Speaking the Truth with Love

I was not one of the cool kids in high school. Part of this was because I was, more or less, a "goody-two shoes" and gave my parents very little grief (unlike my older brother Steven). I am an Eagle Scout and actually wrote about service to others in my college essays. Although Hahvahd and Yale were unimpressed by my concept of helping others, Princeton lived up to its motto of "Princeton in the Nation's service and in the service of all nations" and I was accepted. So I must admit that it was pretty darn painful to watch my Tigers get slaughtered by the Crimson on a rainy day in Boston this past weekend. At National Presbyterian Church we have tried to emphasize the concept of "speaking the truth with love" when it comes to controversial or painful topics. So in regards to my Alma Mater....I can say with authority that the Princeton University Band remains undefeated.

In medicine giving bad news is never easy. In infertility therapy delivering bad news seems especially tough. Patients want their doctor to be enthusiastic and optimistic...but on the other hand we need to be realistic and try to offer a balanced view. I try to discuss all options with my patients and consider the economic, philosophic, emotional and physical costs of these various options. If a patient has coverage for IUI but no coverage for IVF and IUI is a medically reasonable option then I usually suggest that this is an appropriate approach. There are usually many possible options for most couples and one size does not fit all!

Recently I had a patient at another clinic contact me to ask about options at 46 years old. She was unhappy with her care and frustrated that donor egg was her only option with her current RE. I discussed the range of options from FSH/IUI to Natural Cycle IVF to dinner/movie. My honest opinion was that she had been given good advice and that if she was open to donor egg IVF then I think that would be the best choice unless adoption was being considered. I am not sure why she seemed more satisfied with my answer than with her previous doctor's answer but that is the way it goes. I hope that most patients can get beyond the "kill the messenger" view.

So remember that all of us are human and a good doctor tries to give solid helpful advice when dealing with complex medical issues.