Some chilly doctors, we've established, never tell us much, never call us by the name we'd be comfortable with, whether our first or last, speak only in gobbledegook, give us only a rushed few minutes, with hardly any chance to utter a question or comment, and in other ways give us "the silent treatment."

There is another kind of silence: not listening.

Also, not paying attention. A colleague's wife had a baby a few years ago. He was in the room too, "a regular patient's room," he says, "which made it seem very natural.

"Except that the TV was on and the doctor kept looking up at it during the delivery. I wouldn't really say he wasn't keeping an eye on things. But then he'd look up at the TV. It was like a scene out of 'St. Elsewhere.' "

One doctor, in the doctors' magazine Medical Economics, once wrote a confession called "Do You Always Hear Out Your Patients? I Don't." He wrote: "I confess! I'm guilty! I often cut the patient short, and I expect to keep right on doing so. It's the only way I can stay in practice. I simply have to preserve my emotional, physical and mental energies if I'm to perform my job."

But was he doing his job, the job of giving patients the attention they deserve? Is the doctor who rushes from patient to patient preserving energy or adding to income?

We can't expect our doctors to be paragons always. They're only human and they have a job many of us could never face. But more and more, doctors themselves are addressing this subject.

"I cannot be more emphatic," Dr. Stephen Epstein, a Silver Spring and Rockville ear-nose-throat specialist, wrote in a recent Montgomery County medical newsletter. "If we are concerned about providing a better image for ourselves, we must then slow down and establish better doctor-patient relationships."

Dr. Stephen Sheppard of San Diego wrote in Medical Economics of "two communication problems that impair patient relationships: not listening and not talking." He told how he learned from his doctor-father to vocally describe all he saw as he did an examination, because "people who come in for a physical want to know that they're normal." He told how he explained "anything of concern" as he looked over the patient from head to toe.

"Talking relieves anxiety for the patients, and they're more relaxed," he said. "But more important, talking solidifies your relationship . . . The only problem I see in telling a patient, step by step, exactly what you're doing, is that your practice is likely to double before you know it."

What can we do with the silent, ever rushing doctor? Many doctors tell us now: Speak up. Medical care is a two-way street. And it requires the effort of both doctor and patient.

However difficult it may be sometimes, we must learn to say calmly: "You didn't tell me your name." "I think I'd be a little more comfortable if you called me Mr. Jones for a while." Or "Just call me Jack." "I don't understand what you're saying. Can you just repeat that in simpler words?" "I don't understand why I have to do that." "Doctor, this is all going too fast for me. Can you just slow down a bit?"

Don't be shy. Every young reporter knows how hard it is to start asking what seem to be "dumb" questions. Yet once we start to do it -- whether we're reporters or patients -- it gets easier and easier. And, amazingly, it opens the way to real two-way communication.

Dr. Janet Maurer of Toronto General Hospital -- in her 1986 book, "How to Talk to Your Doctor" (Fireside Books, $6.95) -- explains that: "The doctor may be so familiar with the illness that he doesn't realize he is skipping vital basic information. Sometimes, you have to do the reminding."

Or, she says, "the doctor may feel you do not want a lot of information" (and, indeed, some patients do not). And "some doctors believe patients 'can't handle' the technical information or the whole truth about their problems.

"Such an antiquated approach has little room in modern medical practice."

She lists eight "patient's responsibilities":

1. "Disclose all information relating to your illness," including information about your family, home and work and previous medical problems. This is not the time to keep secrets.

2. "Keep office appointments or cancel well in advance."

3. "Plan your visit" -- "organize the kinds of questions you want answered."

4. "Stop the doctor when you do not understand and ask for a simpler explanation . . . He will not think you are stupid; he will probably welcome your participation."

5. "Ask questions." Or "simply say, 'I need more information to understand and cope with my rheumatoid arthritis.' "

6. "Follow the physician's advice; report quickly any adverse effects of therapy, complications from tests or worsening of symptoms."

7. Limit phone calls to problems like those above.

8. "Pay agreed-upon charges promptly or in a way mutually acceptable."

If we truly want good care from our doctors -- even from our very best doctors -- we may every now and then have to follow Dr. Maurer's advice about reminding them.

Dr. Jay Katz of Yale University, in his book, "The Silent World of Doctor and Patient," tells of a time he agreed to be informal adviser to a friend who had breast cancer and had "experienced great difficulty discussing various treatment options with her physicians . . . She wondered whether I would agree to serve as an intermediary . . .

"After she had undergone a modified radical mastectomy, the question arose as to whether to employ radiation and/or chemotherapy . . . It became apparent to me that crucial information about the severity of her disease process had been withheld from her. She needed to know so she could make an appropriate decision . . .

"When I met with {the radiologist}, he told me, 'Jay, the answer is obvious. Why worry the patient? It is for me to decide what to do. It is not the patient's decision.'

"I asked him whether I could read a paragraph or two from a recent article in a medical journal. He agreed and I pulled out the article, written by a physician, which spoke eloquently to the need for women to make their own decisions about the treatment of breast cancer.

"He listened with increasing puzzlement and annoyance, but he did not interrupt me. After I was through, he said, 'I do not understand why you read all this to me . . .'

"I responded, 'But this article was written by you.' "Next Week: How a doctor dresses. Does it matter?