There isn’t a single person who hasn’t felt the stress of time-pressure and who, I would imagine, at one point or another, has reacted in a rushed or short manner to others as a result. Yet, when it comes to our physicians, we expect them to transcend this normal human reaction. We expect them to slow down, treat us as though we are their solitary patient for the day, push off their crammed schedules and personal obligations to spend time talking with us about our worries, fears, and hopes.
Last week, The Atlantic published an article titled, “Effort Is Not the Enemy of Compassion,” in which the author, Leslie Jamison, recounts her experiences of being an actor hired to play the part of a patient so that medical students could practice care interactions. A beautiful and poignant piece, she selects the seemingly smallest details and illustrates the massive impact they can have on a patient. “Checklist item 31 is the most important,” she notes, “‘Voiced empathy for my situation/problem.’ The students have to say the right words to get credit for compassion.” This simple statement struck me: what does empathy sound like?
I assume most of us have experienced an interaction where the person with whom we are speaking has said all the right things at the right moments, but we’ve left the conversation feeling empty. “I am sorry to hear that your mother passed away.” Voiced empathy. The words were said—voiced—(box checked), but did the speaker mean it? And isn’t that truly what matters, that the intent behind those particular combinations of words was genuine? And who is to measure the earnestness of intent?
The reality is that the tone and tenor of how something is said is absolutely key to conveying true concern. It’s not always what you say, but how you say it. As a physician, that is one of the first lessons you learn. But of equal emotional value is the ability to hold one’s tongue and silently listen. Maybe your patient is speaking, maybe she is not. It doesn’t matter. Sometimes there is nothing to say. Sometimes the unspoken is just as powerful as that which is voiced.
I am confident that there isn’t one of my colleagues who would disagree that the power of silence can be one of the most empathetic actions a physician can take. That is part of the art of medicine—knowing when to just simply sit in silent support.
Today is World Voice Day, perhaps we as we consider the artful use of voice, we also appreciate the thoughtful lack thereof, as well.