“Be quick to listen, slow to speak.” That’s the old wisdom I was taught growing
up, though it sure is difficult to apply regularly and consistently, isn’t it? Nonetheless I can’t think of a better
principle for practicing good medicine.
I was reading Dr. Smith’s blog and was touched by his
Patients don’t know
how to put words on their pain, and there is no disease named for the pain that
the patient wants to tell you about. It’s about the inner anguish of this
particular person’s quest for life, their disappointment, the abuse they have
experienced, their feelings of failure and lack of significance, their rage at
the injustices they endure and they don’t have anyone else but you to talk
to. And, by having a relationship with a safe professional, some of their
pain is relieved and, in many cases, they get well or better! In some
cases, they don’t, but that begins to matter less than the fact that you begin
to understand that “getting better” is not the goal here. And,
if you keep trying to make the patient better with a prescription pad, they
will just keep bringing you new problems to chew on until you figure out what
they really need.
The truth is that at the root of many medical
misunderstandings is a listening problem. Sure we hear
lots of things, but in our rush to package complaints into a convenient
diagnosis we often miss the elephant in the room. An excellent example of a doctor practicing
good listening skills was described in Signout’s blog this week.
Some parents appeared a bit overly concerned
about their young child’s cold symptoms. The resident taking care of them
wisely recalled that the mom had mentioned that her aunt died of leukemia
as a child. The doctor made the
connection between that bit of history and their angst – and reassured the
parents that the child’s blood tests were normal, and did not suggest
leukemia (without them directly asking the question). The emotional relief that
ensued was the most therapeutic effect of the physician encounter that day.
The moral of the story is that listening really can be
a healing art. And it’s not just
reserved for psychologists and psychiatrists.