Rachel Naomi Remen, MD
Sunday, August 31, 2008
Listening, compassion, and Ho'oponopono
Becoming a doctor isn't only about attending medical school, graduating, and passing licensure exams. It's also a process of learning to engage with others in a healing way, even when they're feeling their worst. We may think we have little in common with our patients, yet this is an error.
Histories need to be taken, tests and procedures may need to be done, and through it all patients needs to know we comprehend and care about them. I used to think they wouldn't know unless I told them in words, but over the years this has changed. There are many ways to be present when someone is suffering.
One of the most potent of these is also one of the simplest: listening. I mean listening without inserting our point of view, related experience, or advice. This is very difficult for many people, yet ho'oponopono offers a way to keep our minds still while genuinely hearing another. At least it does so for me.
My colleague Rachel Naomi Remen MD is a pediatrician, counselor, speaker, author, and the director of Institute for the Study of Health and Illness in Bolinas, CA. She developed "The Healer's Art", an elective course now run in over 60 medical schools. Having dealt with her own Crohn's Disease for many years, she also knows what it's like to be a patient. In one of her wonderful books, Kitchen Table Wisdom, Dr. Remen writes:
Rachel Naomi Remen, MD
Rachel Naomi Remen, MD
"I suspect that the most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention. And especially if it's given from the heart. When people are talking, there's no need to do anything but receive them. Just take them in. Listen to what they're saying. Care about it. Most times caring about it is even more important than understanding it. Most of us don't value ourselves or out love enough to know this. It has taken me a long time to believe in the power of simply saying, "I'm so sorry," when someone is in pain. And meaning it.
One of my patients told me that when she tried to tell her story people often interrupted to tell her that they once had something just like that happen to them. Subtly her pain became a story about themselves. Eventually she stopped talking to most people. It was just too lonely. We connect through listening. When we interrupt what someone is saying to let them know that we understand, we move the focus of attention to ourselves. When we listen, they know we care. Many people with cancer talk about the relief of having someone just listen.
I have even learned to respond to someone crying by just listening. In the old days I used to reach for the tissues, until I realized that passing a person a tissue many be just another way to shut them down, to take them out of their experience of sadness and grief. Now I just listen. When they have cried all they need to cry, they find me there with them.
This simple thing has not been that easy to learn. It certainly went against everything I had been taught since I was very young. I thought people listened only because they were too timid to speak or did not know the answer. A loving silence often has far more power to heal and to connect than the most well intentioned words."
Before people come to my office, I spend a few moments with my own responses to their names, cleaning with whatever in me is related to their suffering. I am asking Divinity to help me be present with this, so that it may be released from me and from them too. I know I don't know the whole story, but this preparation seems to help me listen more compassionately to whatever patients need to say.
There is no particular outcome I am seeking, only to be present. While they are speaking, I can continue to work silently with myself, so that I can simply receive them. All the pain and troubles they share are opportunities for me to let go, also.
I never thought of patients' problems as opportunities before, but they are. Although we are in separate bodies, my patients and I draw from the same ancestral memory bank. That these people have come to me for assistance means that something we share is up for healing in us both. Ho'oponopono has taught me this. It also gives me a simple way of remaining quiet, present, and listening as people share their suffering -- which is also mine.
I hope this makes me a more compassionate doctor when people come to see me. Hopefully it also frees me to do or say what will benefit them most, even when that is to simply listen.