We get the most interesting Group Therapy questions on Mamamia. Today’s question comes from medical student Amanda and she asks a very interesting question about crossing boundaries. Amanda writes..
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“There is an issue that I have been wrestling with for a while, I am a fifth year medical student and nearing the end of my degree. I’m at the stage now in my studies where I can reach a diagnosis very quickly simply by observing someone. There have been a few occasions recently where I have been standing behind someone in the line at the supermarket or on the bus, and I have noticed a very suspicious looking mole, or an appearance consistent with a hormonal problem etc.
What am I ethically obligated to do? Will I be invading someone’s privacy if I recommend they see their GP, or would this be welcomed? From a medico-legal point of view, I am not required to say anything, but I would be interested to see what the general consensus about receiving unsolicited medical advice would be?
I guess this can be extended to the situation where someone has parsley in their teeth. Do you want to be told by a complete stranger, or should this just be ignored?”
Personally I love it when someone tells me something about my self that I should know – particularly if I can do something about it. What about you? Have you ever had someone tell you something unexpected that you did/didn’t want to know?
Comments
163 Comments so far
I think if it came from a stranger in a supermarket line I would probably feel criticised & wouldn’t feel I could trust what they’re saying because I don’t even know them.
However, I would want to be spoken to if it came from someone I actually know – a friend/family member.
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Amanda – I’m a GP in QLD, I deal with skin cancer every day and even I (and dermatologists I know) still struggle to accurately pick a melanoma. They are not as easy as you might think. So don’t worry about it – there are far too many people out there giving unsolicited advice already. Just enjoy your shopping.
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I would be taken aback if some random person gave me medical advice, however it would probably piqué my interest enough to go to the doctor. I think that even if you told 300 people that ended up ignoring you or getting shirty, but you made a difference to just one of them, then it would be worth it.
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Dear Mamamia readers,
I am the medical student who submitted the question. Thank you all so much for your feedback.
I think the overwhelming consensus is mole – yes, hormonal problems – no.
I apologise to those who consider me ‘cocky’ from my email. However, even with only 5 years of medical training, an very obvious melanoma is pretty easy to spot. (I’m sure even those without medical training could have an idea that something might be going wrong!)
I am not aware of any official stance from the AMA on this topic. The Good Samaritan law covers doctors legally if they are to administer emergency treatment outside of a recognised medical institution but of course this does not apply to this situation as it applies to diagnosis rather than treatment.
Ethically, I feel that I would inform someone if they had a dangerous looking mole, and deal with it if the person was not particularly receptive. I guess it’s a matter of what allows you to sleep at night.
Thank you once again, and hopefully none of you will ever have to deal with this!
Kind regards,
Amanda
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Someone once told me that according to the look of my knees I may well have disease and issues as time goes on – was I offended? I certainly was and I don’t have knee problems and that was 14 years ago.
If it was a mole or something then sure give me your feedback and oh yeah only if you can back it up with “I am a fifth year med student” or “I had a mole like that removed!” Not just by saying “your knees look funny a but like my cousins and he has terrible problems and disease!!!!” idiot!
Go for it Amanda but back it up.
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Sadly, for personal reasons I am now very good at spotting people with bad drinking problems, even when they are successfully hiding them from most friends, family and colleagues around them.
I have never said anything directly to these people. I can never think of anything that would be appropriate to say. I have a couple of times mentioned my concerns to a person’s friend.
In cases of addiction, what are your chances of helping? But then I always wonder if a comment might somehow, even once, be the catalyst for someone seeking help. So maybe I should be sticking my neck out and risking offending them, or receiving abuse back.
Still haven’t resolved this one in my own head.
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It is a hard one – I’ve piped up, only to get abused or have it turned round on to me. I dunno, I’d still rather say something than not though.
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Addiction is not something that can be helped by telling someone they have an addiction. That’s dangerous territory! I wouldn’t stick my neck out for that. It’s very different to the mole scenario. Let the trained counsellors deal with addiction I say.
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Be polite and tell them.
If you can save someone’s life by simply recommending they see their GP then it’s worth the awkwardness!
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I would be happy to hear it as long as it is delivered appropriately – by which I mean that it would help to identify the fact tht you have training and rather than give a ‘diagnosis’ you would be better to suggest they get it checked out properly and leave it at that.
I would also suggest that you not do it when you are going to be trapped with the person for too long in case they want you to have a chat about it!!
Good on you for caring!
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I would want to know.
But perhaps to ensure you’re informing the right person (who wants advice), tell them you’re a medical student and that you have observed something you recommend they see their doctor about to check out. If they seem responsive/ask questions, then tell them what…
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In regards to medical issues – I would find a stranger commenting on me very rude & out of line. It wouldn’t necessarily be agressive or rude back but my distaste in you and your opinion or completely ignoring you would be received. It would also appear to me that you presume I don’t have the common sense to have these things under control myself. On this subject only coming from a friend/family member would be appropriate for me..
