While I was on a visit abroad, a friend told me that a friend of his had recently delivered a baby with a skin problem that worried her. I said I would be happy to stop by her home for a look.
The little girl was just a few weeks old. It turned out that her skin issue was a red blotch in the middle of the forehead and some smaller red blotches on each eyelid, together with the kind of red spot on the neck that used to be called a “stork bite,” back when people liked to tell their kids that the stork brought their little brother or sister.
“My doctor told me that these red marks were never going to go away and that the baby would have to be treated with a laser to get rid of them,” said Mom.
I was happy to tell her otherwise, since the face marks, so-called capillary hemangiomas, always fade away. Only the ones on the neck don’t, but hair eventually hides them.
Although she was happy to hear this, she expressed other concerns. “There were some problems around the delivery,” she said. “The baby was breech for a while. Could that have had something to do with it?”
“Certainly not,” I said.
“I wonder,” she wondered, “whether these spots are because of something I did.”
The idea that birthmarks come from something the pregnant woman did is very old. People used to think that red birthmarks meant the mother had stared at a rose or looked at something else red.
I say that “people used to think” this, because you wouldn’t expect modern, sophisticated people to think such things. But if that what you expect, you’d often be wrong. This particular mother works as an electrical engineer. At work she’s hardheaded and rational. As a mother, she is far from immune to the fear and guilt which have plagued mothers—parents—forever.
I was happy to assure her that nothing she did had anything to do with what would anyway be only temporary annoyances, not permanent blemishes. She looked relieved, though I’m not sure she really accepted my reassurance.
If you want to know how many irrational health beliefs persist in supposedly modern, all you have to do is listen to what they say, not what you think they are supposed to say. Generations of medical students have confirmed what was clear to me when I was in school myself, a long time ago: teaching doctors to listen for what people believe is not on the medical curriculum. Instead, educators focus on what interests them, like what wavelength of light lasers produce to erase birthmarks.
Because that information is scientific, doctors learn it. If patients feel guilty when they don’t need to, that’s not the real medicine doctors are supposed to learn.
So they don’t learn it.
Dr. Rockoff’s new book, Act Like a Doctor, Think Like a Patient: Teaching Patient-Focused Medicine has just been published by Medical Education Press. This book focuses on the need for medical providers to know not just how to diagnose and treat disease, but to understand patient and make them feel better. You can order the book on Amazon.