We as humans are a social species. By that, I mean, we have the intrinsic need to meet and engage in conversation. Even people who call themselves ‘introverts’ have the innate requirement for social interaction. It is a physiological phenomenon, which eons of evolution has not gotten rid of. Or more precisely, eons of evolution has preserved our ability to connect to one another. Despite that, the modern human is not very good at engaging in conversation with another human, effectively.
Dinner parties often require our modern day humans to ingest vast amounts of alcohol to give us the ‘buzz’ so that we can talk to each other with ease. We rely on our social media accounts and our messaging apps on the phone to convey how we truly feel. I myself have engaged in many a passionate argument over a topical issue on my social media account. On buses and trains we’d rather talk to the people across a screen on our devices than to the people we are sat next to. We were all taught as kids that we shouldn’t talk to strangers. But surely as adults we have the capacity to at least smile and greet each other? But nope, if you get on the tube during rush hour, you might spend an entire journey squashed up obtrusively in someone else’s personal space but the world might just end if that fellow commuter spoke to you! Amirite?
It has gotten so ridiculous that I actually have classes at my university called ‘communication skills’. I am going to be a doctor one day and my day’s work will include talking to people. But not just talking to them. Communicating with them. This means that I will smile to show my kindness, listen actively to their problems, giving interjections such as ‘hmm’ to show my interest and say ‘I’m sorry’ when they say something sad and upsetting. I will say all this because it has been drilled into me. I have been educated in the proper format to respond to patients and pick up from their body languages. And perhaps it is a bit of an act and a bit of drama but at least I can communicate effectively. But some part of me feels ashamed that I need to be taught how to respond when someone shares their grief with me. Or how to react when someone tells me their problems. I wish that I didn’t need these communication classes and that I could talk to my patient as another human.
The other day, as I was rushing out of the lifts to grab some lunch before clinic started, a gentleman stopped me with a distressed look on his face. He couldn’t speak English, I quickly gathered and luckily I spoke the language he spoke. I spent the next fourty-five minutes taking him from one place to another and filling in a form with him. When I left him, I told him that a translator on the phone would be with him soon. I returned 3 hours later and he was still there. Shocked, I asked him what happened. He said that he would see the doctor now but there was no translator. He didn’t know me. I didn’t know him. But that evening his panicked, stricken face was all I could think of. He blessed me and being of a spiritual mind, he told me that the heavens would look after me. Looking back on it, I didn’t do anything great or fancy. But I did take the time to understand him and speak the language he spoke (literally). Perhaps that is all the help he actually needed.
A lady was telling a group of us medical students about her experience with her medical problems. Right from 1995 to the present day her biggest grievance with her doctors and nurses was that nobody took the time to explain or give her the information straight up. ‘He shoved the tissue box towards me’ was one of the comments the lady made. This had stuck with her for years. Perhaps people had explained her condition to her. Perhaps not. However, the point was that she didn’t feel that anyone had done so and really that’s a failure in communication.
We as future doctors make an active effort to improve our communication skills. Sometimes we get it wrong but often we don’t. Sometimes the care and genuine concern and desire to help (the reasons we all applied to medical school in the first place) get masked by our desire to impress our supervisors by asking lots of questions. Sometimes we forget that our patients are actually just as human as we are and talking to them how you would your sister or uncle or grandma perhaps is beneficial to both parties. I’ve often stepped away from the rigid Q&A style of patient-doctor interaction and taken a few minutes to understand whom I’m speaking to. I ask about the book they are reading. Or what job they do. Or what countries they’ve been to. Sometimes I learn a thing or two. People (not patients) come with years of life experience and myriad of backgrounds. Illness is just one aspect of every person’s life. It is important to look beyond someone’s illness and see them as themselves.
I wanted to be a doctor because I honestly love people. I love their history, their background, their circumstances. I feel privileged that I am in a position where people show me their vulnerabilities, their tears, their hopes and their worries. How disrespectful would it be and what a shame if I lost out on connecting with a patient just because I was more focussed on their blood result than what they had to say to me.
None of us are quite there but we must all embark on the journey to be better listeners, better talkers and better humans. Communication is what makes us social animals. Let’s not lose it.