In regards to embarassing things – ie: toilet paper/stickers on shoes, skirt stuck in the knickers or something in the teeth! Well please by all means save me!
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I think it is worth pointing out – do you know what the back of your neck or your back looks like? I’ve got a vague idea.
I wish someone had been able to tell my Nan about her melanoma. The doctors could never locate the original and so were only ever treating secondary tumours.
People worry so much about offending others, what would you rather? Maybe offend someone, or maybe save their life? I know I’ve mentioned this in a couple of threads lately, but I’m seeing it a lot more I guess going to classes and stuff. There is no need to be grossed out or offended or embarrassed about medical stuff. I’ve seen too many stories about people putting things off because they’re embarrassed when there is either nothing wrong (eg people not having pap smears) or its easy fixed (eg an STD) but if it isn’t, it can lead to MUCH worse.
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Sorry Bravette – this was meant to stand alone but somehow replied to you!
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I personally think this is potentially opening a can of worms. Depending on the seriousness of the medical issue, you have to make that judgment call whether to intervene but I will say that you may be opening yourself up to some potentially tricky ethical issues that aren’t covered by your workplace. I am a third year social work student on a placement and I have found that going down that unsolicited road maybe opening yourself up to some tricky situations. You have a duty of care and this can and does extend outside your work but you have to create boundaries for yourself. This can also be an issue of self-care as well, if you are constantly seeing this kind of thing and getting involved, you could risk burnout very quickly. And the fact that you’re not completely qualified or covered by any insurance when giving this advice out. I think you are doing the right thing in the long run, but you need to be aware of potential consequences.
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Maybe you could begin the conversation by saying “I’m a fifth year medical student, could I give you some advice?”
That way, if they’re likely to be embarrassed or offended they have the opportunity to tell you they’re not interested and you avoid being told to mind your own business.
Personally, I would prefer someone to tell me, even if it’s embarrassing and especially if it’s something potentially life threatening.
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this is a tangent but has anyone heard about animals being trained to diagnose people? you know how supposedly animals have a sixth sense, like cats at nursing homes who know when people are going to pass away and so they spend the night with them….apparently there was a breed of dog that could predict if someone had cancer-with amazing success rates. but then there was an ethical problem because if you took the dog out for a walk it would go up and sit next to people that it knew had cancer. obviously without these people having asked for a diagnosis…..slightly off topic but i found that rather interesting.
as for amanda, i think that its whether or not you have a thick skin. i have a feeling that a lot of ppl are not going to react very well! although one day they will look back and be very grateful, at the time, they might not be very nice at all.
i wonder if anyone at my dads work had made more of a fuss about his changes in behaviour and the ‘migraines’ that he’d started having, his brain cancer might have been found sooner…..
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yes …please tell me. A melanoma can end your life.
just last week my 15 year old daughter was out jogging with her father when a lady stopped her to tell her that she had a problem with her hips. Well my daughter was not impressed and my husband explained to her that she was just being nice. For me, it confirmed what had sometimes bothered me, that she did have a problem, but as she played high level sport with no worries I kept putting it to the back of my mind. This holidays we will be making a trip to the doctors…
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Absolutely you should tell the person if you notice something harmful/embarrassing. You are sharing your knowledge to assist them. If they react poorly, that is their problem. You are ultimately doing the right thing, with good intentions. Go for it. x
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I’ve read a lot of responses about hormonal issues etc, but that is not what Amanda is asking. She is asking about a clear physical sign (a mole) that is not immediately obvious to the person concerned. Personally, I would want that to be pointed out. Ditto toilet paper, eye liner on my cheek etc. Nowhere has she suggested that she’s going to go up to someone and make a random diagnosis, just a suggestion that they see a doctor. I say go for it! I think you sound lovely. Good luck in your studies Amanda, we need more doctors like you.
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‘I have noticed a very suspicious looking mole, or an appearance consistent with a hormonal problem etc’
Uh, the above is a direct quote from Amanda’s email – using a hormonal problem as an example. That’s is why there are so many responses relating to ‘hormonal issues’.
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Oh. Whoops. Sorry.
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Isn’t this covered in the ethics portion of your medical studies? I ask because I would think that when you qualify, the AMA would have strong views on the topic.
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There was a time when I would see a kindy mum every day and notice her goiter. I really felt that I should have told her, but didn’t. About a year later she found out she had thyroid cancer. I felt badly, because I had thyroid disease previously and I only found out when I went to the Doctor because I had a cough and she noticed my goiter. It grew so slowly that I hadn’t noticed it.
Having had this experience, I believe that if you can be sensitive in your approach, you should say something.
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whats a goiter?
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It looks like lump on your neck and it’s caused by your thyroid gland enlarging. Check out http://www.betterhealth.vic.gov.au if you want to know more.
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I would only point a problem out to a stranger if you felt it was truly life threatening. Otherwise, leave it alone.
