Things people have said to me recently that made them feel better while in hospital:
- A good toothbrush.
- Having their hair done.
- Their own pillow.
- Getting the blinds fixed so the sun doesn’t come in too early.
- Good food.
- No visitors.
- A view of fields.
- A visit from a medical student.
- A good explanation about lab results.
- Chatting about the allotment and what’s growing at the moment.
- Talking about trips to Ullapool and climbing An Teallach.
- A nice private toilet.
- Clean cold sheets.
- A good book.
- The lovely health care assistant that chats when they bring drinks around.
- Eating beetroot.
- Somewhere to put stuff and charge the phone.
- Listening to the chatter of summer swallows gathering outside.
I like that list, so please don’t turn it into a checklist, that would just ruin it. Just think about the list when someone is in hospital. What are your everyday conversations, or maybe like me you need an introvert’s conversation starter kit?
I talked about beetroot with the most amazing lady. We talked about pickling, grating, whole, sliced and what it goes with (everything, especially in sandwiches). We talked about Dan Jackson’s “Beetroot Line”, a well-defined geographical demarcation in pronunciation between the guttural (North) Geordie “beet–rooot” and the (South) Sunderland “beyt-roowt”. She gave me jars of the stuff and we joked about the inevitable gory mess if I fell off my bike while carrying it. I hope it helped, it was a distraction from a horrible illness and helped a lot with her anorexia.
I see patients in intensive care and as they wake and orientate to the day, they can have a great view from our hospital. We have large windows that let in the light from the sky and fields, the blue and green of normal, not the cold hard white of abnormal. I tell them the story of the giant spoon you can make out in the fields below. Yes, there is a giant spoon, just Google “Giant Spoon, Cramlington”. Spoons make for an excellent stimulus to sit up and look out the window.
I noticed a facemask by a patient’s bedside, he was finding the morning light a bit bright as there was a broken blind. He hadn’t slept well but didn’t want to bother anyone about it. It took a phone call to estates, and it was fixed that day. Sleep is always an issue to talk about and it doesn’t always need a tablet to fix.
Hospitals are boring places, they can get you down. People need to talk and sadly we are often too busy. A relative who was ill told me the nicest person they met was the person who brought tea. People benefit from the therapeutic intervention that is the “medical student history”. There is always so much to learn from people.
Having a student listen, enquire and detail your story is an incredible experience. I teach our students that every scar has a story. We have to learn how to deal with the complexity of human experiences. Nothing happens in a logical order, memories can fail and there are many wandering routes through stories. Finding common experiences helps, places you have both been, holiday destinations you share, and habits you have. A diagnosis can be hard to reach but it doesn’t always need a lot of tests, the answer is nearly always in the story.
What strikes me as I think through my list is how much we can do for and learn from people that needs no money, no drug or no test. We can be so much more efficient with our use of these interventions by just having more time with people.
What you need to be able to do is really, truly and completely understand the person in front of you. There isn’t quite a normal word in English which describes this level of understanding apart from a slightly odd one from Robert A. Heinlein. He wrote a book I enjoyed many years ago, “Stanger in a Strange World”. Written in 1961 it talks about a man raised on Mars, who comes to Earth in his early adulthood to understand humans and human culture on Earth. He brings a Martian phrase “to grok” which encapsulates this complete comprehension, a merger of understanding so deep that you merge or blend with a person or subject. We are the Martians, your patients are the earthlings.
The word has made its way into science fiction fandom, computer programming and gaming. I think this word needs to find its way into our medical language. It has made it into the Oxford English Dictionary:
transitive (also with object clause) To understand intuitively or by empathy; to establish rapport with.
When we truly understand people we know what to do for them. We will better use resources, we will do fewer tests, we will intervene less often, we will reduce misdiagnosis, over-diagnosis and can make people happier. It doesn’t take long to do this. Spend 15 minutes with someone, 15 minutes to be curious, to talk, to listen, to understand, to grok them. It will be time well spent.