The Art of Listening

The average physician interrupts their patient in the first 11 seconds of an interview. This is an amazing fact when you think about it. How often do we, in other types of relationships, value the importance of being a good listener, but throw it out the door when we come face-to-face with a medical challenge. The importance of good listening is taught in many medical schools - "90% of your diagnosis is a taking a good history" is an adage repeated multiple times through a medical student's career. It seems, unfortunately, to get quickly forgotten when the student steps out of the classroom, and enters into the realm of the doctor/patient relationship.

It was brutally cold this morning, and while that might not bother you or me, to the types of people I routinely see in my practice, it has a huge influence on whether or not they leave the comforts of their homes (if they have one). My normally busy Wednesday morning schedule was filled with cancellations this morning, as people decided they would just rather reschedule, than brave the weather to wait for the woefully inadequate city buses. One of the gentlemen I did see, however, had decided to embrace the cold, even though it meant walking a mile from his home to the nearest bus stop. He was 30 minutes late, and while that normally would result in an automatic reschedule, the weather-induced vacancies in my schedule allowed for him to be seen. He entered into my office, a tall African American male in his early 60's, gray beard stubble on his face, and MC Hammer (I kid you not) pants under an oversized parka.

His main complaint was depression, and he had been without a job for three years due to an acquired distrust for people - as he put it, "the same 'ol 'I can't trust the white man' song and dance." I asked him about his depression, and simply listened as he proceeded to unfold a story about trust, the breaking of said trust, and now an inability to trust anyone. I'm sure there was another side to the story, but for his sake, I let him just speak. It took about 15 minutes, with me "emphatically listening" to what he had to say. Afterwards, he said, "You know, I've never told anyone what I just told you. I've always felt like people have their own agenda, but you've totally put me at ease. I feel, so...like a weight has been lifted off my shoulders." I responded by thanking him for sharing his story, and the rest of the history and physical proceeded without any aberrations.

The power of just sitting there and listening is immense. Think about your own life, and how different things would be if people actually listened to you, and you listened to them.  Keep in mind, the type of listening I'm talking about is not simply a short-term ability to relay facts, but a true empathic connection with the speaker.  It makes you realize how important it is to put aside all the interruptions, preconceived thoughts and notions (very difficult for an "evidence based physician"), and just let someone talk.

And now, the disability quote of the day:

"I started having back problems after my disc got raptured in an accident."

Have a great hump day,
-DD