Having said that, my personal trainer recently told me a story about an overweight client she trains. They were doing the 4 monthly weigh in to check the client’s progress and the trainer helped her to remove her shoes to get on the scales. She noticed a big black mole on one foot and asked the client if she had seen the doctor about it. The client actually couldn’t see that part of her own foot so she didn’t know it was there. Fast forward one week and the client was in hospital having a chunk of her foot removed as it was a melanoma. It was her lucky day I would say when the trainer mentioned that mole to her…
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There has been a lot of comment about unsolicited advice and the pros & cons, this is a bit off tangent, but bear with me.
To fund my fashionista habit my day job is an accountant. Once people establish that I get all manner of questions about things financial, particularly tax. I know bugger all about tax, it is not my speciality. My line is “contact your financial advisor, they are up to date with all the rules and regulations”. So that is a view from the other side, getting unsolicited questions.
On Amanda’s dilemma, I think she should always recommend that the person get whatever cheked out, although be prepared to be told where to go
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And I always tell strangers if their fly is down, has led to some interesting conversations ….
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try being a lawyer… I have to explain over and over to family and friends that I know F&*k all about property law/ tax/ civil/ administrative. And I don’t work as a defence lawyers and NO I am not giving advice to your cousin’s brother in law’s sister about her drink driving charge
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i reckon tell me… unless it is going to offend. example: I know I am overweight, I know I need to lose weight, I know it is unhealthy. but yeah, if I had a mole or some sort of ailment where it can be rectified quickly and I would otherwise not know, then go for it.
I guess its the tact involved that is tricky.
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Please do tell. I’m committed to letting people know if they’ve got some spinach between their teeth. And I absolutely have to tell if a woman has lipstick on her teeth. Oh and skirt tucked into undies, obviously!!
There’s nothing worse than discovering spinach teeth after you’ve been out socialising (and you were fabulous) but hadn’t eaten anything for hours!
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Ah…the skirt caught in the undies ! I recall the time I noticed this lady having the problem. Casually, I pulled the skirt out and she thumped me.
On the second occasion that I noticed the same lady having the same problem, I pulled the skirt out…and she thumped me.
On the third occasion, I noticed that the skirt had not been caught in the knickers. So I tucked it back in for her….and ran off before she could thump me !
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That’s gold!
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Parsley-smarsley, what about this…
I used to teach at a uni overseas. At some point one morning I must have walked in some dog poo, and then sat down with my foot under me (this is what I figure must have happed – unless someone booby-trapped me) anyway, it ended up on the back of my pants.
All morning I could smell that smell and couldn’t figure it out. Thought it must have just been from my shoe? Though couldn’t see anything on my shoe.
Went to the staff room. No one said anything.
Taught a couple of classes. Every time I turned to write on the blackboard I could hear sniggers. It was awful. Usually I got on pretty well with my students so it was a shock.
Finally in the bathrooms another student (not one of mine) discreetly told me I had something on the back of my pants. I was mortified, and couldn’t believe I had gone the whole morning with noone telling me.
Thank god she told me so I didn’t have to go though the same thing with my afternoon classes.
Oh random foreign student – thank you for telling me about the dog poo!
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Tell me, Tell me.
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I think I would want to be told. I’d probably be quite embarrassed and a little pissed off at the time but after literally a few minutes I would get over it and be very grateful.
A few years ago, a couple of days before Christmas I walked through the city after work to do some shopping and after walking for about 10mins, and while waiting at the lights outside Woolworth’s and the QVB (yes, probably the busiest part of town) a girl tapped me on the shoulder to tell me my skirt was tucked into my (very skimpy) underwear. Was absolutely mortified (I don’t think I even thanked her!) and quickly moved away from her but was so glad afterwards!
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From the comments it seems that people are quite divided, some will welcome the advice and others not so much. By approaching a stranger you’re taking a 50/50 chance on their possible reaction.
I’m sure after a couple of ‘F You’ replies you won’t quite be so eager to dish out unsolicited advice.
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If it’s potentially life-threatening (eg. cancer) or at least serious, then I would much rather someone give me unsolicited advice than to just walk on by and have me die later.
If it’s not life-threatening “Hey, you could have an iron deficiency! You could use acne medication! You need a bit more calcium in your diet!” then don’t tell me.
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Agreed! When I was in high school catching the bus home a lady wrote down all this stuff about a face wash she reccomended and proceeded to loudly tell me how I can fix all those pimples on my face. The entire bus could hear and I was a TEENAGE GIRL! I was mortified and it was just pimples, what teenage girl doesn’t get them at some point? That discussion if needed is something for a parent or friend. I wouldn’t really ever think approaching kids or teenagers would be needed kids would hopefully have parents or guardians who would be more appropriate to tell and teenagers are going through enough! I would say though that you should tell people things that can help them. Bree from Big Brother found her cancer because a doctor noticed it when she was hosting Friday night live and rang the show relentlessly until they listened to him.
