What is the doctor doing now and why?”
These hypothetical situations are typical of the usual physical examinations that you may encounter routinely in a clinic or a private physician’s office. Sup- pose you have a more complex problem, such as a neurological condition, for which the diagnostic procedures may indeed be painful and complicated. Have you ever had a CT scan? A magnetic resonance image (MRI)? An angioplasty? Quite often, those who deliver care have neither experienced nor witnessed the vast number of procedures that are performed in diagnostic workups and in treatment. They have little awareness of what the patient is thinking, feeling, and experiencing. Similarly, because the names and the purposes of the proce- dures are familiar to health care workers—don’t forget, this is their culture— they may take their own understanding of the procedures for granted and have difficulty appreciating why the patient cannot understand what is happening.