Grand Rounds Vol. 6 No. 46: The Power of Listening

I once worked with a psychiatrist who called listening the most underrated skill, and his words are truer now than ever. Listening is hard work; too often, we just wait for our turn to talk. And that’s if we’re being polite. We don’t talk to each other; we talk at each other or sometimes over each other in the loudest voice possible.

This trend is both sad and wrong, but there is hope, as evidenced by the thoughtful posts I received on all facets of communication. In the wonderful post The Hidden Pearls of Medicine: Stories From Our Patients, Medical Resident recalls a first patient encounter. MR calls hearing patient stories a privilege and “has been left with a sense of wonder” after these encounters. On behalf of patients everywhere, thank you.

Fads in communication come and go, and Will Meek, a psychologist in Vancouver, wrote about discredited psychological treatments (Neuro-linguistic Programming, anyone?) He also offers sound advice about finding treatment that stands the test of time.

Dr. Rob at Musings of A Distractible Mind wrote the insightful Letter to Patients With Chronic Disease. It became a bit of a Rorschach test, prompting wildly varying interpretations of what he said. And How To Cope With Pain, a psychiatrist who both treats and endures chronic pain, offered How to Connect With Your Doc.

Erin is a pre-med student who has cerebral palsy. Like other chronic illnesses, it comes with assumptions and stereotypes, which she dismantles in “Cerebral Palsy: What It Isn’t.” I predict that her experience will make her a compassionate doctor.

Speaking of compassion, one of the toughest parts of being a doctor must be sharing bad news. Anne Marie, a family doctor and clinical lecturer at Cardiff University in Wales, shows us how medical students learn this difficult art in Teaching Communication Skills. Bongi, a general surgeon in South Africa who blogs at Other Things Amanzi, shares a real-life story in Salt Water Wells Up. And Marie, who blogs at Nourish Ourselves, describes being on the receiving end of such news in Breaking News, Breaking Faith.

But not all communication is sad. Dr. Michael Kirsch at MDWhistleblower decodes The VIP Patient: Doctor, What If I Were Your Mom? His fill in the blank examples are priceless. Sharp Incisions, the blog and nom de plume of a medical student, shows how a stethoscope can become a successful if unconventional communication tool. And Elizabeth, a medical resident in Texas who blogs at OB Cookie, explains how her conversational and party Spanish didn’t quite cut it in the gynecology arena. In addition to being very funny, I love how her affection for her patients shines through.

Like it or not, technology is affecting the way we communicate. Jill of All Trades, MD has a funny but pointed take on cell phones in Mission Impossible. (You’ll want your sound turned up to get the full effect.)

Some people even question whether computers and robotics will make doctors obsolete. Dr. Eric Van De Graaff, a cardiologist who blogs at Alegent Health, refutes this theory quite well in The Art of Medicine and Whether Computers Can Replace Doctors at KevinMD.com.

And the Happy Hospitalist’s Patient Initiated Rapid Response Teams has a bit of a Brave New World feel, as it takes patient empowerment to its not-so-logical conclusion (and it involves cell phones!  I’m sensing a theme here.)

The notion of patient empowerment is affecting not just communication, but compliance, Julie Rosen explains in The Balance of Power Between Patient and Doctor. (Read it in conjuction with Medical Resident’s Hidden Pearls.)

Empowerment was not in the medical research vernacular in 1951, when Henrietta Lacks died of metastatic cervical cancer. In Henrietta’s Cells Speak, Dr. Elaine Schattner recounts how Ms. Lacks’ poor, uneducated family had no idea her cancer cells were bought, sold and used at research institutions worldwide.

It’s not always about doctors and patients. Nurses are an important part of the equation, and Jacqueline, who blogs at Laika’s MedLibLog, offers 10 Random Tips for Nurses. 

Communicating is connecting, and I want to close with what I consider the ultimate example of human connection, Flowers for the Lovely Wounded at the Examining Room of Dr. Charles. In the tradition of William Carlos Williams, Dr. Charles is both doctor and poet. (Check out his poetry contest.) I wonder if that’s what made him so good at hearing what his patient didn’t say. Dr. Charles, I know she remembered those flowers and your kindness until the day she died.

Next week’s Grand Rounds will be hosted by Dr. Ed Pullen at DrPullen.com. His theme is In the Office, which can be wherever you give or receive medical care.

Thanks so much to all who submitted. This was truly an honor. Now if you’ll excuse me, I have to go get my “I Hosted Grand Rounds” badge.

25 thoughts on “Grand Rounds Vol. 6 No. 46: The Power of Listening

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      • Ha! I’ll pack my Birkenstocks! You just triggered another flashback–I went to an NLP workshop in Des Moines in the mid 80s and the hotel was also hosting a Budweiser sales meeting. So the hotel bar was the Clash of the Birkenstocks vs. the Loud Plaid Golf Pants. Ah, memories—

      • My brother and sil are hugely into NLP. Me? Not so much. My opinions on the subject might account for the fact that he does not speak to me. lol

        And Birkenstocks? I have 8 pair. That is all I wear. And, God help me, even in the winter, with socks. lol I can say I have shoes older than half these writers. The Birks would be the ones I mean. lol

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  5. One of the best grand rounds yet, and a very humanistic rendering. Of course I am flattered by the last bit, undeserved, but thank you. I enjoyed reading through just about all of the links tonight!

    • Thanks! Glad you enjoyed it.

      I’ve had a couple of colleagues comment on “Flowers.” And I would argue until the cows come home that my comments were well-deserved.

  6. Hi Jackie,

    We were honored to have our blog included in this wonderful collection of posts about the importance of listening in health care! Lots of useful information and many great insights!

    Julie Rosen & Jamie Rauscher
    The Kenneth B. Schwartz Center

    • Thank you, Julie and Jamie!
      This whole balance of power thing is most interesting. And I love how your post dovetailed with Medical Resident’s post about a noncompliant high school girl. Thanks so much for adding to the discussion!
      Jackie

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