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On the mole thing. I’m not a Dr but did tell a friend that she had a very dangerous mole, spend enough time in a GP’s waiting room and you have those scary looking things memorised. She had a huge chunk of her leg taken out but it no doubt saved her life.
I see nothing wrong with telling a stranger either, you don’t even have to preface it with ” I’m a med student” if they tell you to bugger off then just consider it training for the difficult patients you are undoubtedly going to encounter when you finish your studies.
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Just because someone has told her to to mind her own business doesn’t automatically place them in the ‘difficult patient’ category. It just means if they wanted a doc’s opinion, they would visit one in their office.
By the way, I wasn’t being rude, just an opinion.
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This is not exactly on point, but I’m a white person covered in moles and freckles of odd shapes, sizes and colours, and constantly being told to have things “checked out” by all manner of people (those who go to melanomia clinics and have stuff cut out ‘just in case’ every 6 months seem to be the biggest authority). Often accompanied by phrases such as “you’ll be sorry if you don’t”. Nice.
It gets a bit old.
If someone were to speak to me quietly, and tell me exactly why they think I should have something seen to then I would consider their advice. Especially if it were said in language that didn’t condescend, and also communicated that the reason they were telling me is because they care about me as a fellow human being.
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I get exactly the same thing! I am heavily freckled but I get checked out by my GP every time I’m there for a pap smear or something else and in 43 years I have had nothing to worry about. However, if I had a dollar for every time someone said ‘gee, you should watch that freckle, it’s a bit dark, you should get that checked’ I would not be sitting in an office chair today. It seems like everyone’s an authority and assumes I’m not screening it myself.
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I would want to be told. I have a lump on my lip that was worrying me.. It has been there for YEARS and has only just started to get to me..
On a different topic!
My hair was blonde once, and a lady said “Your hair is very brassy. You should dye it again” Yeah, cheers, mind your own business.
My family constantly pick at the way I eat “You aren’t holding your cutlery right. Eat with your mouth closed. Why aren’t you eating all of that?” Sheesh! I was eating a pie yesterday, and my Dad comes up and says “You are wasting that pie, you don’t eat the crust” GAH!
Ever notice that people will always tell you the part you don’t want to eat is “the best part!”?
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I had a spot on my nose for years. It turned out to be a basal cell carcinoma. That said, while I was at the specialist’s office getting it removed I also pointed out other little spots that seemed odd and had been around for a while and none of them were an issue. Hopefully it’s nothing, but a specialist’s opinion would at least give you peace of mind.
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Im a speech therapist and im constantly wanting to tell parents I meet or friends / family that their child really needs help, eg. language delay, stuttering etc. ive learnt over the years that telling them is actually a bad idea, unless they specifically ask me for advise. 9 times out of 10 their reaction is really bad. For example i told my neighbour in the nicest way possible that their non verbal 3.5 year old might benefit from speech therapy…. she hasn’t spoken to me since… the child is now 12.
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This is so frustrating. Our child had a speech delay (auditory processing disorder), but being our first child, we didn’t realise. It wasn’t until she started 4 year old kinder, when the kindergarten teacher pulled us aside after a couple of weeks. Upon which we had her tested, got her speech therapy, and got her grommits. And of course it has been ongoing ever since making sure she gets the extra help she needs so she can keep up with her peers.
The creche (who had her three days a week since the age of 1), theoretically with qualified kindergarten teachers, said to us. “Oh we didn’t think things were quite right”. Why tell us that everything was good then all the way through?
But parents in particular can be in denial. My cousin’s child (who also had a number of health issues – allergies et all), suffered from similar symptoms. We all gently suggested several times that she should get him tested. Alas it fell on deaf ears until he was finally tested by the school at about the age of 10. Earlier intervention could have helped him so much before he lost confidence and felt that he was “dumb”.
The other part of the equation I don’t understand is when parents can afford to pay for the testing, but refuse to, because they feel the school or a govt department should be paying for it – and this then delays testing and action for several months or years. The sooner you have a diagnosis, the sooner you work on remedial action.
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Its a tough one. I totally agree with you. the early intervention is exactly why speech paths want to tell the parents. unfortunately people aren’t as accepting as you.
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I met an ex’s son once (he moved away with his mum shortly after) and picked him as having developmental issues. I got yelled at when I brought it up “Oh he’s my son, you don’t know him well”. Um, yeah, I don’t know him well and I can see that there is something not right with him.
I think, as Wendy mentions, when you don’t have much exposure to other kids and it is just how your munchkin operates, it is easy to overlook or ignore. No-one wants anything to be wrong with their kids, but if there is, wouldn’t you want to know and work on it as soon as you could??
I have another friend whose little dude is autistic, and she talks about how exhausting it can be, but at least with it having been diagnosed and being worked on, they can ALL learn coping techniques for it.
Its no-one’s fault. If your kid needed glasses you’d go and get their eyes checked – I don’t see it as any different.
