Optimism, trust and the power of communication
The Lantern: Volume III, Issue 2 - Article #1
It was quite a while ago, but the first time I sat in on a clinic session with my American friend Nick Dent I learned a lot about the therapy of communication.
A patient had just left, exclaiming “Thanks, Doc! The way you explained my symptoms matched exactly how I felt myself – it really made a whole lot of sense.”
Nick smiled at me when the patient was gone. “It’s not too surprising that it matched how he felt,” he said. “Chinese medicine theory is based squarely on the patient’s own sensations, plus the observable tongue and palpable pulse, of course. What is interesting is why they should be so surprised that our explanation matches how they feel.”
“Well, it must be because they don’t get that sort of explanation otherwise,” I ventured.
“I think you’re right,” he said. “It is hard to relate to a series of numbers on a blood test, since we don’t sense changes at that level. But TCM works with the same level patients live at in everyday life. For us, the sun really does circle the earth, so to speak, the moon does rise and set, and these things are meaningful. We live in the same world, and so naturally our explanations make sense, and it is easier to relate to patients.”
I related a few anecdotes about poor doctor-patient relationships.
“Tell me about it,” he agreed. “Some practitioners have no idea about the effects their words have on the patient; it can be almost criminal sometimes. If the patient isn’t strong, it can be devastating. Just the other day a patient told me that her local doctor mused, as he was looking at her blood tests, ‘Hmmm, interesting. These results are similar to those of a patient with cancer.’
“‘Excuse me,’ my patient interrupted. ‘Are you saying that I have cancer?!’ Her doctor looked surprised and said ‘Why, no, not at all.’ She demanded ‘Well then, why did you say that?’ He replied lamely ‘Well, it is true – and I just thought it was interesting.’
“Now if this patient had not been strong enough to confront the doctor – who many regard as the giver of life and death, remember – she might have taken this casual statement seriously, with God only knows what effects on her health.”
In the clinic with Nick, I noticed that he did not tend to use much TCM jargon when speaking to patients, he would always try to explain Chinese medicine physiology in simple everyday phrases. “Spleen” for example became “the function of absorbing energy from food and distributing it around the body”. Something a bit more complicated, such as “Spleen controls blood” might go something like “we have noticed that when the digestion is weak, a person bruises and bleeds more easily. Improving the digestion in turn leads to less bruising and bleeding.”
When I asked him about this, he said “Jargon serves many functions; it can be a status indicator and power symbol – ‘I know what this means and you don’t’ – and it can be used to hide ignorance – ‘Ah, yes, madam, I can state with great confidence that you have idiopathic borborygmus.’ The one thing jargon is not good for is communication, except among a peer group anxious to maintain boundaries. I am trying to give the patient a way of understanding how his body is working, and how I will be going about getting it to work better. Simple clear speech is best for this. You know, terminology that is difficult or unusual is not more accurate just because it is difficult or unusual. A patient who knows what I am doing and why will leave this office with a sense of optimism, and that has important therapeutic implications.”
Over the years of using many of his phrases and explanations in my own practice, I think it is the attitude of encouraging optimism that has shown the most profound benefits. Nick emphasised that every word, gesture, and facial expression could either help or harm the patient, and contribute or detract from your therapeutic effectiveness. The professionalism of your demeanour, your clothing, office layout, the lighting, air quality, music and general ambience of the clinical setting should all be therapeutic in aim.
“It’s not that you have to wear a suit and tie,” Nick said. “That depends on your clientele and what makes them comfortable. But if they trust you, the effects will be better, because they will have the confidence that allows their own healing powers to act at the fullest. And that is an ally you want on your side.”
– STEVEN CLAVEY
