A National Day of Listening – Every Day

As I was driving to see a friend the Saturday after Thanksgiving, I turned on NPR to listen to my favorite show, Wait Wait…Don’t Tell Me! (check it out – hilarious and informative), and heard the newscaster announce that it was the National Day of Listening. Great idea – we have a national day for many things, so why not one for listening? NPR is a big proponent of listening. One of its many great programs is called StoryCorps, which is a collection of brief interviews with people who tell a story from their life. These stories can be of harrowing events, historic situations, or everyday occurrences that teach an important lesson. The stories are usually riveting and very moving – listening to them gives me a greater appreciation for life and usually shows me a different perspective than I have held. In fact, listening is by far the most important aspect of all communication. It’s seemingly ironic that while most of us consider talking to be the essential part of communication, communication is a two-way street in which we need to listen first in order to even determine what we want to say. There is no real communication without listening.

Unfortunately, listening as an art is on the endangered species list.

As we whiz through our lives, communicate electronically, and often feel that we need to multi-task (I am certainly guilty of checking email while supposedly listening on the phone), listening falls lower and lower on our list of priorities. So let’s take a minute and consider what listening is, and how it actually benefits us.

In coaching, we talk about three levels of listening. When we’re listening at level one, we hear what the other person is saying and consider how it relates to us. If someone tells us about their sick dog, we might recall the last time we took our dog to the vet. Or we might decide that they won’t be able to take on the additional responsibility that we were about to ask of them. Level two listening is intensely directed at the other person – we hear and hang on every word they say. Our attention is fully on the subject of their conversation. When we drop into level three listening, we listen less to the words and more to the feeling, the tone of their voice, and what is not being said. If we ask how things are at work and the person pauses before saying, “oh, everything’s ok” in a quiet voice, our level three listening sends out an alarm, telling us that things are not really “ok”and we might ask again in a different way if we really want to know, or quickly change the subject if we don’t want to get into it.

A friend recently told me about the breakthrough she had with a patient when she employed level three listening. The patient repeatedly came in to see her with very high Hemoglobin A1C levels. No matter what the physician tried, the patient’s blood sugar remained uncontrolled. At a recent visit, she asked what he would like to discuss and he simply said, “nothing.” So she continued to gently express her opinion that she was sure there was something that he wanted to talk about until he sadly shared that his son had committed suicide. Clearly, this was important in the patient’s inability to control his blood sugars and pointed his skillful doctor in a very different direction than continuing to educate her patient about diabetes. By listening to what was not being said, she was able to find the real issue that the patient was trying to communicate.

I hope that we can each bring real listening to all of our interactions. The quality of our relationships, the effectiveness of our practice, and our own satisfaction with life can’t help but improve. For my part, I’m turning my computer and distractions off when I talk and am looking forward to hearing – and not hearing – much more of every conversation.

About Helane Fronek

Over the past 28 years I have had a fascinating and fulfilling career in medicine, initially practicing as a general internist and then as a procedural specialist, caring for patients with vein disorders. As Assistant Clinical Professor of Medicine at UC- San Diego School of Medicine, I’m thrilled to be teaching medical students crucial communication skills along with many other aspects involved in the practice of medicine.
This entry was posted in building relationship with patients, effective communication in healthcare, physician coaching, physician communication, physician fulfillment and tagged , . Bookmark the permalink.

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