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. At times, a medical student may get a different version of the patient’s history than the attending physician does, providing insight into the patient’s experience that would otherwise have been missed.
Unfortunately, the current climate limits the amount of time clinicians have with patients, potentially jeopardizing their well-being. The introduction of electronic medical records, a significant advancement in the field, brought with it some unintended consequences such as diminished interaction with patients and checklists that may satisfy performance metrics without actually addressing patients’ needs. It is easy to run down lists of standard questions, rather than listening to our patients and connecting with them in a meaningful way. If we focus on computer screens rather than making eye contact with patients, we miss their facial expressions and other nonverbal cues.
Similarly, in a musical performance, important cues are missed without the appropriate focus. If members of an orchestra focus only on their individual instruments and ignore the conductor, the results can be disastrous.
When I was in medical school, a psychiatrist told us a story that demonstrates the power of listening in a very profound way. He had asked a medical student to interview a patient with conversion disorder. The patient had been unable to move his arm for a significant amount of time, and there was no physical explanation for this. The student took the time to listen to the patient’s story and, at the end of the session, he was suddenly able to move his “paralyzed” arm. He was essentially healed as result of a medical student’s taking the time to listen to his story.
In medicine, as in music, there is a lot to be learned by listening and paying attention. Sometimes a listening ear can be the one thing that makes a difference in a patient’s life.