Saturday, 23 March 2013

Am I too good a listener?

"A good listener"

That is what we all want our doctors to be.
As patients we want to be listened to for practical reasons as well as the emotionally therapeutic benefits. There is a whole 'industry' to listen to patients, which, don't get me wrong, is excellent and much needed. But I want to talk about the listening skills of patients in this post.
Rather like buses, I have had three medical appointments in the last six weeks, with my consultant, specialist nurse and GP. I see the consultant yearly and this is the first time I have seen the specialist nurse. When appointments are so few and far between and conditions are so rare that these are really the only people that can give you any answers, it is understandable, I think, to listen to them. Listening to them is so important that I always take someone with me, just to listen and take notes.
When I told my consultant about my relapses, they didn't say anything and glossed over them with a matter of indifference. Everything was fine apparently. Describing them to my specialist nurse a month later, I got a very different response - "I don't think that is normal at all. I think you should get examined by a doctor next time you have a relapse." There was no trace of indifference this time.

I brought this up with my GP as I needed to pre-warn him I would be booking an emergency appointment when I next had a relapse. My GP said that I was a very good listener, but perhaps too good?! I needed to take both comments with a pinch of salt, that the truth of my relapses lay somewhere in between the two.

It was like the three bears, with me as Goldilocks stuck in the middle! Consultant saying nothing to worry about, specialist nurse saying lots to worry about, and GP saying something in the middle (I am yet to work out if what the GP said was 'just right' yet!).

As a patient who actively self-manages, information is important. I need the expert knowledge of my clinicians to help me manage my health as effectively as possible. To do that, I need to listen to them. But I do more than just listen, I hang on their EVERY word! I see them so rarely and respect their expertise so much, each word is like gold-dust - a potential clue to help me get better, or at least cope better. Maybe that is a sign that I am not self-managing as effectively as I could, but I think it is quite realistic for patients to listen like this. Picking up on their tone, body language and words, we build our own interpretation of what doctors and nurses say, and that can stay with us for a very long time. I can remember the exact words of various doctors over the years, and part of the emotional roller-coaster following all appointments and conversations is deciphering the intricacies of these messages - did they mean that?

It is undeniable that patients need to listen, to understand their diagnosis and treatments or management, but at what point can we become too good at listening? To the extent that it is actually detrimental? Putting aside differences in clinical opinion about my case, all my healthcare team are human and the doctor/nurse-patient relationship is a human one, which means that each persons' idiosyncratic tendencies will be present. Am I listening to the way their character communicates or the hard and fast facts? I am not sure, but I do know that when it comes to more sensitive issues, the character that shines through the communication, the compassion, can be the saving grace of many medical conversations.

As to which response was "just right", I will just have to wait until the next relapse. . .
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1 comment:

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