RUMINATIONS FROM DEEP INSIDE
By Lavjay Butani
As I write this (or rather type this), I am reminded of how unique the act of scribing is, in of itself. Something that we take for granted, yet an act that is so profoundly powerful. For it creates..it gives meaning to formless and amorphous thoughts, ideas and emotions. And that is such an awe inspiring occurrence-the ability to create something tangible from nothingness and that too without the need for anything except one's own self.
Narration becomes even more powerful when it attempts to portray the deepest and innermost fears and desires of those who are vulnerable and at-risk, such as patients, who entrust us with this information and expect us, not only to faithfully represent these, but also to then act on these and allay their distress. Yet, medicine has become so far removed from the rich emotion laden narrative style of the past, to the sterile dispassionate approach of the present- a shift that has occurred slowly but steadily, but also very deliberately. This shift has been driven by various factors- the supposed need for 'objectivity' in health care professionals, the pithiness demanded by supervising doctors from learners, the 'busy'ness of our lives making us want to be short and succinct and the need to satisfy reimbursement requirements.
What that does, inevitably, is that the needs to those who depend on us the most-our patients, are left ignored or unaddressed, creating enormous dissatisfaction with the health care system. Studies in the medical literature have shown that documentation of patient-doctor discussions are very poorly done and that little can be surmised from written notes about the depth of exploration of patient emotions and concerns. Yet isn't that what medicine is all about: comforting and caring? Some might argue that care and comfort are provided, just not well documented. Perhaps to a certain extent that is true, but I know from personal experience that in the majority of instances, that is not correct. As we go through our lives and jobs and become efficient 'doers' our automaticity takes away from the personal engagement with patients and does them and our own selves a huge disservice-for somewhere deep down inside of ourselves, there is a voice that is telling us that what we are doing is incomplete and not what we were meant to do nor what we promised ourselves we would do when we entered into this noble profession. And this leads to the drifting away of our own soul and the loss of a sense of self-worth and integrity, and then to burnout.
Writing, especially from the perspective of others in our lives, can be one way to reinvigorate our relationships and the bonds that we have and can be profoundly therapeutic. By visualizing the World from the perspective of another, one can try to get a glimpse into their feelings. Sharing such narrations with the person from whose perspective we are writing can further lead to a strengthening of the therapeutic relationship by being the starting point for a discussion of different perspectives and then to an understanding of each others' realities. This is equally powerful when done at a patient-physician level.
All of this, of course, presupposes that we as patients and as health care providers do value this relationship. And of course, this takes time-everything that is valuable and important does. But should that prevent us from doing the right thing. NO!!
As Henry David Thoreau said 'A written word is the choicest of relics.'
So listen, write about and share your writings with anyone who you care about…pick up your pens and go forth to sow the seeds of creation and happiness!