The stuttering patient: Stuttering and health care

This is a summary and review of the article "A Simple Case Of Chest Pain: Sensitizing Doctors To Patients With Disabilities" by Leana S. Wen, from Health Affairs, October 2014.

Leana Wen Dr. Leana S. Wen

In the recent issue of Health Affairs, Dr. Leana S. Wen discusses the problems people with communication difficulties sometimes have getting adequate medical attention. As she is a person who stutters herself, she brings some insight to the problem. In the article, she relates a story that took place in the emergency ward of a hospital where she was working as an intern. Late at night, a man with chest pains was brought in. He stuttered badly when the senior resident talked to him, and the doctor walked away from him telling Leana to “talk slowly so he understands.”

Leana, of course, knew the patient was not mentally challenged. She found out he was a successful practicing lawyer and, like her, had been a covert stutterer all his life, hiding it most of the time. The patient, James, had recently got a promotion at his firm that involved dealing more directly with clients. That night, out for dinner and discussing an important case, his speech skills disastrously fell apart. He could not get out one word and started struggling and panicking. When he felt heart pain and grabbed his chest, his colleagues called an ambulance.

In medical school, Leana found doctors to be unsympathetic, one professor telling her to “come back when you learn how to speak!”

Leana related to his story. She had tried to hide her stuttering too, both as a teen and a young adult working through medical school. She found doctors to be unsympathetic, one professor telling her to “come back when you learn how to speak!”. She finally reached a point where she got therapy and it helped. Now, talking to James and spending some time listening to his story, Leana had a realization. People with communication difficulties can get a pretty bad deal when it comes to medical care.

In Leana’s research for her article she discovered findings showing that people with disabilities got inferior health care in general. Also, sometimes they were put through unnecessary tests because a physician found them hard to understand or communicate with. Indeed, the emergency ward doctor who immediately dismissed James as mentally deficient might have opted for a barrage of unnecessary and stressful tests rather than spend ten minutes to find out the cause of the problem. In medical schools, little training is dedicated to dealing with patients with communication difficulties or other disabilities.

After a conversation with James, Leana realized that he had not had a heart attack, just a panic attack. She told him about speech therapy and how it had helped her control her panic attacks under stressful speaking situations. He was grateful for the understanding and advice. Later that night, she approached the Emergency Ward doctor, and told him James was a person who stuttered, and it just took a little extra time to talk to him and find out what was wrong. They had both been hurt by the comment implying that he was mentally challenged. To her surprise, the doctor got his phone number and called him to apologize. He also supported Leana in organizing a training session for other students and residents to advise them on treating patients with communication difficulties. James returned to give a speech to the class about being a person who stuttered. Leana and James are still in touch and mentor college students who stutter.

Download the entire article here.