In “This Story”, Melissa Rosato spends more than the allotted thirty minutes with a new patient, and in doing so, helps to relieve some of her patient’s emotional burdens by simply listening to her story. As a consequence of allowing time for her patient to tell her story, Rosato is left to navigate a dark and deserted clinic after the office staff has cleared out early on a Friday afternoon. Rosato’s experience reminds us of the time constraints that can hinder doctors’ efforts to build rapport with patients and practice humanistic medicine.
As a medical student, I have witnessed a share of clinical encounters that were rushed and starved of true human connection. These scenarios often follow an uninspired script: Doctor asks, “What’s wrong?” Patient shares, “XYZ hurts.” Doctor asks for clarifying information. Patient answers yes/no. Doctor gives diagnosis and treatment plan.
In less than fifteen minutes, patients are ushered back out to waiting rooms. The ink has barely dried on the prescriptions clutched in their hands, and their heads still reverberate with unresolved questions/fears. The whole exchange resembles a rapid-fire tennis match, an exercise in word volley between two opposing players.
This is not the way to practice medicine. Instead, narrative medicine, as shown by Rosato, aims to foster the human connection between healer and patient. It thrives on dialogue, and dialogue is unlike tennis. In tennis, you answer an opponent’s play with an immediate and punishing stroke of your own racket. In dialogue, you aim not to silence an opposing player and close out a set, but to stand together to face an altogether different opponent—the tumultuous emotions and uncertainties of health and disease. Dialogue requires that a participant be attentive to the unspoken needs and wishes of the other. It requires that pain and grief be acknowledged, respected, and only then, comforted.
In “Finding the Words,” therapist Kerry Malawista writes of a dialogue spanning months with a patient who eventually was able to vocalize and heal from past grief. During a session, her patient divulged that she had lost a son to leukemia many years ago. Malawista, too, had also lost a child, and it would have been easy to speak about her own loss and commiserate. However, through unspoken dialogue and body language, Malawista realized that the mother had been carrying this sorrow with her for forty years and needed the space and language to grieve. Instead of immediately jumping to offering her sympathies, Malawista simply listened and beheld her patient’s recollections of her lost son.
Both Rosato’s and Malawista’s patients were eventually able to derive comfort and peace from dialogue. The dialogue that was shared between healer and patient was unrushed, non-judgmental, raw; it was the key feature of the doctor-patient relationship that helped to improve communication, personalize the patient’s medical experience, and ease suffering.
Annie Xiao is a medical student at the University of Chicago Pritzker School of Medicine. She completed her undergraduate studies at the University of Michigan in Biochemistry and Gender & Health. Annie is interested in exploring the unique doctor-patient relationship, medical ethics, and narrative medicine themes of illness identity and agency. Annie Xiao is on the editorial board of Intima: A Journal of Narrative Medicine.
© 2017 Intima: A Journal of Narrative Medicine