For those of us living in the Midwest of the United States a sump pump in the basement of the house is a necessity. The sump pump keeps the basement dry by pumping the accumulating water out.

So, what do a sump pump and your heart have in common?

Both pump the fluid (blood in the heart’s case) from point A to point B. Beyond that, there is not much in common.

Comparing the heart to a sump pump is a good analogy when describing congestive heart failure. It is often difficult to understand, for the person with no medical background, why the lungs fill up with water when the heart fails.

Trying to explain the underlying mechanism including the rise in the hydrostatic pressure may only confuse the patient. Using the sump pump analogy, for those who knows what sump pump is, is not only easier to understand, but easier to remember.

This is not to insult the patient’s intelligence. You should not even try to explain to me the intricacies of an internal combustion engine, even though, I drive a car every day.

In addition to using analogies to help the patients understand and remember, using graphical tools might be helpful as well.

I was not born an artist, yet I can reproduce a very simplified drawing of a human organ or system. I often realize that the patient is pretty much clueless what I am talking about until I literally draw a picture on a piece of paper or a white board.

Once, I had a patient who carried around a piece of paper with my drawing on it. She was using it to explain other people what was going on.

Obviously, different analogies and associations will work for different people depending on the educational level, social background and even religious beliefs. For example, patients from Florida might have no idea of what sump pump is and, thus, this analogy will never work.

Analogies and associations might also have an adverse effect. I once had a patient who refused to take the anticoagulant Coumadin since he thought of it as rat poison. He simply could not get over it.

It is only half the battle to make a diagnosis and develop a treatment plan. If the patient does not stick to this plan due to a lack of understanding or even lack of trust, the effort is wasted.