The healing art of listening
“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
observations:
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.
*another case of good listening here*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
In our level 4 NICU, we get a lot of stressed parents, many of whom quickly get labeled as “difficult.” I have found that many of our parents are justifiably difficult. One baby, for example, was born via EXIT procedure for known lung problems and was expected to be very sick. After birth, the baby was also diagnosed with mosiac trisomy 18. The parents were very intense, questioning everything, around for most of the day. Mom had a history of 4 or 5 miscarriages. I can’t even imagine what this family has gone through to get to this point. They have their precious little baby who, despite his problems, couldn’t be more perfect in their eyes. They have been fighting for him since their first miscarriage. Keeping this in mind when interacting with them, I quickly earned their trust and, surprise, they became a lot less “difficult.” A lot of the nurses in our unit are young and don’t have kids themselves. Most of us haven’t experienced anything close to what our families are going through and then we ask them to sit quietly next to the bed while we “do what is best” for their child. The sum of the family is not what we see of them in the hospital. They have been through years of their own experiences, all of which shape how they act once they are in “our” world. Keeping this in mind has made the nightmerish NICU experience a lot more tolerable for the families and makes difficult families a lot easier to interact with.
I thank Dr. Smith for raising the issue of healing listening and for the amplification that Dr. Jones provided the message.
Most of what we mean when we speak remains undisclosed until a good listener guides us along. When we are in the midst of a medical crisis this process becomes even more vital.
Drs. Smith and Jones’ posts are examples of how the internet will eventually support transformation of routine encounters with physicians. It will take some time, but the viral nature of good ideas cannot resist spreading.
Thanks again!
Thanks for your supportive comment, Village Elder. Drs. Smith & Jones will continue to do our part to be quick to listen and slow to speak.
I agree. I remember when i was pregnant with my 3 rd child and was searching for an OB/GYN. I must’ve interviewed a dozen doctors before choosing Dr. Hasan. Not only was she experienced, but her caring, thoughtful and genuine nature made a huge impact on me. I was so glad I chose her
.
Coincidentally, my labor and delivery with my 3rd was the quickest and painless of all my 4 pregnancies