I can’t hear you while I’m listening

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When you go to a doctor’s office and sit down with a physician/PA/NP, do you feel listened to?  Have you ever walked out thinking to yourself, “Wow, they really took the time to listen and understand my perspective.”  I’m learning more and more that the art of being a good medical provider is more about communication and listening skills, than it is memorizing drugs and diseases (that’s what we have iPhone apps for.)  There are no apps for compassion, listening, empathy, and giving someone all your attention and enough time to be heard.

It is important to get diagnoses right: to recognize psoriasis and lupus, cancer and schizophrenia, AIDS and alcoholism.  However, it is no less important to get the name of the illness right. It is no less important to recognize that for the sufferer, the name of the disease, spiritually speaking, is humiliation or fear or malaise or endless pain or loneliness or despair or the end of a career or the end of a life.  It is no less important to recognize that this is a human being to whom a terrible thing is happening, and whatever other name this terrible thing bears, its name is tragedy.   

One of the things we have talked about extensively in our courses is that being able to “take a good medical history” is everything.  However, somehow you have to find a balance between allowing the patient to tell us THEIR story with the nuances, effects, burdens, joy, sadness, discouragement and perseverance that is their own experience, and the list of a gazillion questions we have to make sure we cover somehow.  The dance between “tell me about why you’re here today” and “have you ever had cough? vomiting? heartburn? difficulty peeing? constipation? tremor? incontinence?  colonoscopy? tetanus shot? tuberculosis?  epilepsy?  do you shoot up heroin??” 

The truth we must bear as ministers of medicine, is that we must first see the suffering if we are to help relieve it, and that we cannot see it without in some sense experiencing it.  To be transformed, to love with open eyes, is to join in the suffering of the world, as Jesus did.

By joining the sufferer’s story through listening and affirming, I can honor the fullness of their personhood, that they are the hero of their own story, that I am joining them on their journey but that they are the ones courageous enough to carry the suffering that they do.  I must affirm that their experience and who they are is more than just an interesting diagnosis and a list of pertinent positives and negatives, that their story is much more complicated than merely the symptoms of disease, just as my own story is more than my own health problems.  Who we are is a composite of all aspects of our lives, everything is intertwined, which is why working as a healthcare provider is a spiritual endeavor.  To be truly compassionate we cannot stand at a distance.  We have to find out what exactly that disease means to the sufferer- is it merely the annoyance of flaky skin?  Or is it the identity as an outcast, a “leper,” unaccepted and uncomfortable out in our community?  What does the disease mean for their personhood?  Or have they been made to feel less of a person by impersonal healthcare workers and gawking society members?

I will never forget that scene in Erin Brockovich in which the cancer sufferer from the community Erin was advocating for asked if after having a double mastectomy and total hysterectomy, if she was still even a woman? 

This is where I believe I have to be willing to go with a patient, in order to convey the depth of love, compassion, and care that I believe I am compelled to convey as a follower of Jesus.  Yeah, it’s heartbreaking, but when suffering ceases to break out hearts, we have disconnected ourselves from the realities of this world in a way that reduces our ability to provide excellent care.

‘To be a patient is to be one who is patient, one who endures.’ ‘The Stoic ideal of patience is designed to result in resignation.  In contrast, Christian endurance produces hope.  The difference is crucial.  The Christian virtue of patience is the power that looks suffering square in the face, sees it for what it is, and then decides what is to be done about it.  It is in this process of clear vision, open acknowledgment, and careful decision that endurance produces character, the sort of character that is full of the hope that neither suffering nor anything else in all creation will ever be able to separate us from the love of God.’

I want to be the sort of provider that points patients toward hope.  Not a fruitless, misleading hope that “everything is going to be ok” but hope in that they are worthwhile, their lives have meaning, they are loved by the God of the universe, and that at least someone, if only myself, is IN it with them, is willing to truly listen to their heart.  I don’t want to be so busy getting through my questions and listening to their heart sounds that I miss their broken heart. 

note: all quotes from Margaret Mohrmann MD “Medicine as Ministry”

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One response »

  1. Well..I can honestly say that I had two of the best phyisicans in MO..our general and my OB..both we have had now for almost 20 yrs…and there’s a reason for that..we would go in..and they would listen..listen..listen..sometimes for an hour and half..never once making us feel rushed or like a number..now the challenge begins to find physicians in UT like that..at this point..it’s worth a plane ticket back to MO to see them yearly…but not practical to think I can do that forever..I believe you’ll be that type of PA for your patients…

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