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There’s also a theory of “critical windows” for learning and development. Basically it means that there are periods early in life where rapid and significant learning and development occurs in a number of areas (speech, language, motor skills etc) and if something impacts on this critical period, such as a language disorder, and appropriate development is not achieved, the effects could impact on the child for the rest of their life.
Unfortunately it’s so hard to approach someone and suggest their little one may benefit from some form of intervention. And it’s understandable why people could be upset or made uncomfortable by what is intended as a completely good natured and well intended piece of advice. Most parents have some degree of feeling like anything that happens to their child is their fault or a reflection of their parenting abilities.
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I know its not the same thing, but my aunty suffered from terrible headaches a couple of years ago. She went to the emergency room three times with debilitating headaches and was turned away and told to take a panadol three times. A couple of weeks later she felt better and went to a breakfast with some work colleagues from another city. One of the women there was an ex-nurse and upon hearing my aunty’s story, demanded that she go immediately back to hospital.
She had a brain aneurism.
Sometimes I think fate gives us little taps on the shoulder almost to say “hey buddy – you need to be moving in this direction”. If you are fortunate enough to be in front of a doctor who recognises a potentially deadly illness, I’d call that lucky. Personally I’d be happy it was pointed out to me – I can’t see my own back and skin cancer runs in my family.
And to the people who would tell Amanda to “fuck off” – get a grip! She’s trying to help, its not about being nosy. If it could save your life then seriously what have you got to lose? Plus, I’m sure she doesn’t see melanomas every time she goes to Coles – we’re talking about a couple of isolated incidents.
When did we all become so aggressive?
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I can identify particularly with this tale…
In July, my otherwise healthy aunt collapsed at work after complaining of a headache that morning. It turned out to be a massive brain aneurism and, sadly, she is no longer with us. In shock afterwards, we were all asking each other if there were any signs that this had been coming. Apparently she had been telling my mum that she’d been having trouble concentrating on things.
This awful occurrence has now convinced me to be cautious rather than cavalier about any health matters.
I think as long as Amanda prefaces the observation and any suggestions with ‘I’m a medical student/doctor’, I’d be OK with hearing it!
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Exactly the same story. My aunt was about 45 and had had a few headaches, that was the only warning.
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So sorry to hear about your Aunt, Josephine. Mine was very lucky and survived – and she has an huge dent in her skull as a reminder. Someone was looking out for her I guess…
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sorry for your loss too Sarah x
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I would hope this sort of debate is covered before med students graduate..hello ethics 101? I don’t know what the answer is, I would suggest you’re the one who’s educated in the field so go with your gut..but surely there’s a “medicine & ethics 101″ course that covers this!
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While I am not a med student, having just finished a uni degree, the vast majority of courses have an ethics component attached. Even areas such as engineering. What this type of course would cover though, are general, typical examples which would be seen often in clinics and surgeries. The stuff that can arise outside work and working hours would probably not be so thoroughly covered, due to it not directly being part of the job.
Consider though all the ethics that different professions are faced with every day, and I think you’d find that the ethics related directly to where and when one works would (especially in medicine), be a massive consideration to make.
Personally, I would approach someone if what I saw was potentially quite harmful, but it might be worth sussing the person out first to see how they may handle it. Not always possible I know, but listen to your gut too. Rarely will it be wrong.
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If you feel strongly that your diagnosis is correct and that your warning could potentially save someone’s life I say go ahead. Just be prepared to be told to mind your own business. Some people will welcome the advice while others will be offended you felt you had the right to comment on their appearance, no matter how life-threatening their potential condition may be. I suspect as you become more experienced you will get better at deciphering these situations. Personally I would be grateful to be informed of a suspicious mole on the back of my neck, yet highly offended if a stranger told me I looked like I had a hormonal imbalance. In some cases people will already be aware (and probably self-conscious if it something physically visible) of their condition and would be very embarrassed to have it pointed out in public by a complete stranger. Also, for many people the doctor’s office is a ‘safe place’ where they feel comfortable discussing problems that would be very embarrassing for them to discuss in a public place like a supermarket without any warning. I would suggest you speak to some practicing doctors and your lecturers and see how they handle this kind of situation.
Good luck with your studies. You seem very capable and eager which makes me sure you’ll be a fantastic doctor.
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Mole? Yes please.
Looking back, my biggest regrets are the things I wish I had done. Not the things I actually did.
Good luck with your career Amanda. Caring GPs are treasures!
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You mention that from a medicolegal perspective, your not obliged to say anything. I would go further and say, from a medicolegal perspective, you shouldn’t say anything – if for no other reason than, your insurance won’t cover you.
But then again…. I’m a lawyer giving unsolicited legal advice, outside the context of my practice….hypocritical much!!!!lol! I think mum used to call it the pot calling the kettle grimy arse!
