Sunday, April 9, 2017


From Erich Fromm's The Art of Listening:

  1. The basic rule for practicing this art is the complete concentration of the listener.
  2. Nothing of importance must be on his mind, he must be optimally free from anxiety as well as from greed.
  3. He must possess a freely-working imagination which is sufficiently concrete to be expressed in words.
  4. He must be endowed with a capacity for empathy with another person and strong enough to feel the experience of the other as if it were his own.
  5. The condition for such empathy is a crucial facet of the capacity for love. To understand another means to love him — not in the erotic sense but in the sense of reaching out to him and of overcoming the fear of losing oneself.
  6. Understanding and loving are inseparable. If they are separate, it is a cerebral process and the door to essential understanding remains closed.
 Some useful advice in there for the working physician.  It may not improve your patient satisfaction scores.  Press-Ganey is unlikely to have a metric that measures one's adherence to the above.  But a concentrated effort to focus on your patient's narrative with open mindedness, imagination, empathy and love sure seems like a good way to be a better doctor.

It's the best part of the job, really.  Once the OR lights go off, the post op orders are written, you finally sign out of the EMR for the night, what you will remember most are all those moments in time when you sat in a room alone with other human beings and listened to them tell you not only what hurt but what things were like before the pain started. Past and current lives and loves.  What the future might hold.  Expressions of gratitude and disappointment.  You will hear special and unique kinds of humor and anger and fear.  In a minute of side wise glances between spouses you will see the theretofore hidden dynamics of an entire relationship.  In short, you will experience the transformation of the human into the Human.  Real known people will emerge from the great mass of anonymity that we mindlessly push through every day like prairie grasses.  And all you have to do is sit there with patience and an open heart, ask a few questions, and just.... listen.

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