Time to listen

Entschuldigung’. A single word used by the nurse in the Swiss hospital to express ‘I’m sorry, but I have to give you a prick’. Experienced, she was ready with tourniquet, needle and vial for the blood sample – no doubt a routine part of her job. But that single word, spoken with thought for me, meant that I felt I was actually visible, and treated with care. Empathy can be that simple.

Recent literature research  into general practice has (once again) shown that empathetic communication contributes to a patient’s health. It makes a difference if, as a doctor, you can understand the position and feelings of the patient. And so developing empathy is a must for doctors. You learn that little by little, the basis during training and after that day in, day out in the ‘university of life’. And if you are sick yourself and realise your own vulnerability your learning curve usually takes a sharp turn upward. That was my own experience, and it comes out in the personal stories in the book ‘Dokter is ziek’ [Doctor is ill] for which Gonny ten Haaft interviewed various doctors. And the conclusion? Due to their experiences these doctors began to realise how healthcare could be better!

Obviously this isn’t advocating doctors being ill. Luckily you can learn a lot about empathy from reading books and watching films. So it’s great that this year a special film committee of Medical Contact considered the question ‘Which films must every doctor see?’ And as a trainer it motivated me in the on-going training for doctors to make as much use possible of experience-orientated learning.  In this respect the development of serious gaming offers some great opportunities, such as the dementia-cabin ‘Into d’mentia’, in which you – in virtual reality – stand in the shoes of someone in the early stages of dementia. The reactions of a number of participants in a recent report by Omroep Gelderland speak volumes.

Back to empathy in everyday healthcare, back to the first step that every doctor today can take. From the inaugural speech ‘Kom communiceren’ [Let’s communicate] by Professor Sandra van Dulmen, PhD it appears that silence at the start of a consultation helps. Just listen to the way a patient tells his or her story. Listen to the words used, to the silences. Surprisingly this does not mean longer consultations; after two minutes the majority of patients have told their story. The doctor, by listening, obtains valuable information in a couple of minutes, information that they can’t really do without; and the patient has the feeling that someone has listened to them.

Empathy then develops simply by being quiet. By taking the time and paying attention – and trusting that you will find the right word at the right time.

Ssssh. Just be quiet and listen.

Or watch the film ‘As it is in heaven’, which, as far as I am concerned is on the list of films that everyone should see. Yes, including doctors – because I’ve never met anybody who hasn’t been touched by this film.

Trailer ‘As it is in heaven’ (with English subtitles)


A blog by Angele van de Ven