Essays

Accept the silence

I have learned to accept the silence. When I first started in my practice of medicine I found myself talking quite a bit. I would imagine most of it was nerves. The anxious excitement of having come so far and worked so hard to become a practicing physician. The worry about saying the right thing in the exam room. The fear of not doing what needed to be done for that particular patient. All of these things combined to create an energy in me that was unstoppable. One that filled every single pause in a conversation with words.

In this society this is not abnormal. We are a culture who is unnerved by silence. A study of 580 undergraduate students undertaken over six years, reported by Bruce Fell on The Conversation, shows that the constant accessibility and exposure to background media has created a mass of people who fear silence. We feel awkward and the silence unfamiliar as a result of this. And so our conversations continue, hurried and without so much as a pause to collect our thoughts.

 

As time went on, I began to be more confident in my skills as a physician. At the same time, I began to truly take the time to invest in myself. For me that meant taking small pauses throughout the day to center myself and continue to move forward. The benefits of meditation even in small forms have been proven over and over. Through this practice, I learned to value the silence. Silence is powerful. Not filling the silence with words, even moreso.

 

This comfort with the silence began to appear in the exam room as well. The outcome of which I was unprepared for. Patients are used to hurried physicians who have limited time to spend addressing their problems. They are accustomed to the way government has interfered into healthcare and turned this into the norm. They are not at all alarmed at our pressured speech or our quick small talk while we are doing four other things simultaneously. What they are not prepared for is the silence. As I started to allow a few seconds of silence while the patient was telling their story rather than the typical “what I hear your saying is” or some sort of redirect to hurry things along a beautiful thing began to happen. Patients began to open up about things that truly were affecting their lives and subsequently their health. They felt heard, listened to, and valued. Comments such as “I have never had someone listen to me like this” began to be regularly mentioned to myself and my staff. I began to see the healing power of listening. Many of my patients had conditions that I could not improve. Conditions that would ultimately end up taking their lives. What I could do was to meet them on a human level, attempt to understand and respect the silence. That in and of itself has such healing power.

I am a private practitioner and feel daily the pressure to see more and more patients. What I realized, however, was that allowing a few seconds of silence in a conversation took no substantial time out of my day. It did not put me behind. It did not create anxiety, stress, or a hurried sensation.  However, the effects on my patient interactions and therefore my patient’s perceptions of care were astounding. This translated into increasing my job satisfaction and allowed me to feel more involved in my patients lives. And it all began with a few seconds of uninterrupted silence.

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