I met Miss Swanley* on August 10 in the RCRMC ED. She wasn’t the first patient I have ever personally interacted with; and yet, she was. I’ve done a fair bit of volunteer work and interning over the past few years. Getting brief histories, slapping on manual cuffs to stumble through taking BPs, and making casual small talk with patients and/or family members as their rooms were entered or cleaned. This time was different. Yes, it was another patient, in another hospital gown, in another standard bed. Another room entrance and conversation. But this time, my body and words weren’t there just to fill the silence. They were present to connect; to learn and listen. Interesting how much intentionality is needed to scaffold those things. The things that build relationship. The things that make a white coat (yes, even a short one with no breast embroidery) worth wearing. The things that earn those rays of respect and expectation painted in a worried face.
I walked in alone and swept myself to join her behind the veil. I was in her space now; the intruder to her little medical microcosm. This is where she’d spent the last several hours. She was its owner; I, a brief tenant, renting some floor and conversation space. She deserved my respect.
I hadn’t been given much time to prepare before entering the room. My intended preparatory prayer was more of a whisper hushed to God as my feet brought me in. “Help me listen and connect.” Looking back, I can’t believe pieces of the cheesy CLEAR acronym made it into my heavenly request. I’ve since sworn to myself to attempt a little more creativity. I found something out incredibly quickly—the mouth is not the only piece of the face required for effective communication. Her eyes were wide, and probed my own. I held contact and spoke clearly. She needed to hear my words and match them to the rest of my unspoken tongue.
Her initial body language was to stiffen and readjust into what I’m assuming was a more “decent” position. Fear and respect and anticipation blended into a cocktail I didn’t deserve. I came closer. I called her “Miss Swanley.” I smiled with my eyes and spoke clearly, beginning casually. “How ya doin’?” “How ya feelin’?” A well placed “Are you comfortable?” followed by the readjustment of her pillow. I eased in, lacking jargon and rigidity—partly because my stash of each is quite limited, and partly because she looked more like she needed a hug than a battery of stone terms. I began our verbal connection by stating the obvious—acknowledging her as a patient and inquiring about her status. I asked about her pain. What it felt like and where it was physically. If she’d ever had it before, and whether or not it scared her. Her words matched her eyes—yes, she was frightened. But she was also more relaxed, sinking deeper into her bed, less rigid than before. Feeling the cue to approach, I came forward and put my hand on her left ankle. I asked her how she was dealing emotionally. I’m not in my sixties. I’m not a minority. I’m not a patient whose family opted not to visit. But I became those things in that moment. We talked, just like a couple of people. My job wasn’t to give her medical advice—it was to reassure her that my team was doing everything they could. My job wasn’t to physically heal her—it was to reignite her hope. Her family wasn’t by her side, but I was there with my hand on her ankle. And I think that’s all she really needed. Yes, I would relay to my team that she’d like to be fed. Yes, I would see if her treadmill test results were back. Yes, I would check on how quickly she could “get outta this [gosh darn] fold-up bed.” And yes, I was listening.
I learned so much in that little chunk of time. That I have a natural tendency to tune-out of conversations, and need to be an active listener. Nodding and smiling only get you so far, and are often not the answer to questions of approach. I learned that I like to touch people—to be invited into their space and feel their body, their life. It helps me bind their situation to my own. I learned that though a picture may be worth 1,000 words, an expression have a going rate at least twice that. Exchanging looks. Speaking beyond the formation of words. It takes more effort, but that’s because it’s worth so incredibly much more. I learned that the patient is vulnerable, scared, and searching for a trust to cling onto. Healing is a hero with many faces. Some faces can be physically mended. Others hide deeper, hidden in thoughts and fears and soul. Making man whole involves gazing into each of these faces—the entirety of the being. Practicing medicine is a science. And an art. And a story. And silence not meant for your own words. And a hand on a left ankle in a [gosh darn] fold-up bed.
*Name has been changed to respect patient privacy