THE VALUE OF TAKING
TIME AND LISTENING

In our fascination with the latest scientific advances and in our zeal to run an efficient and bustling medical practice, we sometimes forget that some of the most valuable healing experiences (both for our patients and ourselves) come from the human interaction between patient and physician. That point was emphasized in a recent article published in Medical Economics.

A physician working at a busy walk-in clinic saw an elderly man (Bill) for a sore leg. Fortunately, the diagnosis and management were quite simple, and the doctor felt relieved that the visit would require only a few minutes, allowing trim to start clearing out the rest of the overflowing waiting room. However, feeling that he had been a little abrupt, the doctor decided to engage Bill in a brief conversation, and asked him how he had fallen.

Surprisingly, the question brought tears to the old man's eyes. As it turned out, Bill's wife had recently died of cancer, his children lived far away, and he was lonely. The fall that he suffered underscored how alone he was, as no one had been around to help him after he had fallen. The doctor dutifully listened to Bill's story and then, so as not to fall farther behind, prepared to end the visit. However, while rolling down the patient's pants leg, he noticed faint scars on Bill's knee, and asked reflexively where the scars had come from.

Patient and doctor looked at each other, the former contemplating whether he wanted to answer the question, the latter worrying about how much time the answer would set him back. Finally, the patient spoke and the doctor listened. It turned out that Bill had sustained the injury while fighting the Japanese on a South Pacific island during World War II. In the fierce battle, a lot of American soldiers had been killed or seriously wounded. Fortunately, Bill's injury was only minor. But, while he was running across the beach he found himself standing face to face with a young Japanese soldier. As they pointed their rifles at each other, Bill did what he had been trained to do; he killed the young man.

After the battle was over, Bill returned to the area where the dead soldier lay and took out the man's wallet, which contained a picture of his wife and young son. Bill took the wallet with him. After the war ended and Bill returned to his own wife and young child, he felt responsible for having left a young child without his father and a woman without her husband. So, he wrote to the soldier's widow and offered to finance the education of her son. They corresponded several times and, years later, Bill got a letter saying the son wanted to come to California to go to college. As he had promised, Bill paid for the son's college.

After the last tuition bills were paid, Bill never heard from the Japanese woman again. He went on with his life, raised his children, and retired. Then his wife died.

At the funeral chapel, Bill was surprised to see a room full of flowers (which he had not ordered). He was also told by the funeral director that all of the funeral expenses had been taken care of, including the flowers. Too grief-stricken to ask anything more, he proceeded with the funeral and then went on to the cemetery. Among the few people there was a middle-aged Japanese man, who turned out to be the son of the Japanese soldier Bill had killed so long ago. After college, the son had stayed in California and had managed to keep informed about his benefactor. When he learned that Bill's wife had died, he flew to Wisconsin and paid the funeral expenses. Although Bill was too stunned to say much, he and the Japanese man hugged each other, after which the man drove away in his rental car.

After Bill finished his story, he wept quietly, while the doctor was too moved to speak. They sat with each other for another few minutes; Bill then thanked the doctor for listening, shook his hand, and left.

The doctor had been with Bill for almost an hour, and had been told a story that Bill had never told anyone else, not even his wife and family. Despite being confronted with a waiting room full of frustrated and angry patients, the doctor did not regret having spent that time with Bill. He understood that Bill had much more than a sore leg - his entire being was in pain. The doctor also rediscovered the sacredness of the doctor-patient relationship. That bond had allowed Bill to open up in a way he had never done before, and to heal at a level that would not have been possible during a hurried office visit.

Alan R. Gaby, MD

Lundquiat TW. Why I listened to this patient for an hour. Medical Economics, April 14, 1997, pp. 194-198.

(Reprint, Townsend Letter for Doctors & Patients - Aug./Sept. '97 edition)

Copyright © 1996. The Light Party.