Symphony of Silence

I remember the curtains like a mantle enfolding us, protecting us from the darkness of the night. Only a dim light glowed in the room. The thrum of the oxygen machine—dedoov … dedoov … dedoov—made it hard to sit comfortably in my recliner. 

I watched his face, his hands, his upper body slowly going up and down in their own rhythm. I recalled how privileged I’d felt when his relatives asked me to watch over him in his last stage of life. 

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I stare straight ahead at the computer screen, trying to blend in with the other medical tools in the room: IV drips, ventilator, feeding pump, chest tube canisters, nurse. I listen to my patient’s mother read to him.

She’s reading from a book my mother read to me many times. Listening to the story sends me back to my childhood. I’m cuddled up in my mom’s arms, in my pink flannel pajamas, in my parents’ warm, familiar bed.

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Listening with an Invisible Ear

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

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The Sounds of Grief and Mourning

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.

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Listening in Music and Medicine

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.

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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.

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Always Time To Check In

“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?

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An Abiding Presence

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?”

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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.

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Last Wishes

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.

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A Golden Gift

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.

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February More Voices: Listening

Dear Pulse readers,
If someone were to ask me what’s the most important and rewarding part of being a doctor, I would probably answer: Listening.
That answer might seem odd: You don’t need to go to medical school to learn how to listen.
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