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How listening for stories saved my career in medicine: Scope@10,000

Throughout her medical career, listening to her patients has help psychiatrist Shaili Jain transcend the job's challenges.

Twenty-five years ago, I was a second-year medical student in Liverpool, England, who was secretly making plans to drop out. 

I had just spent the better part of the last two years studying thick textbooks with monastic fixation and hurdling my way over a steady rotation of tests, quizzes, anatomy spotters and final exams. I struggled to find meaning in what I was doing and found myself questioning all the tightly held ideals and motives that had set me on the course to becoming a physician in the first place. 

Thankfully, help came just in the nick of time.

My rigid medical school curricula finally opened to allow me to set foot on a ward and meet the city's people in their role as patients. From their mouths came the illness scripts that infused the textbook data stored in my brain with meaning.

These hours spent with patients engaged my eyes and ears in a way a book could never do. Through their stories, I learned how the chest pain of a heart attack is "crushing" and the thirst of diabetes is "insatiable." I came to know that joints riddled with osteoarthritis ache the most at the end of the day and that the trembling hands caused by Parkinson's disease shake most when those hands are resting.  

Thus began my gradual transformation from student to doctor.  

In the years that followed, I honed a practice of listening to patients' stories. When done correctly, this can yield volumes of critical information. After hours and hours of listening, my brain started to automatically organize and catalogue a patient's narrative, weaving it together into a coherent outline. I learned to make dabs of inference, while keeping their story in social context and paying as much attention to what is said as to what is not said, all the while searching for patterns and clues in the raw data that was being offered to me. 

Twenty years ago, I moved to the United States for postgraduate training. Being an immigrant is often bewildering, as adapting to a new country requires one to undergo a metamorphosis of sorts. I spent my first year in America as an intern, shuffling between intensive care units, emergency departments, bedsides and clinics, taking in the differences in language, culture, habits and customs of my new surroundings.  

To steady myself, amid all this foreignness, I gravitated again to my patients' stories. Through listening, I learned an invaluable life lesson that anchored me among this turbulence. At their core, these stories were not that that different from the ones I had heard on the other side of "the pond." Regardless of one's color, nationality, religion or race, the things that drive us as humans are fundamentally the same. We humans have more in common than we have differences. 

Today, as a frontline clinician practicing 21st century medicine, I find myself facing a new set of hurdles. Back-to-back clinic schedules; an electronic medical record that dishes up a steady stream of alerts, notifications and orders that demand my continued visual attention; instant messages, emails, texts and phone calls that require me to make immediate decisions and judgments; and, of course, mounds and mounds of paperwork. 

Through all this noise, once again, I find my ear searching for my patients' stories. I remain in awe at how the permutations of these stories are infinite and the possible outcomes endless. These stories still hold a universality of significance that often transcend the moment in the clinic and the defined space between doctor and patient. 

I still feel a sense of privilege that I am allowed access to these stories and can bear witness to the lives of their owners. I feel reassured in the knowledge that by insisting on deconstructing, understanding and honoring their words, I can sustain myself and my future as a physician. 

Shaili Jain, MD, is a psychiatrist specializing in treating post-traumatic stress disorder. She currently serves as Medical Director for Integrated Care at the VA Palo Alto Healthcare System and is a clinical associate professor of psychiatry and behavioral sciences at the School of Medicine. PTSD is the subject of her debut nonfiction book, The Unspeakable Mind

This piece is part of Scope@10,000, a series of original narrative essays from writers, physicians and thinkers in honor of Stanford Medicine's Scope blog publishing 10,000 posts.

Photo by Shutterstock

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