BOOK REVIEW Your Medical Mind: How to Decide What Is Right for You
A few months ago, I read the book Your Medical Mind: How to Decide What Is Right for You by Jerome Groopman, MD and Pamela Hartzband, MD. The book covers both internal and external factors that influence our medical decision making while also diving into some of the cognitive shortcuts humans use to make those decisions (SPOILER ALERT: while cognitive shortcuts often help us make quick decisions, they don’t always help us make good decisions).
True confession – I was really annoyed when I first finished this book. I expected that when I was done, I would have a blueprint for how, exactly, I would always be able to make the “right” medical decisions for myself, in the future, forever and ever, amen.
Ridiculous, I know. But the siren song of certainty is a beautiful and enticing one, even when I know it’s an illusion.
Image description: a baby, with short, dark hair, wearing a red, short sleeved, polo-style shirt, lays on their back on a white sheet and stares out of frame to their left.
Since then though, many of the ideas in the book have been percolating in my brain and I wanted to share a Cole’s notes version with you because I think you’ll find it helpful to explore these ideas as you make decisions for your own pregnancy, birth, and postpartum.
One of your tasks of preparation as a pregnant person or the partner of a pregnant person, is to explore your deeply held beliefs about medical decision making and how those beliefs may interact and influence your current decision making process, for better or worse.
It may also be helpful to open up a dialogue between you and your partner to help you better understand each other when it comes to medical decision making as you begin to parent (and make medical decisions for) your little one together.
Consider the following four questions:
Are you a believer or a doubter?
Believers tend to believe that there is a successful solution to their problem somewhere while doubters tend to approach all treatment options with profound skepticism (deeply risk-averse, acutely aware of the potential side effects and limitations of drugs and procedures).
Do you have a naturalism orientation or a technology orientation?
If you have a naturalism orientation you tend to believe that the body can often heal itself if given the proper environment, where as if you have a technology orientation you believe that cutting-edge research yielding new medications and innovative procedures holds the answer.
Do you prefer minimal treatment or maximal treatment?
If you prefer minimal treatment you tend to avoid treatment if at all possible or if not possible, try to use the fewest medications at the lowest possible doses or to select the most conservative surgery or procedure first (less is more – risks and unintended consequences may overshadow apparent benefits) where as if you prefer maximal treatment you believe that more is usually better.
How much autonomy do you want?
When it comes to medical decision making, do you want the buck to stop with you (full autonomy), with your care provider (no autonomy), or somewhere in the middle (shared decision making)?
Those are the four key questions to help you consider your own medical decision-making process. Take a moment to consider where you personally fall in each of these areas. While these are presented as opposites, most likely you’ll find that you’re actually a blend of each one (with maybe a lean towards one side or the other).
You may find that in some areas, it’s a strong lean. 😉
You may also find it helpful to consider how your own default settings (so to speak) interact with each other. It’s tempting to assume that certain traits will always go together. For example, you might assume that someone with a naturalism orientation will always prefer the minimal treatment route.
But it’s quite possible someone with a naturalism orientation will prefer a maximal treatment route meaning they’ll try all the things because they believe that more is usually better, but the things they try may be more holistic in nature (supplements, herbal treatments, etc) rather than technology oriented.
As you begin to explore these ideas, keep in mind that the purpose is NOT to beat yourself up if you’re more of one thing or another or to decide that one type of medical mind is The Best and all the others are clearly irrational. Whatever your default setting, I can guarantee that there’s a good and valid reason that it exists.
The game is to notice where your default settings are working for you, and where they’re not, and then to make a CONSCIOUS choice about how to move forward.
You’re simply putting a pause in the pattern by noticing it.
This is something your doulas can help with. If you’re ready to meet your doula team:
