Practice

The gift of non-anxious presence.

wheelchairs

Opinion by Robin Youngson

As an engineer turned doctor, I had an irresistible urge to fix things. When I stayed with friends, I sought their broken toasters, clocks or radios. Pretty soon, I’d proudly demonstrate a piece of machinery brought back to life.

I found this didn’t work quite so well in my personal relationships. I was slow to learn that when my wife talked about problems, the last thing she wanted was for me to offer solutions. She just wanted me to listen and to empathise. Moreover, I gained the insight that when I offered a solution, it tended to trivialise or discount the concern that she was raising. She has been coaching me for thirty-five years and I hope my performance is improving.

It occurred to me that the way I cared for patients had echoes of this habit. As a young doctor, I often tried to fix a patient when quiet presence would have served better. My professional role was bound up in treating and curing and for me the most abject statement of failure was, “There’s nothing more I can do.”

Disability, brokenness, suffering and death were conditions that caused me a great deal of anxiety. My response was to get busy. I see similar behaviour in others. From time to time on busy wards, we negotiate agreement with a patient and family to withdraw active treatment and allow death to visit. My sad observation is that many of these patients get ‘treated to death’ with unnecessary doses of drugs, oxygen masks, blood pressure checks, and so on – none of which contribute to a peaceful death.

Sometimes our role is just to bear witness to suffering. The most moving account I ever heard was that of a medical school professor who was also a ‘frequent flier’ patient. He suffered a severe congenital disease and confounded all his doctors by surviving into his forties. He spoke of the contrast between his power and status as a professor one day, and his utter helplessness as a patient the next. A deeply thoughtful and spiritual man, he said the most profoundly therapeutic act he had ever experienced was the willingness of a doctor to sit with him in compassionate silence and not be anxious about his brokenness.

Non-anxious presence and compassionate silence may be our most precious gifts.

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