Do They Know What I Am Thinking?

Always interested in receiving feedback about the “Difficult Conversations Toolkit”, a patient asked me if I would read what she had written.  “I am unsure,” she said, “of how I have structured it.”

“I’d be pleased to read what you have written,” I said.

As I often do, I looked up the definition of the word structure, which in and of itself refers to “an arrangement of parts and elements that are something complex.”

Her feedback arrived in an e-mail titled STRUCTURE OF THE ESSAY, with the following content. 

…You need to know the facts of my life

…You need to know the losses of my life

…You need to know my body

…You need to know my heart

…You need to sustain my hope

A conversation with a friend revealed the assumptions I make: typing in each one of my needs I thought about the assumptions I/a patient makes about their doctors and nurses.  Do they know, what I am thinking? There are so many levels to my thoughts and feelings about illness and treatment. Do I need permission to talk about the issues?

–reading each section and experiencing ones ability to make clear the issues prompted me to identify and explore my own position –a lot to handle all at once—deal with one section at a time.

–need to use prompts to help patient open up.

–watch out for those who compare rather than identify

This may be an unusual commentary for feedback. Yet, it strikes me that when offering patients a structure [Toolkit] to explore the experience of illness they usually respond by describing intimate thoughts and feelings. I discovered that initiating use of the Toolkit often comes down to a gentle nudge. Can it be that simple?