Listening! It’s not hard to listen, is it? Most of us don’t need any special equipment. You can listen anywhere. You don’t have to get dressed in a suit and tie to listen. So why don’t people listen?
Patients often don’t listen. They feel pressure to tell their story or make their point. Often, they have consulted Dr. Google and think they know the answer and what they want. Others have emotionally bought into an idea and don’t want to discuss it. They simply want a substance (or don’t want one) and there is no convincing them no matter how strong the data is.
Physicians often don’t listen. Their excuse is often that they don’t have time, rushing from one patient to another. One of the most dangerous problems in medicine is called “anchoring.” When you anchor, you lock into the first item on the differential diagnosis list and fail to entertain the other less obvious diagnoses.
What’s a fellow to do? I always told my patients that, if they felt I wasn’t listening, to call a time out and call my attention to what they were saying. When I suspected that my patient was not listening to me or a consultant, I would ask them to repeat, in their own words, what they had heard.
Listening to each other is vital. Listening with an open, non-anchored mind is essential to developing a healthy body, relationship and lifestyle. Knowing who you are listening to is critical. Listening to the static on the internet can be dangerous. The scourge of measles, once eradicated, is back because people are listening to the wrong sources.
Below is an article published in 2012. Reading THE ART OF LISTENING has reinforced my need for exercise. I need endorphins and with persistent exercise, I’ll get them.
Listen to me. You want to do everything you can to stay healthy! You want to clean up your act, eat an appropriate diet, exercise and take the time to enjoy life now, while you can. Also, say a little prayer. G-d may be listening. Tell him chronic illness is not fun and ask for a little help for you, me and the rest of mankind.
August 31, 2012
Over the last two days, I have addressed the question, “As patients, which qualities in your physicians do you value most?” Yesterday’s article focused on the value of “time.” Today, I want to focus on the value of listening. One of the most important skills a physician can develop is the skill of listening to both what a patient says and doesn’t say. Listening takes time but its value is immeasurable.
In prior articles I have strived to help my readers understand how doctors think. One of my most popular articles reviewed the decision making process involved in formulating a “differential diagnosis.” Recently, I was formulating a differential diagnosis for a patient suffering from a sleep disorder. The diagnostic possibilities were many. My patient, in typical teenager fashion, was a boy of few words. When he did answer my questions, his answers were vague. Luckily, his mother was present for his exam.
Mothers are great diagnosticians. After all, they know their children better than anyone. In my experience, once you get mothers engaged in the diagnostic process, they stand a good chance of coming up with an accurate diagnosis on their own. This particular mother inspired today’s article. Listening to her was a pleasure; and, sure enough, she made my job easy by coming up with the most likely diagnosis.
My patient’s sleep disorder stemmed from his exercise routine. In today’s vernacular, my patient was “cut.” He obviously spent a great deal of the time exercising. The problem was that his hours of exercise occurred in between 7 -9:30 p.m. Exercise stimulates endorphins. Everyone knows about a “runner’s high.”
According to Wikipedia, “Endorphins (“endogenous morphine”) are endogenous opioid peptides that function as neurotransmitters. They are produced by the pituitary gland and the hypothalamus in vertebrates during exercise, excitement, pain, consumption of spicy food, love and orgasm,and they resemble the opiates in their abilities to produce analgesia and a feeling of well-being.” They also will keep you awake!
Mom, without realizing it, led me to a diagnosis that might have taken many visits and tests to uncover. She saved a lot of time, money, and hassle. I’m glad my listening ears were on and functioning fully.
The takeaway message is clear: listen long enough and you will find gems of value in every walk of life. The true gems in this story are the endorphins. If they can keep a young man awake, what can they do for you? What are you willing to do to get them? All it takes is a daily exercise routine and patience. Just remember, you want your endorphins in the morning!