Thursday, March 7, 2013

Embracing Helplessness, by Nathan Douthit




My classmate Sarah wrote an excellent post on our clinical rotations just last week. If you have time, you should go read it (seriously, go now, this post can wait). The day she is writing about I was in the same group, forced to speak Hebrew with a patient who did not know English. It was kind of a random draw, nobody knew who was going to interview whom, and I ended up with a Bedouin woman who spoke only Arabic and a little Hebrew. During this rotation, and through the course of my Hebrew learning, I have learned a very difficult, but important lesson for all who wish to be medical professionals.

            First, a word about my Hebrew speaking proficiency. There are many students at MSIH who grew up with Hebrew speakers in their families, or went to day school and learned when they were younger, or had some type of connection to Israel that caused them to learn the language early. They came in July, and were able to settle in, shop, look things up online, figure out their bills, etc. I am not one of those students. When I arrived, I could barely distinguish between an aleph and a tav. Transition to life here was not smooth, but jarring and difficult, and in many cases, very lengthy. As a matter of fact, after several frustrating hours in a government office and on the phone (Most important phrase I’ve learned: “Eta medebear anglit?” or “Do you speak English?”) I just secured a student discount for our apartment tax, 8 months after we arrived.

Anyways, back to my story. I slogged through my interview, struggling with grammar, syntax and appropriate wording (asking some inappropriate questions on the way, quite by accident) and struggled to understand her answers (thankfully she occasionally shifted to Arabic with our translator, who then told me in English). Afterwards, I was exhausted from the mental effort. Once the woman had returned to her son’s side, the translator told us a little more about her. She lacked significant formal education, and her son was one of her four children. When he was young, he was diagnosed with a rare genetic disorder, in which he can’t feel pain. When she first came to the hospital, this woman spoke no Hebrew. She learned what she knew through her many repeated visits. I tried to imagine myself in that situation, and shuddered to think of it. I remembered all the difficult situations I had been in as I was learning Hebrew, and realized they paled in comparison. As helpless as I felt at the market, or the post office, or any government building, this woman must have felt it a million times more. Watching doctors measure her son’s symptoms and ask her unintelligible questions I realized that was no game for her; she wasn’t trying to buy cheese or pay bills, but to have her son healed. What a nightmare that must have been. What unimaginable helplessness.

Patients have a variety of complaints against doctors. They have no time, they use words I don’t understand, they don’t listen, etc. But as I listened to the difficulties this mother had faced and overcome, I realized that these complaints can be summed up in one. Doctors don’t speak the language of their patients. By the time we battle for medical school admissions, spend four years filling our heads with knowledge and then 3-10 years filling our hands with work, we’ve left behind the most important experience of all. We have forgotten what it is like to feel helpless. We feel no compulsion to slow down, listen, and speak to our patients. We feel no obligation to immerse in their culture, to understand their hopes, dreams and fears. We have the answers, and  we can just shove them down their throats until they feel well. We act as those who have no vulnerability, who possess no weakness, who fear no thing.

            I reflect on the times when I’ve struggled in my language learning, and see the many times I have felt helpless, and realize that the simplest kindness from any stranger has helped me so much. It is, in my opinion, valuable for doctors to experience this, to remember their own frailty and so have compassion on the frailty of others. Learning Hebrew is difficult and continues to be a challenge, but it is good for me, and for all future doctors, to embrace helplessness in a situation. In so doing, we may learn empathy when we are the ones who can bring comfort or affliction, peace or unrest. - Nathan Douthit, blogger of the month

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