Talking with Patients, Volume 1

Book excerpt: Spoken language is the most important diagnostic and therapeutic tool in medicine, and, according to Dr. Cassell, "we must be as precise with it as a surgeon with a scalpel." In these two volumes, he analyzes doctor-patient communication and shows how doctors can use language for the maximum benefit of their patients. Throughout, Dr. Cassell stresses that patients are complex, changing, psychological, social and physical beings whose illnesses are well represented by their own communication. He proposes that both listening and speaking are arts that can be learned best when they are based on the way that spoken language functions in medicine. Accordingly, Volume I focuses on the workings of spoken language in the clinical setting. It analyzes such important aspects of speech as paralanguage (non-word phenomenon like pause, pitch, and speech rate), how patients describe themselves and their illnesses, the logic of conversation, and the levels of meanings of words. Volume II is a practical, detailed, how to guide that demonstrates the process of history taking and how the doctor can learn the most from the information that the patient has to offer. His arguments are amply illustrated in both volumes by transcripts of real interactions between patients and their doctors.