At dinner with our neighbors last night, we went around the table and each shared our Roman Empire. Your Roman Empire is that one thing you get so fired up about and feel so passionately about that your voice shifts into another octave and your hands start waving around excitedly. You’ll know someone’s Roman Empire because you won’t get a word in edgewise - except maybe to egg them on in their rant.
Some of ours were sidewalk accessibility and Helena’s upcoming school bond.* My own personal Roman Empire is health care providers who use fear and over-medicalize health concerns when speaking with patients. I’ve heard so many of my clients say their doctor told them never to run again, that their pain would only worsen, or that it may never improve. (Many of these same clients have experienced huge improvement in their conditions after working together.)
This type of language has a name: nocebo. Nocebic language is language that negatively impacts someone’s perception of their own health or triggers a negative expectation, potentially leading to worse outcomes. You may recognize its inverse: the placebo.
I want to encourage you to pay careful attention to the way your providers speak about your medical conditions. It is absolutely possible to communicate the reality of many conditions - or at the very least, what we know to be true during a given appointment - without exaggerating the risks or suggesting negative outcomes are inevitable.
The human body is incredibly adaptable, and our psychology and physiology are deeply interconnected. If your provider talks about your condition in a way that feels fatalistic, you deserve a second opinion. In the meantime, while you seek one out, keep an open mind.
This is my Roman Empire. I’m smashing the keys right now with more words than I know how to express in a newsletter. I’ll leave it at this: I believe that nocebic language is one of the biggest harms our current medical model creates.
Let’s take an active approach and do what we can to combat the possibility of negative outcomes, known or unknown. After all, we can only control the controllables.
Tell me, what’s your Roman Empire?
Katy Kelly, PT, DPT
*(I’ll be voting yes on the school bond, with some conflicted feelings, but I’m happy to chat if you’re still undecided! Ultimately, I believe Helena students deserve better schools.)