Doctors’ sickest patients struggle to be heard, but the ABC taught me to listen
When my patient Paul died unexpectedly, there was an outpouring of grief. He’d considered himself an ordinary man but his memorial was filled with those who spoke of his selflessness, goodwill and uncommon poise in the face of a terminal illness. The funeral came and went. The insurance forms, too. But whenever I handed over another form to his wife, I saw her sorrow and wondered how to assuage it. The short answer was not much else except await the consolations of time.
Some time later, I was making a program for the ABC about the ripple effect of cancer.
When people face an illness, their narrative is all too often taken over by others but I wanted the actual sufferers to tell their story. In approaching Paul’s wife, I had two intentions. First, I hoped that, in some small way for her, a sorrow shared might be a sorrow halved. Second, it was my way of saying to Paul that I still remembered him.
I took a deep breath before calling Paul’s wife.
“Do you feel ready to talk about Paul?”
“It’s the ABC,” I added, not prepared to push any more.
“Then I’ll do it.”
I needed two more patients to complete the series but never had a chance to go down my list because the first two said yes. It wasn’t the first time I saw that people had an inherent belief that the ABC would treat their sacrosanct stories with the respect they deserved. Indeed, this became a recurring theme and I am glad to say that the patients were never disappointed and often thrilled. After all, where else would an Afghan refugee, an Indian migrant and a Sudanese teacher find free expression?
Amid news of the roiling controversies embracing the national broadcaster, I have felt much sadness for, and solidarity with, the staff I have been fortunate to know. They have taught me some invaluable skills along the way.
Bedside medicine, affecting change one patient at a time, contains great meaning but I have also yearned to democratise medicine. If the doctor-patient relationship lies at the heart of good medicine, doctors must publicly champion humanity, ethics and professionalism on behalf of all people before they become our patients. I wanted to tell stories because we live and learn through stories. This is why several years ago I went to the ABC, looking for direction and guidance, armed with nothing more than ideas. I was not seeking a job but looking for a platform. I was a migrant, the lucky recipient of an Australian medical education, but I had no clever connections, no public profile and no media experience. I expected nothing but received more than I had ever imagined.
For a start, nearly every single person, from top to bottom, whom I wrote to actually responded. One prominent journalist began with apologising for the delay in formulating a meaningful response. Another introduced me to the then editor of Guardian Australia. Seconds before going live, a presenter calmed my nerves. Another helped me prepare for my first few public events. Producers, researchers and camera operators all found time. They made me practise till I protested that medicine was easier, and gave me lessons on expression, content and avoiding misadventures with a live microphone. They were unstinting in their goodwill even as they were squeezed for resources and their own future was in doubt. And their sincerity and sensitivity towards my most vulnerable patients never failed to move me. As an outsider, it was remarkable for me to witness how these people cared not just about stories but the people who told them.
These days, I am an occasional cohost on the Conversation Hour with Jon Faine.
On the show, I have an opportunity to canvas important healthcare issues such as loneliness and caregiver stress and also interview guests who range from authors and sopranos to comedians and counsellors and everyone in between. As an oncologist, my career revolves around extracting stories from strangers but, of course, medicine has its own way of doing this. It’s called taking a history and involves rapid-fire questions. How would you rate your pain? Why didn’t you take your pills? What did the surgeon say? How much do you smoke? When was your last scan? Unfortunately, far too many histories ignore the hapless patient, with the average doctor interrupting within 20 seconds.
The most important skill I have learnt at the ABC is how to listen. Like every novice interviewer, I started by racking my brains for what to say next so as to not sound clueless on live radio. But then, there was nothing more grating than a missed insight while I wandered the corridors of my own brain. Through a lot of watching and learning, I realised that if you pay attention to a conversation, the rest will come. In fact, this understanding has been my saving grace as a doctor. All too often, my sickest patients are receiving the right drugs but they struggle to be heard. The majority of healthcare complaints involve a failure of communication. Making patients feel as if their story is the only thing that matters in whatever time we have is integral to good medicine and it uncovers clues that might otherwise have been easily missed. Cynics might ask where the time is to listen amid the trappings of modern medicine but, even as a matter of expediency, a heard patient is a satisfied customer.
Recent events and the dismayed public reaction have underscored the important role the ABC plays in the lives of millions of Australians. I could never have predicted it but it has certainly shaped my life and allowed me to affect the lives of my patients. Not too many doctors are taught by journalists but I will happily admit that the people of the ABC have filled in some important gaps in my education. It turns out that the ABC enriches society in some uncommon ways, which is why I sincerely hope it finds its feet and continues to uphold its fine tradition.
When people face an illness, their narrative is all too often taken over by others.
The majority of healthcare complaints involve a failure of communication.