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When patients are willing to share their stories

Bruce Campbell, MD
Conditions
September 22, 2010
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We say we exchange words when we meet. What we exchange is souls.
-Minot J. Savage

It was Monday evening. The shelves in the electronics department overflowed with different styles, prices, and brands of headphones, all displayed in sealed plastic cases. I was in the mood to buy but was baffled by the array of options in front of me. This was not going to be as simple as I had thought.

A young salesperson broke off his conversation and sauntered casually to where I was struggling. Grinning impishly, he leaned on the display.  “Hey,” he wanted to know, “how was your weekend?”

“How was my weekend?” I repeated silently to myself. I neither looked up nor answered. What kind of question was that? Was this some new technique he had learned guaranteed to increase the likelihood of a sale? I’m here looking at headphones and he wants to know about my weekend?

I put down the package I was examining and glanced up at him. “It was busy but I doubt anything that happened would be of much interest to you.” My desire to spend money at that store had evaporated. As I headed toward the door, he called after me to wish me a nice day. I can only imagine his facial expression as he did so.

The next morning, I was in the office seeing a newly diagnosed cancer patient. Each question about her cancer and its symptoms elicited more anxiety. She nearly shook as she related the problems she had experienced: worsening pain, trouble swallowing, difficulty talking.  Her unease only grew as I probed her smoking and dietary habits. Her family tried to reassure her.

I crossed the room to begin the examination. As I checked her skin, I noticed that she had a faint sunburn. Maybe there was a story there. “So tell me,” I asked with a smile, “how was your weekend?”

Her face lit up. As I continued the examination, she told me about how Saturday had been spent outdoors watching her grandchildren play soccer, taking them both to the park, and then stopping for ice cream. Sunday had started with church and then a quiet afternoon with an old and dear friend. By the time she finished, she had visibly relaxed and I had a context through which to understand how her upcoming treatment would affect her, her family, and her close friends.

I suppose it was presumptuous of me to ask about my patient’s weekend. I had, after all, bristled at the notion that the young salesperson considered it his right to ask about mine. Occasionally, a patient will let me know that I have crossed a boundary when I steer the discussion toward the more personal.

Most of the time, though, my patients are very willing to share their stories. From my perspective, there are practical reasons to understand social contexts and relationships; what they choose to share often points to the people and things that are most important to them.

Months from now, when the fear of the disease has been mastered and she finally sees her life as pre-cancer and post-cancer, it is very possible that my patient will turn to me with a smile and ask about my weekend. As I happily summarize my time away from work, maybe I will throw in the tale about how I was so rude to the young salesperson. I suspect we will laugh at both his ingratiating tactic and my overly sensitive reaction. After all, when I tell it correctly, it really does make for a great story.

Bruce Campbell is an otolaryngologist who blogs at
Reflections in a Head Mirror.

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