Dialogue Volume 15, Issue 2 2019 - Page 37

PRACTICE PARTNER if he could meet with the patient privately. This student had practised mirroring through the Alda Center. He didn’t use the words metastatic or malignant. He just talked to the patient slowly and simply, holding her hand as she started to cry and ask questions. “It was the perfect mirror exercise,” the medical student recounted. “I had been lead- ing, then she took over and I followed. Ulti- mately, what emerged was that I helped her understand death, and she helped me under- stand how to be a better doctor. It was exactly what the mirror exercise is about – that level of connection.” 3 Start at the end Alda has talked about the work of Dr. Evonne Kaplan-Liss, a former actress who worked as a journalist, then studied medicine and became a pediatri- cian. She now trains doctors. One anesthesi- ologist wrote to her and said she had changed her practice because of one piece of advice from Dr. Kaplan-Liss. Don’t start with the details; just get to the bottom line. The anesthesiologist used to give patients a lengthy description of what they could expect, and felt good about her thoroughness. Now, she begins by saying something like this: “You’re going to be fine. I’m here to keep you safe and comfortable. You’re not going to be in any pain.” Patients visibly relax. Only then does this anesthesiologist get into the specifics. Think of what patients want and need to know most, and give it to them first. The rest is background. 4 Create a narrative On Clear + Vivid Alda inter- viewed Dr. Karl VanDevender, who described his approach to first visits. He has a blackboard in his office, and has patients go through a timeline of their life. Just the act of writing things on the board in their presence shows that you’re listening. Then Dr. VanDevender puts what he’s learned into narrative form. The patient can add to it or change it. Patients aren’t a series of checklists to mark off, a catalogue of complaints or a set of symptoms. They’re walking narratives. “Everybody has a story. Everybody has a life experience that has texture and meaning to them,” says Alda. MD ISSUE 2, 2019 DIALOGUE 37