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On Listening

Writer's picture: Dr BahrouDr Bahrou

Recently, in a visit with a new patient, somewhere in the middle of the visit, I felt the familiar tug of insecurity. I wasn’t sure exactly what to do. I know. I know. I do not always need to have the answers. Frankly, more often than not, I will not have all the answers all the time and certainly not right away.


This is my journey of UNLEARNING.


In medical school, we are habituated to the process of a visit:


1. Subjective data: the patient’s concerns in the patient’s own words

2. Objective data: vital signs, previous labs, physical exam

3. Assessment: how do I put it all together

4. Plan: what are we going to do about it


Throughout residency and in my early years as a clinician, I was trained to try to make this happen in 20-40-minute visits, even with a person I was meeting for the very first time.


As consumers of western medical care, we are groomed to expect this process and to expect our doctor to know what to do and to have a plan during our visit.


This is no longer my process and I am grateful for the space to stretch and to listen and reread and cross reference and ask more questions.


In my solo practice, I can spend as much time as I need. Sometimes with new patients who have a long history, we sit together for more than an hour. As humans, our brains are wired to hear and put information together in story format.


“Humans only really learn from each other by storytelling. We didn’t evolve to memorize things. We evolved to hear each other’s stories and feel them in our heart. Your life is the most powerful story you can tell.” -- Martha Beck

“You’re never going to kill storytelling because it’s built in with the human plan. We come with it.” – Margaret Atwood

During that visit with my patient I squashed my insecurity by letting her know that it would take me a couple days to review the notes I had made during the visit as well as the medical history and labs that had been sent to me.


The freedom to take my time in contemplating the stories of the people I see allows me to explore more thoroughly and make more connections between what they have told me and what I have seen in the past. I can make a more detailed and individualized plan.


My time with my patient in the clinic is a time for listening. Only listening.


“When you talk, you are only repeating what you already know. But if you listen, you may learn something new.” -- Dalai Lama




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