‘Please Just Listen to Me’

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Written June 2017

It’s a cry of exasperation from a man desperately wanting to feel better. He’d obviously been given explanations for his illness which didn’t help, or even made him feel worse, so he strikes out in self-defence. ‘Please keep silent – just listen to me!’ he’s saying.

Is there a lesson in this little exchange in the book of Job for us physicians and other health workers, often trained for an action-oriented approach? We need to examine the skin, look for the anaesthetic patch, palpate the nerves, look at the eyes, check the hands and feet, then get out the scalpel for skin smears and rush them off to the laboratory to check for m.leprae. We confirm the diagnosis and prescribe the drug regimen. ‘Next patient, please!’

‘But please sir,’ came the question from a young teenager when I told him he had leprosy, ‘Can I ask you a question?’ It came as something of a shock to me, but I stopped. He wanted an explanation of how and why he’d contracted the disease. So I gave it to him, as best I could, and that helped him more than anything else I’d done for him that afternoon.

That short conversation changed the way I conducted consultations. Even with the problems of language and the pressures of work I focussed increasingly on taking the history and made sure everyone had the opportunity to ask the questions that were on their mind. I got to know them better; they probably felt better valued as people.

Years later in dealing with end of life issues in palliative care I found that listening is probably the most important skill to develop. But by then I was starting to have trouble hearing. Did it matter? I could keep silent. That would be wisdom.

Perhaps they, like Job, just wanted to hear what God had to say about it.