Whose body?

“Do you want to hear what your heart sounds like?”
I never even thought about it, and all of a sudden it just felt so natural. I had just spent 10 minutes taking a history from my patient, listening to him describing his ailments as well as very personal details about his life, and then moved onto listening to his heart, checking pulses and all the rest of the tick boxing. As I semi-mechanically went through the process, it almost felt like the patient’s body had temporarily been consigned to me – my mind was working through symptomatology and differential diagnoses, now fully concerned with analysing the body in all its parts to figure out the reason for his admission – and it was now in my “domain”, somewhat. It’s as if at the beginning of every consultation patients agree to temporarily give up their exclusive intimacy with their body for someone else to get to know it closely, hold it in their hands and take it close to them, as it belonged to them. Of course, it’s all in best interest, and there is nothing particularly odd about that either (surprisingly enough).
However, it seems that while doctors do their doctoring with patients’ bodies, they rarely share their own art and discovery with the patients themselves.

So, as I heard that loud whooshing sound on the left sternal edge, it dawned on me. Whose body was this then? I had discovered something about the patient’s very own body that they were not aware of. Almost as if I knew their body better than they did, in that particular respect.
“Do you want to hear what your heart sounds like?”
I just blurted that out, in half excitement. Had it been my body, I would have wanted to find out that there was something I hadn’t known about it before.
“Yeah, why not – go on then”
I popped my stethoscope in his ears.
“Can you hear that?”
“Oh! I see!”

It was almost like giving that body back. Not keeping a portion of the patient’s body to ourselves, forever precluded from going back to the owner.
It’s worth remembering whose body it is.

It wasn’t mine. It was his.

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Silence

Silence. The first act was silence. And he exploded in a river of emotions, of pain that had been bottled up for too long. I like to think it was almost osmosis. Silence invites words, not just to fill the space, but to go beyond – as if they were attracted to not only fill the space in between us, but my space too. In those few minutes of silence, I gathered a deep understanding of the man standing in front of me. A man who had not been given any silence in months in which to pour his emotions. It was a river closed off by a dam – once the dam was broken, the river flowed with energy, but then placated itself and went back to its usual stillness.

Medical students often fear silence. There is a precise list of questions, a method, a sequence we go through in a patient history to specifically avoid that silence. Part of that is due to the time constraints we are often reminded of, that will be part of our professional lives. A precious 10 minutes per patient. And then there are the patients who seize the silence with force, and fill it with rambling words – they scare medical students too, and perhaps more than silence itself. When you can’t use silence, you have to revert to the questions, and the sequence and the method. But how much more superficial will that consultation have been, albeit necessary.

Silence breaks the barriers between us, vanishes the dams, and lets the rivers inside us meet and flow together. Silence is where souls touch.