regarding which area of your mouth needs to be prepped for surgery, and he or she starts to anesthetize the area around tooth #14, instead of #4. Even if your gum is numb, speak up!

A speakeasy was a place that sold liquor. But I say, “speak easy,” but speak clearly.

The best example of the epitome of a doctor-patient conversation that I’ve had lately is when a doctor initially suggested a cyst aspiration, due to a suspicious finding on a mammogram. But then she said that she’d be fine if we just waited a year and did a screening mammogram. I told her that I’d lose sleep for a year if we went that route, so we mutually decided on another test entirely: a biopsy of this particular area, which showed something, but not something to worry about (just something to be monitored).

In the olden days, which would have been my younger days, I wouldn’t have questioned a doctor. But I know myself very well. Our conversation was the best example of cooperation and collaboration between a doctor and a patient, resulting in corroboration regarding my health care.

Speak firmly, then leave, when necessary. When one doctor seemed to not be listening to my mom regarding my dad’s health, she was initially reluctant to get a second opinion. She said she didn’t want to hurt the doctor’s feelings. I said that daddy was hurting, so which is worse. She took my suggestion and found another doctor who was a better match for them.

We encourage quiet kids in a classroom to speak up. We should take our own advice. I also need to stress the importance of listening on both sides of the classroom or the stethoscope. If no one is willing to listen to you, it’s like speaking into that proverbial forest — where if a tree fell and there was no one there to witness it, did it really fall?

In certain circumstances, we’ve been told that if we see something (out of the ordinary) we should say something. The same should be true in medicine. If you see something out of the ordinary, a change in your skin, a lump, a bump, etc. — say something. Either your fears will be allayed or further tests will be done, which should also allay your fears with the fact that someone is listening to you and doing something about your concerns.

If the American Academy of (fill in the blank) recommends a yearly exam for (fill in the blank) but you want to be seen more often — speak up. It’s no skin off the doctor’s back. But it was off of mine due to skin cancer. Luckily, all of my doctors understand that medicine is a two-way street between a doctor and a patient. Well, really, it’s like a roundabout between doctors, patients, insurance companies, hospitals, etc. But for the purpose of this post, let’s think of it as a two-way street, as opposed to a one-way street.

Patients aren’t the only ones who need to “say something if they see something.” That would apply to all health care professionals as well. For example, if you’re a nurse in an operating room and see that a surgeon is about to operate on the wrong side of a patient — say something. I imagine you wouldn’t want the surgeon to lose face, to be embarrassed by his or her error, but no one would want to lose a patient either.

President Roosevelt used an expression, “Speak softly and carry a big stick.” I say, “Speak so someone can hear you.” And hopefully is willing to listen. You don’t have to be screaming, but you need to be heard, whether you’re speaking loudly or in a whisper.

“Silence is golden,” but not when you have something to say.

R. Lynn Barnett is the author of What Patients Want: Anecdotes and Advice and My Mother has Alzheimer’s and My Dog Has Tapeworms:  A Caregiver’s Tale. She can be reached on Twtter @rlynnbarnett1.

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