The three questions easy to ask but difficult to answer

Calm explanation by doctor and stoical understanding by patient needed to confront tough questions in medicine.

- DR HEMANT MADAN

Over years of my experience as a doctor, I have learnt one simple truth. Questions with a clear medical response are usually the easiest to handle. If someone asks about a blood pressure reading, a cholesterol value, or the result of an angiogram, medical knowledge offers reasonably firm information to respond quickly and specifically. Guidelines, clinical trials, and numbers, they all come to our rescue. Both a doctor and patient find comfort in objectivity.

The real challenge lies in answering a question that sits uncomfortably at the crossroads of medicine, society, beliefs, personal experience, and expectation. These are the questions for which textbooks offer little guidance and experience matters more than evidence.

When confronted with these questions, doctors often pause and ponder — not because they lack knowledge, but because they recognise uncertainty.

That pause, however, can be unsettling for patients. A carefully worded explanation may sound evasive, while an honest admission of ambiguity may be mistaken for incompetence. Ironically, the very effort to give a balanced answer can leave the patient more confused and unconvinced than before. Over the years, I have realised that three questions recur in almost every cardiology clinic. They sound simple, even reasonable, yet answering them in a way that truly reassures patients, is remarkably difficult.

The first question which a patient often asks with a mix of surprise, confusion, and a quiet resentment is “doctor, why did I get this disease?”