2022

The eternal goal for those in the medical profession is to accomplish treating, curing, and healing our patients. This has become particularly challenging with so many encounters now limited by Zoom, time constraints, masks, compartmentalization due to specialization, and shared anxiety due to the pandemic. But the challenge is one we must meet. The integrity of our profession depends on it.

I would make the case that listening is the universal medicament—an alchemy that transcends all else in clinical medicine. It is not limited by technical skill but instead is enhanced by the health professional’s willingness to be a witness to the patient’s story.

Here’s but one example: In the 1970s, when I was practicing as a primary-care physician, if one of my patients suffered a heart attack I would ask them, “Why did you choose that day to have your heart attack?”

I was surprised by the insights my patients offered. Virtually all of them who’d suffered a heart attack were trapped in life situations in which they had lost control. For them to be truly healed, they needed help uncovering the biopsychosocial, spiritual, and ecological interrelationships in their illness. This required a profound level of listening that went

Since mid-January, I have focused on listening. One morning the phone’s ring pierced my slumber. I listened intently to my mother’s words and tone as she explained that my father was hospitalized. New urgency and concern cut through her usual anxiety, altering the quality of her voice.

While attending a music retreat several years ago, I had the opportunity to play a piano duet with a more experienced piano player. As we prepared for the recital, it became evident that it wasn’t enough to focus on my part. I also had to listen to what my duet partner was playing in order to make pleasant-sounding music.

Sometimes, when dealing with patients, we get the real “story behind the story” only at the end of the visit or after several visits.

I leaned toward the physician I was shadowing and apologized. I had a class to get to. She nodded and said, “No problem. Hopefully today was a good experience.” She didn’t shake my hand, as her finger was the only thing blocking a hole in her patient’s common iliac artery. I wished I could stay longer, but class called. Med school puts you in odd situations.

“There’s always time to check in,” my supervising physician told me the other day, offering to chat about a patient who was not doing well. Would it be unprofessional to tell her that my problem is wishing I’d checked in not with the patient, but with my friend who’s now gone forever?

On a cold, February morning in 2017, I received a phone call from the resident psychiatrist on the psych unit at University of Maryland Medical Center. He introduced himself as Dr. Shapir Rosenberg, the doctor taking care of my twenty-five-year-old son, Adam.

With his warm and patient voice, he said, “Your son entered the psych ER with a drug induced psychosis. He was admitted to the psych unit and stabilized with Haldol. He’s doing much better. I wanted to reach out and ask about his history. Is this a good time to speak?”

Prior to my illness, I never had a regular doctor. I felt no need for one. My experiences with my small-town doctor growing up had convinced me that doctors cared. Doctors listened. Doctors would help when needed.

When I was hit with the very difficult neuroimmune illness, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), I was terrified. The symptoms knocked me into outer space; they were unlike anything I had experienced before.

Making my rounds, I come to Room 603. As I put on my PPE, I see that my patient is desaturating, despite the heated, high-flow oxygen I placed her on yesterday. She isn’t in distress, but the numbers on her monitor tell me where things are headed. When she was admitted two days ago, we talked about the possibility of her needing a breathing tube if she got worse. At that time, she told me that, yes, she wanted everything done to save her life if it came to that.

I spent my early years as a talker—one who told stories to her dolls and instructed them how to behave in imaginary social situations. Although I was a good student, teachers often labeled me as loquacious, as the student who raised her hand but spoke before being called on. Only when my parents and paternal grandmother told me stories did I stop speaking and start listening. The more they shared, the more I learned the value of not just hearing the words of others but of listening to the meaning behind those words.