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But aren’t doctors legally obliged to help in a medical emergency even though they are ‘off duty’? How does this fit in with the legal framework? And considering this is just another medical opinion – or even just a ‘I recommend to get it checked’ – off the street could this still get her into trouble if it is the non-emergency kind?
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I don’t think doctors are legally obliged to help in a medical emergency if they’re off-duty, but I think most of them would. My mum is a doctor and I have memories of us pulling over every time there was a car accident so she could offer assistance.
I don’t think medical indemnity will cover you giving out opinions in the supermarket – which of course is why Amanda says she would suggest that the people see the doctor. I agree with LilLucy, you probably shouldn’t say anything if for no other reason than that it will raise questions of indemnity and duty of care, when you are not yet qualified.
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I think that they are but I’m neither a Dr or a lawyer so I could very well be wrong.
I know that 2 nurses in England were struck off for not helping someone who had been in an accident. I wonder if it’s the same here?
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I think that you don’t have a duty of care to help anyone outside of work, but once you become involved with the person, you enter into a duty of care. For example – you can legally drive past an accident. But once you stop, you are bound by duty of care to continue to help until the person is safe or until help arrives (as long as you can’t come to harm (eg – get run over yourself).
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LilLucy I think you’re probably right.
I’m a clinical psychologist and our ethics explicitly state that we can’t intervene in such personal/informal situations.
And insurance certainy wouldnt cover us if we did.
Might be ok to say, “you perhaps should see your GP” though?
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Pre-cancerous mole? Yes, tell me about that!
But…when my first baby was little he had severe eczema and often had his limbs bandaged to try and manage it. It got to the point where I couldn’t go out with getting unsolicited advice on treatment options. I had tried everything, and I did that for years. I was so worried and stressed that I couldn’t filter all the information/advice I was getting and it increased our stress so much. I guess that’s just the other side to it.
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Oh I thought I was the only person who ever did this!
My daughter used to suffer from eczema on the backs of her hands and I often bandaged them up too to stop her from scratching and to let the creams work without being washed off every five minutes.
People liked to stop me to ask what had happened to her and to offer their advice too. I used the old ‘smile and nod’ technique, but I was really glad when she grew out of it and I didn’t have to constantly explain.
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While it is nice that you are showing concern for others, health is an incredibly personal thing and I wouldn’t recommend giving strangers such advice. While some people may be grateful, most probably won’t see you as a concerned doctor but a nosy person invading their privacy. People may actually feel violated by being told there may be something wrong with their health and if someone takes it wrong it could lead to issues for you for your professional reputation and future.
This advice is obviously purely my opinion, but being a student in health related area as a speech pathology student, I know some of where you are coming from. I have come across many a child with obvious speech and language delays and disorders, which can be significant for success later in life, socially, academically, vocationally etc, but I try to keep my observations to myself. It isn’t my place.
If you are that unsure, talk to doctors you have built rapport with throughout your studies and whose opinion you respect. They will be the best placed to address this issue, as they would have dealt with your same feelings.
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I don’t know how you can compare a speech problem with a suspect mole? I don’t know any adults that have speech or language delays or disorders because most children just grow out of them, but I do know of 2 people that have died from Melanoma.
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Oh we’re around, not everyone ‘grows out of it’. There is much better education around speech problems these days, with early intervention far & away the best solution. I know 3 children who no longer have speech impediments thanks to their parents noticing and taking them to speech therapy. No big deal, no dramas.
I’m sure these parents had well-meaning people mention it to them as well, but I can assure you they already knew there was a problem. I agree with S, you can hardly compare it to a mole which has potentially deadly consequences and may easily go unnoticed.
Sorry, bit OT, but that was a little too close to home!
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That is why I said I know “some of where” she is coming from. I was using my personal experience to put a context to my opinion, not comparing.
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You opinion was “I wouldn’t recommend giving health advice”. Well health advice is about health. A speech impediment isn’t life threatening or about health. Your recommendation to “not” give advice could cost someone their life.
The context you used compares your personal experience of being a speech pathologist with that of a 5 year Med student giving a diagnosis of a suspect mole.
It’s definitely a comparison.
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Mum told me a story a couple of days ago about someone who wore a sundress to church. A doctor was seated behind her and told her she needed to get a mole on her back (that she didn’t know about) checked out immediately. She did, and it turned out to be cancerous but it looks like it has been caught in time. She is thankful for her life at the unsolicited advise.
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I told another Mum at school that she should really get a mole on her neck looked at. I’ve had two skin cancers myself..I guess you feel a smidgen more entitled to speak up?!?!
She did have that mole looked at by a doctor. He cut it out straight away and sent for a biopsy – he told my friend she did the right thing coming to see him.
Not sure I’d tell a stranger though…I think that’s probably pushing the boundary.
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I can’t believe that if you had observed a person and made an obvious medical diagnosis, that you wouldn’t share the information for fear of offending someone. Surely the risk of offending someone is less weighty than the benefits one may gain from a diagnosis?
