How do I check that a patient really understands their diagnosis before I present options? I stop and ask, then I wait. After laying out the findings I ask directly, does any of this surprise you, and I let the silence sit. If they say nothing surprised them, good, we move forward. If they ask me to explain something again, I go back to the photos and illustrations and stay simple. I do not pile on more technical detail to sound thorough. Here is my rule. If the patient or their spouse cannot repeat the basics of what is wrong back [...]