Breaking Through the Teenage Mask: A Teen’s Perspective on Communication Challenges

Author: Lena Zhu

I am not a doctor or a nurse or a parent like the rest of the contributors. I don’t know the difference between a tibula and a fibula - I haven’t even graduated high school yet. But I am a 16-year-old teenager who knows what people my age and younger think about hospitals and healthcare professionals. Like most teens, I’ve had a couple of completely preventable, seemingly stupid accidents that have landed me in the ER and have had my own set of medical problems. But unlike most teens, I have taken a glimpse into the world of patient safety and have been asked to share my experiences and opinions. Though I have had little medical training outside of volunteering at a hospital, I hope that you can look at my teen perspective as a tool and an insight into the confusing minds of teenagers.

I have been given the opportunity to provide my perspective in the analysis of anonymous 
survey responses by healthcare professionals about their top tips for improving healthcare. I was surprised by the overwhelmingly obvious problem that plagues hospitals worldwide: lack of communication both amongst healthcare professionals and between healthcare professionals and children/families. 76% of healthcare professionals who completed the survey emphasized the importance of communication, whether it was something as rudimentary as “listen[ing] to parents” and “put[ting] the child’s needs first” or something less obvious like “communicat[ing] about tensions openly instead of behind the backs of seniors” to avoid the “politics of the situation.”

I’m not going to pretend that I’m an expert on communication. I am just like every other teenager who thinks that my friends and family have memorized what each of my grunts, glares, and eye rolls mean. I also know that, at least between teenagers, thoughts and emotions are sometimes masked. However, I have also witnessed teenagers and kids communicate and collaborate successfully with each other in certain contexts, when there is an important task at hand. This could be in part due to my schooling. Growing up, we have always been taught to “use our words” to express our feelings and to always listen carefully, and just last year in health class, my teacher re-taught us
I-Statements, something I was taught in second grade - I feel (emotion) . . . When you (behavior) . . . Because (why) . . . - to better express our feelings. Perhaps I’m being naïve, but I think it is reasonable to assume that if teenagers can communicate effectively when necessary, adult healthcare professionals can communicate at least as well, especially when a child’s care and potentially life is in their hands.

Of course, it’s obviously not my place to judge or even try to understand how hospitals operate and how co-workers interact. But if I’m being completely honest, I will say that while the lack of communication is distressing, it is also bizarrely reassuring in the sense that it humanizes doctors and makes them seem like real people.

For the longest time, I viewed doctors as these all-powerful, knowledgeable, and slightly terrifying people who sometimes inflict pain on me via shots or blood tests. Let’s just say the doctor wasn’t exactly a person I looked forward to visiting. I also understand that teens with our masked emotions can make it difficult for doctors to communicate with us. As a teenager who has seen several kinds of doctors, the doctors who genuinely made me feel safe and at ease were the ones that seemed to truly care about my feelings rather than simply my physical state. I’m not saying that they were trying to be my best friend or that they were warm and fuzzy, but at least they seemed to care for me as an individual rather than a diagnosis and didn’t seem rushed. These were the doctors I felt I could frankly confide in and open up to. It’s a two way street: once we notice a doctor showing a genuine interest in us as an individual, we’ll tell them the information they want to hear as a doctor making a diagnosis or treatment plan. A trust needs to form between the two individuals, not just a one-way street of terrifying tests and diagnoses that we inherently would prefer to avoid by saying nothing useful.

When I was little, I only liked the happy, enthusiastic doctors who gave me (sugar-free) candy after the visit; now as a teenager, I like the doctors who can read through my mask. Most don’t seem to care how I feel emotionally, because, after all, they just see me for ten minutes at most. However, I had one orthotist for my scoliosis back brace who saw right through my plastic smile. As a father himself, he knew what my mother and I were feeling and calmed our turbulent nerves by realistically illustrating my spine in a way that didn’t make me want to explode with anxiety. I was the last patient, so by spending extra time talking to my mom and I about my back and our worries after the appointment, he made me see my condition in a different light and slowly broke through the wall of emotions I put up. Sometimes a different perspective, rather than the literal, relentlessly terrifying facts online, can make a world of difference.

In conclusion, I am surprised by how communication challenges are universal in healthcare and my purpose for writing this blog is to open up the way I think healthcare professionals should view and treat teen/child patients. As much as you need us to talk about ourselves and our bodies in order to make a diagnosis and treatment plan, we need you to connect with us emotionally to generate that necessary trust. We want you to be able to discern past our plastic smiles and comfort the scared five-year-old inside. We want you to ask how we are and know when “good” really means okay but actually not really, and show that you’re interested in exploring why this is the case. We want you to know when we’re scared and we need you to remind us of facts we already know but refuse to believe. Remember what it was like to be a teenager or a frightened child. Sometimes they’re the same.

Related Links:
Justin's HOPE - "Survey Initiative to Improve Paediatric Patient Safety Internationally"
2. Austin Community College District - "I-Statements"