The practice of medicine is unpredictable. Schedules are interrupted by emergency visits, requests by other physicians to see their infectious disease or dying patients in the hospital, unexpected admissions to the hospice in-patient unit, concerns from families as well as the hospice staff. Some days go along smoothly, with time to chat at the bedside with patients and families, as well as with staff. Other days are a nightmare.
I still carry a pager as well as a cellphone, and I have been paged and called simultaneously many times a day, even while I am in the midst of discussing a patient with a nurse or social worker. There is literally no time for quiet contemplation. My daughter called me many years ago from her college in Tucson and asked if we could have lunch together. I was delighted and asked if she could come to my office. She arrived about 30 minutes early, sat in my office, and watched as I was interrupted during patient visits by several emergency or physician phone calls, and a walk-in by a distressed family member, all the while I was trying to attend to my office patients and finish at noon so I could spend a half-hour with Rachael. At 12:05, I finally sat down with my daughter, whose greeting was, “Is that how your day usually goes?” When I nodded “yes,” Rachael shook her head and replied, “This is crazy.” I actually felt better because on those days, I feet the same way on the inside while I act “professionally” on the outside.
After a while, like many docs, I learned short cuts, efficiencies, hopefully to finish my day and have energy to take care of myself and have meaningful family time. One short-cut was to stop asking questions about my patient’s lives and focus on the medical problem at hand. If patients began to drift off topic, I would gently interrupt their story and bring them back to my concerns. Their concerns took too much time.
Then, I met Elisabeth Kubler-Ross-Ross, attended her workshop, and trained with her. The workshops, among other things, were a safe place for participants to tell their stories and release pent-up rage, grief and fear. One by one, participants came to the front of the group, sat on a mattress on the floor, shared their pain and released pent-up emotions. Very powerful, but equally powerful was watching Elisabeth, sitting quietly, a light amidst the pain and darkness, just bearing witness. She never offered advice. She knew that if people just had a safe place to grieve, to be seen and heard, that they would discover the insights they were ready to learn and make the changes that they were capable of making at that time. Besides working with her, I brought that faith with me to my medical practice.
Mostly, I ask the questions that I once avoided, because I know that my patients, most of all, want to be seen and heard. Of course, I need to be proficient in my medical skills. After all, that is part of my contract with my patients. In addition, however, they want to know that they are not just a staph infection, or the prostate cancer, to the Parkinson’s disease. They want a witness, not to fix their inner life, but to shine a light on their fears, grief and celebrations, when and if they are ready. Occasionally, my question will be an invitation to light up the darkness.
I have found that it takes very little time to listen to people’s stories when I do not need to fix them. Fixing is what takes, and often wastes, time. After a long piece of mat work, Elisabeth would often end the session with a simple, humble “thank you.” It is a gift to bear witness, an honor and a privilege. Elisabeth knew that her light could not exist without the darkness. As she often said, “All true benefits are mutual.”
The trust of my patients has been a tremendous gift. I chose a profession where I have had the opportunity to shine a light into the world. Equally important, I have learned that I gift others when I am humble enough to request that they shine their beacon onto my darkness.