If I were the medic, I would step out of my comfort zone and share my skill with the public and go to bed at night knowing that regardless of the person’s discomfort, I had done the right thing. As the Medic you could ask yourself “what if this person doesn’t like what I tell them or is offended by it?” to which you could answer yourself “What if they don’t know and would like to know?” There’s no question in my mind. Too bad to the few that would be offended, do it for the others!
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I don’t think it’s about offending people. It’s that one cannot make a medical diagnosis on observation of someone whose medical history they don’t know.
What’s she going to say if they turn around and say “yes, I have a melanoma. It’s getting cut out tomorrow.”???
As well as that, she’s not a medical professional and such, shouldn’t be making judgement calls like that. She’s a medical student. She isn’t licensed to work in any hospitals, she’s not legally able to treat or diagnose patients independently. I’m not sure how being in a supermarket queue makes that any better or changes that fact.
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If it’s not about offending people, what is it about? I disagree that one cannot make a medical diagnosis without history. How does history change the appearance of a mole?
Where is the harm in sharing your knowledge?
A think a 5th Year medical student is in a good position to be making “judgement calls” if it means drawing attention to an obvious medical problem.
To answer your question “what’s she going to say…?” How about.. “oh that’s great. Sorry to bother you.”
I still think the medical student is doing the right thing by sharing her knowledge as I can’t help but think of the family members that could be without their loved one because a Dr or Med Student didn’t want to risk making a mistake. I’m all for making mistakes if they happen when good intent goes awry!
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Well said!
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I think its wonderful that you want to – it shows you’re passionate about what you’re doing and that you really care. Two excellent qualities for a medical professional. But I also agree with other commenters who have recommended caution – I just can’t imagine there are that many serious conditions that can be reliably diagnosed in a few minutes. Suspicious moles might be the exception – but you would still want to be very discreet and just give a gentle suggestion that the person have it looked at.
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I totally agree, Bowerbird
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Your diagnoses is life and death in this instance.
You are not obliged I would think and it is up to you how much you offer your services in the general sphere.
I would appreciate it, if told my someone as yourself.
“excuse me, i don’t want to alarm you but I am a training doctor and noticed a mole on your neck. it could be nothing, but have you had it checked out?” said with smile and in calm voice!
Once you ARE a working doctor, I suspect you will switch off as almost everyone has something wrong with them and diagnosing will overtake your life!!
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She’s a medical student – not a “training doctor”. Big difference.
From one medical student to another: a little knowledge is a dangerous thing. I’m sure the author has self-diagnosed herself with countless things – yet I trust she continues to study in good health. It’s none of her business to encroach on other’s business and personal space – without adequate information or understanding to make a correct diagnose.
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How does a 5 year med student (who is at the stage in her studies that she can reach a diagnosis easily with observation) become a person with “little knowledge” ??
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I didn’t say she was ignorant; but like me, she is still a medical student – she is still learning. And while we all have great intentions, doesn’t mean we have the clinical experience or judgement that comes with years of experience. Being a fifth year medical student is NOT the same as being a doctor.
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Nobody said it’s the same as being a Doctor. If you are suggesting that all 5 year Med Students are the same and wouldn’t know what a sus mole looks like, then I think you are wrong. You say 5 years study “doesn’t mean we have clinical experience”. Is “clinical experience” the only way to learn what a sus mole looks like? I would suggest that the lack of “clinical experience” doesn’t mean you can’t know what a sus mole looks like.
I just struggle to understand how you can determine how much or how little somebody that you’ve never met,knows???
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I would want to know- it would be embarrassing and confronting most definitely.
However, I would rather 5 minutes of embarrassment than have to deal with a cancerous mole, or something else, down the track.
My advice would be to try and speak to people in private, like waiting till you can talk to them alone or in a busy place where people can’t eaves drop. If you can’t do that (like for example you are on a bus) then perhaps give it a miss.
Maybe you can write a little note for them and give it to them discreetly? That way they can act on their own accord and you aren’t confronting them.
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Wouldn’t you be sus about taking a note from a stranger?
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A couple of things have come to mind since reading all the comments (I posted early on).
1. The person may already know they have a problem and might not appreciate someone else pointing it out, ESPECIALLY if it’s a hormonal problem.
2. You could cause someone a lot of worry if you point out a mole which turns out to be nothing.
I’m pretty sure and have faith that 99% of people mean no harm when making comments or “noticing” something about your appearance. Sure, they may have zero tact, discretion or manners but usually they are only trying to help or make conversation. My 2yo daughter had open heart surgery when she was 7 months old and, depending on what I dress her in, her chest scar is visible. I get at least one comment per outing about her scar and people are genuinely interested in hearing about her scar. I get tired of talking about her surgery (she’s fine now and healthy) but you can’t stop human interest.
I think if you go with your gut feeling, hopefully it will serve you right.
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“You could cause someone a lot of worry if you point out a mole which turns out to be nothing.”
