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| The Importance of Patience and Listening |
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by Matthew Goodemote MPT, Dip MDT - October 4, 2010
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In my last couple of articles, I have been trying to draw attention to how important communication is when it comes to your well-being. This week, I would like to provide you with a specific example of how important it is to be patient with yourself and others and to really listen hard.
When I was in physical therapy school, I learned a lesson that became the foundation for my career. It was a seemingly uneventful day. I was in my orthopedic class and we were learning about the evaluation process, and I was hard at work writing down exactly what the professor was saying about the evaluation process.
In my physical therapy program, most of students recorded the professors’ lectures and wrote down in their notes word for word what the professor said. Later, when studying, they would listen to the professor as they studied their notes and basically memorize what the professor had said during class. I was never quite this extreme, but I did try to copy word for word what the professor said.
So on this uneventful day, I was once again taking dictation from the lecture and I happened to look up from writing my notes and notice a friend of mine sitting there with his hands on the back of his head listening…just listening. I was stunned. He was not writing down what the professor was saying! I went up to him after the class and asked why he never wrote notes. This is what he said: “If I am writing what the professor is saying, I miss what I need to know. When I hear something I think is really important, I write it down and then later when I am studying, I read what I wrote down and it triggers my memory and I can remember what the professor was talking about.” I was stunned…again! How was it possible to remember an entire lecture by listening and just writing a couple words or phrases to trigger a memory?
I decided to conduct an experiment. I tried just listening to the lecture. Believe me, the first couple of times I had a hard time breaking my habit of writing down the professor’s words. But I found out that when I really listened, I didn’t need to write anything down. In fact, to this day, I can read a lot of my notes and remember the lectures. I have lost some of my recollection from 15 years ago, but surprisingly, I have retained a lot of it.
So how is this relevant to you? Well, I learned that if I listened, really listened, I could remember. More recently, I have learned that because I really listen, I can really hear what is going on. It is as though the picture becomes so clear that it is hard for me to forget and hard for me to miss the subtle, but important, pieces of the puzzle.
I have mentioned before how our initial reaction to an event is often more reliable than how we see it if we get too much information. Too much information can confuse the situation and often leads us down a more difficult road to wellness. This past week, a patient came in with complaints of knee pain. The problem was that pain levels didn’t match the possible problems. Not only that, the positions that provided relief to the knee didn’t “sound like a knee.” The pieces of the puzzle didn’t fit.
So I listened. I really listened to the patient’s complaints. The patient’s pain had started from no apparent reason. The patient got relief by getting into the fetal position, bringing her knees to her chest. This is knee flexion, but if she got into other positions with her knees flexed, she found no relief. Elevation, which often provides relief, gave a sense of more pain and tightness in the knee. When I did the examination of her knee, there were no obvious signs that the issue was truly a knee problem. I reluctantly recommended that she get more tests, knowing that when the clinical presentation doesn’t match the history, more information can confuse the situation. My main reason for recommending this was that I could use the test results to rule out findings, if any, that didn’t match the history. In other words, the tests would help me to eliminate the possibilities.
Fortunately and unfortunately, the test results showed an injury. The cartilage in her knee was torn. This extra information was not helpful because it didn’t match the history that she had reported, and it was also helpful for the very same reason. I had been expecting the test to come back clean. When it came up with a possible finding, I had to revisit the possibilities. I had to listen to the history again. I had to remember what she told me and make sure I did not miss any questions. I had to be patient and not jump to any conclusions.
The patient’s signs and symptoms were not representative of a knee problem, so I recommended that she start treating the knee and keep me informed about her symptoms. I didn’t think it was her knee, but I knew that treating it wouldn’t hurt, and in case I was wrong, at least we would have already started treating her knee. Fortunately, a couple of days later, the picture became clear when the patient reported that her big toe was now numb and her pain was not just in her knee anymore, it was shooting up her leg into her back.
I KNEW IT!! It was her back, or at least some of it was her back. Sure, the cartilage injury might be contributing to her knee pain, but the severity of the pain made more sense as a “sciatica” than a “knee” problem. We started treating her “knee” with lower back exercises and her leg got better and better. Not only that, she could distinguish between her “knee” and her “sciatica.” She is now on her way to recovery.
It is critical for your well-being to be clear about what is going on. When you and the medical practitioner enter the treatment room, both parties should be open and listening. Listen to the questions and respond clearly. If you feel misunderstood, ask to say it again more clearly. The ability to really listen is the difference between treating a knee problem when the source is your back and treating the back when the source is your back! For me, it started with my friend suggesting that I listen to my professors and now it has grown into listening to my patients. For patients and medical practitioners alike, patience and listening are so important.
 Matthew Goodemote is the founder and owner of Community Physical Therapy & Wellness in Gloversville, NY. He has degrees in Exercise Science, Health Science, Physical Therapy, and he is one of just over 250 in the world with a Diploma from the McKenzie International Spine Institute. Matthew is recognized as an expert in the fields of Physical Therapy, orthopedics, spinal disorders, sports medicine, and wellness. He is routinely called upon to offer tips and suggestions relating to health and wellness. His unique approach makes him a highly sought after expert at different ends of the media spectrum. He has received requests to participate in studies for scientific journals, and to write articles for trade magazines and popular press magazines such as Fitness to offer proven recommendations that stand the test of time. More of Matt’s blogs can be found at http://www.matthewgoodemote.com/blog/.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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