People don’t care how much you know, until they know how much you care

An Open Letter to Caregivers

As a new doctor in New Zealand,  I’ve had my challenges. For one, I’m an American, and in a thousand different ways that comes with a legacy. Most people I work with want to know all about how I got here and why I left, and it’s usually a great introduction into building a therapeutic relationship.

But there’s also a little apprehension.

You’re an American. Not from here. Not even from New Zealand. What do you know about me and where I come from? And do you even care?

People take their time thinking about that last part, I assure you.

Do you even care?

New Zealand as a country is probably a lot like America was a hundred years ago. People come here from everywhere. And there were plenty of people here before the white people got here as well.

I heard the quote this essay begins with in a seminar about working with people from the Pacific Islands, and honestly it kind of hit me like a thunderbolt.

People don’t care how much you know, until they know how much you care.

I think every doctor should be locked into a room to mediate on this statement for one solid month. To really think about it and examine it, and truly reflect on why they got into a helping profession in the first place.

All relationships, from the friendship to the romantic to the therapeutic, at their very essence boil down to one important question.

Do I trust you?

Can I tell you things I wouldn’t tell another person? Can I let you behind the curtain of my little life and hope you’ll try and understand? Can I let my guard down with you? Tell you things other people might laugh at?

If I can’t, we’re colleagues. Or acquaintances. Or perhaps we have a business relationship.

But I promise I’m not telling you everything.

I think we as doctors often forget what a tremendous act of courage it is for a patient to even COME to the first session. They wouldn’t be there if they didn't know something wasn’t right. But they were scared to come and see us all the same. They probably worried about what to wear, and wondered if they were going to say the wrong thing, and hoping we wouldn’t see them as a loser or a failure or someone that had no interest in taking care of themselves.

We’ve all been there. Every doctor in the world. Every patient in the world.

But we forget. We get busy. One patient runs into another, and years later we find ourselves with a lot less empathy than we started with when we first heard the words “first do no harm.”

But there’s a real person there. A scared person. A vulnerable person. And they’re there hoping you might be able to make them right again.

There is no greater responsibility.

Interestingly, a lot of the heart and soul of these ideas is supported by research. Doctors who are kind don’t get sued, NEARLY as much as doctors who come across as cold-hearted. Even if they are inferior doctors! It’s fascinating research actually. Here is a summary, “physicians who were never sued were perceived by their patients as concerned, accessible, and willing to communicate. Doctors who were sued the most came across as hurried, uninterested, and unwilling to listen and answer questions.”
http://news.google.com/newspapers?nid=1926&dat=19950110&id=g1krAAAAIBAJ&sjid=Cf8EAAAAIBAJ&pg=4380,485345

The numbers are pretty convincing..

It’s a good reminder for me as a psychologist doing business 10,000 miles from home. No one cares too much about my accomplishments here, as well they shouldn’t. They want to know I care. That’s what counts. Sincerity, genuineness, and empathy. All of those tanks that get a little more worn out with each passing year in business. We all could use a little reminder I think. It’s certainly been humbling for me to think about doing business so far away from home.

Once upon a time we were all that little kid, terrified to go to the doctor and begging mom to forget it and take us somewhere else.

For God’s sake even animals get restless when they sense they’re going to the vet.

All of us have been that scared child. Some of still are at 20, or 60, or 90. By definition we’re seeing people at some of the most vulnerable moments of their lives.

The least we could do is care. It means a lot.

It means everything actually.