A doctor’s most powerful tool
The most powerful way a doctor can help their patient is to listen.
By far, listening is the greatest portion of the value of any consultation.
Whatever the monetary value, even for a procedure, the greatest portion of the value is a doctor’s listening ear.
Feeling heard and understood is at the heart of every plight.
Because, if it was us in the adjacent seat, we’d want our physician to hear our story too.
To sit with, to bear witness to and join together in understanding, provides the greatest return of the patient-doctor relationship.
To listen is to provide true whole-patient medicine.
The mandarin word for listening “Ting“. It has an interesting composition and deserves our attention because it provides us with a vital clue to the listening posture that we must adopt with our patients.
When it is broken down into its constituent parts, the meaning “Ting” taken together can profoundly change the way that you listen.
The ear is king —The ear is central. Be present, stop your inner chatter and listen.
Ten eyes — Look at the person in front of you from several vantage points.
One heart —Listen with your heart and allow it to be moved, touched and changed.
I learnt this principle from Emeritus Professor Doug Bridge, one of the earliest members and past president of the Australian Chapter of Palliative Medicine. Doug has been the driving force and pioneer in teaching about the Spiritual dimensions of Palliative Care in Australia.
Doug first taught me that our “ear is king” and central in any consultation. Our patients deserve our undivided attention and non-fiddling presence to truly hear what they are saying.
Secondly, we are to employ our “ten eyes” to see where our patient is coming from. What does the world look like to them?
And finally to listen with “one heart” to feel where our patient is coming from.
Proverbs 4:23 (MSG) says that “all life begins in the heart” it is the “wellspring of life”. Our heart is sacred ground. It is the essence of who we are. It is our spirit. To listen with your heart is to truly connect with another human-being.
The details of listening with “Ting” in our practice lies within the anatomy of the clinical conversation.
When we listen and push past our urge to talk and interrupt, the first aspects of the conversation are often about the physical — what is troubling our patients, why they are here and why they are seeking our help?
But moving past this, we start to hear, see and feel for the true psychological and social impact of our patient’s plight. And moving even deeper as we engage our ears, eyes and heart, we start to hear about the heart of the matter — broken connections (either with self, others, nature, the sacred or the significant), the very basis of spirituality.
In one simple, profound but often difficult act, we have the opportunity to provide true holistic care — spiritual-psychological-social-physical care.
Listening — it is a doctor’s most powerful tool
For even if you sat in an uncomfortable silence and held that sacred space of suffering for your patient, that is too meaningful. To know that your doctor, is swimming in that sea of suffering with you, riches cannot buy this type of care.
A patient is more than their diagnosis, although a diagnosis is rather nice to have!
“Listen to your patient. He is telling you his diagnosis” — Sir William Osler
My encouragement to you is to think about the aspects of “Ting” next time you engage in a conversation with your patient.
Are you listening with an “ear that is king” using your “ten eyes” and listening with “open heart“?
Enjoy your health
Dr. Jonathan Ramachenderan