How to talk science to a non-scientist

On Friday I went in for a laser hair removal “consultation.” Before “approving” me for the process, the clinic needs to meet me, ask some health questions, and assess whether “laser is right for me.”
I sat in the fancy waiting area on the curved red sofa and filled in an information form. A few minutes later the effusive nurse came to greet me and show me into one of the rooms. We started with basic information (birthdate, health problems) and moved to current medications.

Me: None.

Nurse: Any multivitamins?

Me: I take a multivitamin and fenugreek – for milk production, though it doesn’t seem to help me. Oh, and D and omega 3s.

Nurse: Oh, I’ve never heard of the fenu … what is that?

Me: Fenugreek. It’s for increasing milk production. Because I’m breastfeeding.

Nurse. Oh, I see. [Puts down pen.] So you are breastfeeding right now?

Me: Yes. [Note: at this point, are you noticing one of the reasons why I don’t excel at writing fiction?]

Nurse: Now, with our treatments, our doctors have a very strict policy. We don’t perform these on women who are breastfeeding or pregnant.

Me: Oh! I didn’t know that.

Nurse: Yes. We just like to be as safe as possible, so as our policy, we don’t work on women who are breastfeeding.

Me: I can appreciate that. Can you tell me, I’m curious, what exactly is the risk from laser treatments?

Nurse: Well, let me see. How can I put this? We just want to be very, very careful. We don’t want to put anyone at risk, so we don’t work on breastfeeding women.

Me: Yes, I appreciate that you want to be cautious. I’m just wondering, how exactly could laser hair removal cause a risk? What is it about the procedure that could create problems?

Nurse: Yes, you see, let me see how to explain this. You see, just in case there might be a problem that was transmitted to your baby, it hasn’t happened yet but what if this was the first time it happened? We don’t want to run the risk that your baby would be harmed, and of course, you wouldn’t want that. We want to be as cautious as possible, just in case something happens.

Me: I understand you’re saying that the doctors want to be as careful as possible. That’s great. What I’m wondering is, what is the biology behind the concern? What are the biological mechanism by which the laser might create problems for someone who is breastfeeding?

Nurse (with unflagging patience, since this client is particularly slow in grasping the essential point): You see, how can I explain this … for women who are breastfeeding, or pregnant, or even just trying to get pregnant, we just have a policy that we don’t work on them just in case something from the treatment harms them. We don’t know that it would, but we want to be extra sure that we aren’t causing damage to the woman or the baby. Can you understand that?

Me: Okay. I see. You are very concerned that the laser might cause damage, so you don’t work on women who are pregnant or breastfeeding.

Nurse: Yes! That’s right.

Pause.

Nurse: You see, the lasers penetrate the skin quite deeply, so because they go that far into the body, we don’t know if they might cause some damage. (At last!!! Some reference to a possible physical specificity of the laser that might have biological effects!)

Me: Aaah, I understand. The concern is that the laser penetrates the body, so it might cause some effects.

Nurse (relieved that at last the client is tuning into the same wavelength): Yes, that’s right! And we just don’t want to take that risk.

We ended our meeting with smiles on both sides, and her assurance that they would be there when I’m finished breastfeeding.

Still not sure what exactly I’ll do. Believe it or not, I’m not quite clear on how exactly lasers might be a risk while I’m breastfeeding. However, it did put some questions in my mind, and I don’t know if I have the motivation to figure out what the risks are and if I want to go ahead regardless.

4 Comments

  1. I am studying Physical Therapy. Electric stimulation is a great way to provide pain relief and activate muscles that are weakened by atrophy. The mild electric current runs through the muscles just between the electrode patches on the skin. There is no clinical evidence that it can harm a developing baby. However, we are not allowed to do it if the woman says there is ANY chance she could be pregnant. The actual problem is that when anything HAS gone wrong with a pregnancy, and the woman choose to blame Estim, all court cases ruled in favor of the woman against the Physical Therapist who administered Estim. Therefore I would not be able to tell a pregnant woman the biologic/ physiologic rationale behind not administering Estim while she is pregnant. There is none. But we won’t do it nonetheless.

    • Hi Katie, thanks so much for this comment!!! Very helpful to understanding what the rationale might be. For me, the amusing part (because it was funny, not frustrating) was that she didn’t seem to understand my question, or maybe she was just answering the question she thought I was asking. Though if there really isn’t a physical process by which it might be dangerous, perhaps she didn’t want to state that directly.

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