Elisheva, Excellent tactic! I use a somewhat similar approach with
physicians--"I am interested in your thinking on why you told Ms A
to.....What information do you have about her---subjective and objective
data did you use to make that decision or give her the advice. Could you
give me some references..
Carol
----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, December 16, 1999 7:08 PM
Subject: Frustrations with misinformation


> In my never-ending effort to "curb my tongue from speaking evil" while
still
> getting out the word, I have fallen back on the tactic of asking lots of
> questions.   These effectively trace what the mother knows, or even thinks
> she knows, and eventually come to the point where it becomes clear to her
(if
> I'm doing it right) that there is something she wishes she knew.
>
> For example, a close friend of mine is a developmental pediatrician (!!!!)
> who nursed her kids for about 6 months with great pleasure.  When I saw
her
> with her younger child, then about 9 months, feeding formula in a bottle,
I
> expressed amazement and was told with resignation, "I know, it's too bad,
but
> my milk dried up at about six months -- it was the same with my son."   So
I
> asked her, "How did you know it dried up?"
>
> She had a bunch of answers -- less fullness, hungry baby, etc.   Instead
of
> arguing with her answers, which after all might or might not be correct,
some
> moms really do experience a drop in supply, I asked another question.
"When
> that happened, what did you do about it?"  This had just never occured to
her
> -- in the world she lived in, if your "milk dried up," then you fed
formula,
> end of story.
>
> "And what did your pediatrician recommend for your milk supply?" I asked.
> Still drawing a blank.   By now she was wondering whether there was
anything
> she should have done; but after all her pedi *hadn't* told her anything,
so
> why be perturbed.
>
> At this point, when it had become clear that there was something she *now
> wished she had known then,* I could go a little more in the direction of a
> rhetorical or argumentative questions.  "And if some other of your
> physiologic fluids dried up -- say, your kidneys stopped making urine --
> would you just go resignedly to dialysis, or would you seek some
professional
> advice?"
>
> By this time I could stop asking her questions -- now she was asking me
> questions, about who she could have seen (an IBCLC, naturally) and what
kind
> of things they might have tried (anything from nurse-a-thons to fenugreek
to
> lots of stuff I in my untrained state probably don't even think of!).
> Suffice it to say that if *her* patients' mothers now say their milk is
> drying up, her first advice to them *may* not be to cut straight to
formula.
>
> This approach doesn't always work -- no approach always works, right? --
and
> I find myself undermining it sometimes by making the questions too
> argumentative or rhetorical too early, before the non-argumentative
questions
> have brought the mother to see that something is missing from her story.
> But if I am able to ask *true* questions, really trying to find out how
the
> mother's own process of arriving at her conclusion went ("Why did he say
that
> taking penicillin necessitated weaning?")  I find many of these mothers
may
> begin to think twice about what they previously swallowed without thinking
> once.
>
> Elisheva Urbas
> struggling every day for tact and just the right, small amount of
> judgmentalism in NYC
>
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