–> and what if she doesn’t point it out and it is melanoma and it then doesn’t get diagnosed quick enough?
I prefer a bit of worry than ignorance.
Also – everyone living in places like Australia and NZ should have regular skin checks. It comes with the territory.
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What about highly anxious depressed people? – every day is a struggle for them for whatever reasons. A bit of worry to them is not a bit of worry to someone else and having a stranger critisise and point things out is definitely not going to help their current situation.
Also – how do we know they’re ignorant? I have my checks every 6 mths and I am fine however I have a couple of heinous moles on me that rude strangers feel the need to comment on – Some even to the point of POKING IT!
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I am a nurse and I always point out dodgy looking moles to patients/family/friends. I have never given unsolicited advice to a stranger but – I think that would be rude.
As someone said before you are a fifth year med student – no doubt you are smart and capable, but you don’t have much clinical experience to back up your knowledge. I think diagnosing people based solely on their appearance is more of an educated guess than a diagnosis.
I reckon with a bit of tact you could probably get away with pointing out suspicious looking moles, depending on the situation. But if I were you I wouldn’t approach people about much more than that.
Anyway, after a while you will become horrified by the amount of people who want to show you their weird rash/health problem once they find out you’re in the medical field. I know I am disturbed by the things that people I barely know have tried to show me once they find out I’m a nurse.
Good luck!
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I hear you! I went out with a doctor for a couple of months and couldn’t believe the amount of stuff people told/showed him all the time… bars, dinner parties – anywhere. It was overwhelming.
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I agree. I’m a massage therapist and, if I see a funny-looking spot on a client’s back, I’ll say something like, “There’s a spot here (I touch their back to demonstrate where) that looks a bit odd, maybe get it looked at next time you’re at the doctor’s?”
Although Amanda is in a slightly different situation in that she soon will be a doctor, she doesn’t have any history of the client or test results to know whether is is, in fact, a cancer. With something as potentially life-and-death as that, she could probably get away with saying something similar to what I do, but I don’t think she should be diagnosing them in the supermarket. (I also think her medical indemnity insurer would have something to say about a diagnosis without any case history.)
As for other problems eg hormonal, don’t go there. At best she’ll embarrass the hell out of them, especially if it’s something they already are aware of and getting treatment for.
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I was born with dislocated hips which wasn’t diagnosed until I was a six month old baby. By the time my hips were eased back into place, the damage was done – I have walked an unsightly and obvious pidgeon-toed walk ever since.
I can’t tell you how horrible it is to have well-meaning people come up and tell you that they can help you and that all will be made well if I only… (fill in with any combination of standing up straight, try ballet, do yoga, sit cross-legged on the floor, wear built up shoes, do balance and posture exercises, try a marching team or physie, or stop swinging my hips as I walk). It added untold misery to my childhood and teenage years. I don’t ever remember it being said in private. Often it was said in front of others. Family friends. In a school parent teacher meeting. Most memorably, in a country general store for a full 20 minutes. I couldn’t get away.
Look, a potential melanoma is a different kettle of fish and should be taken more seriously, but I defend the right of everyone with mottled freckly skin, a perceived hormonal imbalance or poor posture to live their lives in peace.
You need to really, I mean REALLY pick and choose the right time to raise the issue, however inconsequential you think it is. The risk of humiliation, especially in a public setting like a supermarket queue could easily outweigh the value of anything concrete you may have to say.
Discretion is the better part of valor, after all.
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I can’t say that I would be particularly happy for some random person to come and tell me that there is something wrong with me from a quick look. It’s bad enough dealing with the stupid comments from people when they find out I have Type I Diabetes such as how often do I have an ‘episode’ or have I tried wearing magnetic bracelet’s…etc etc Quite frankly I have enough medical appointments and would prefer to be left alone when I was getting on with my stuff.
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I’ve suffered from acne since I was 13 and I’ve had random people offer me advice about it for years … Which I dont appreciate. Its on my face I can obviously see it and I’m taking steps to improve it … Anyways the point to this rant is that people know their own bodies and I’m sure they would come across strange moles etc all by themselves and take the required action
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I totally get what you’re saying because everytime I get a pimple my dad will say “whats that on your chin?’ ‘YES THANKYOU DAD – I’VE SEEN IT!!”
but…
We are talking about a mole on someone’s back or neck – which they would hardly ever see – unlike acne which you would see everyday. So is it fair to say that its not really the same thing?
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When pregnant, I was told by a doctor in a supermarket that I was ‘too small’ and that I should get checked out.
Now I think back and think ‘What a fucking arsehole, did you think I wasn’t getting pre-natal care?’
Ethically, I would say you are obliged to say nothing, you don’t know anything about that person or their history. You might point out a mole to someone who suffers from a body image disorder that really affects them, for example. A simple comment from you could be very damaging.
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i agree – tell the mole, not the hormonal problem. ONly moles…nothing else!! and come to my supermarket and stand behind me just in case.
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