‘I can read you like a book.’
I’ve never actually said this to anyone, but sometimes it’s true. As a first-year genetic counseling student, I’ve had many opportunities to observe genetic counseling sessions with patients and their families. This has given me a lot of practice reading faces, and it’s amazing what a patient’s face can tell you about their thoughts.
In one session, I observed a young woman about to receive her BRCA1/2 genetic test results with anxiety written all over her face. I had a rare window into the whirlwind of questions growing in her mind. What were her results? Could she cope with a high risk of breast and ovarian cancer? Upon learning that she had a disease-causing mutation, I could see that her anxiety morphed into worry. That same window showed me a new set of questions growing in her mind. Thankfully, the genetic counselor saw them too, and spent the rest of the session calming her fears and giving her resources.
It’s also amazing what a patient’s face cannot tell you. In our training, we’ve discussed how different expressions and gestures can have multiple meanings. For example, if a person crosses their arms, they might not be angry – they could just be cold. We must consider all the possible meanings we know of behind a person’s gestures, otherwise we might not properly address their concerns.
I observed a session with a baby boy and his parents. The father seemed disinterested. His face appeared blank as he stared at the ground. My window into his mind gave me a “closed” feeling, and I wondered what the family relationship was like at home. Suddenly, the father spoke, saying he would do everything possible to get the best medical treatment for his son. His words conveyed all the loving emotion that his face did not. It reminded me how tricky reading faces can be, and how often we can get it wrong.
My advantage as someone observing genetic counseling sessions is a “detached” view of what’s happening. If a genetic counselor picks up on cues or signals wrong, or even misses them, helping their patient becomes harder. I once observed a patient who looked very confused during a session, but I had no idea what he didn’t understand. He didn’t ask any questions. Afterwards, the genetic counselor told me that she didn’t see confusion; she saw attentive listening. We agreed that it could have been either, and if the patient did have questions, they weren’t answered. It’s amazing what a patient’s face can’t tell you.
So, here’s what my observations have taught me so far, which I’m hoping can also help you. If you’re thinking about going to a genetic counselor to talk about a genetic disease in you or your family – definitely go! Just remember that, like anyone, genetic counselors aren’t mind readers. And the session is a two-way conversation that’s meant to help you. Don’t be afraid to ask questions, if you have them. The more genetic counselors know about you and your situation, the more they can help you. They’re here for you – and you can clearly see that in their faces!