I have recently visited the Chicago Institute of Art, spending most of my time mesmerized by their contemporary and modern collections. One exhibition in particular, featuring avant-garde Chinese videographer Zhang Peili, made me feel particularly anxious and uncomfortable almost immediately. I walked into the miniature theater to a black-and-white Chinese revolutionary movie scene with one twist: every spoken line was instantly re-winded and replayed five to ten times. It was immensely irritating to see seemingly random conversations between two Chinese revolutionaries repeated indefinitely, the movie progressing at an insufferable pace. I left the theater after two minutes, muttering angrily to myself.
Only afterwards did it occur to me what Zhang Peili was trying to convey; by repeating each subsequent clip so many times, the audience was given an unprecedented amount of time to analyze the way a line was delivered, the facial expressions, or the body language of the two conversationalists. Every moment and every line is meant to be scrutinized to show just how much information can be gathered, or rather, how much is missed the first time around.
This exhibition inadvertedly made me contemplate perhaps the most important clinical skill that this hospice experience has given me – picking up on and proactively responding to the subtle cues of the patient. More so than in other professions, the success of a doctor often reflects on his/her ability to make the patient feel comfortable and secure, which takes years of experience to perfect.
I had a particularly unique hospice experience interacting with SK, a nonverbal patient. Much of the advice and guidance that I received during the training process are thrown out the window when the patient cannot respond to any questions. Instead, my initial interactions with SK always devolved into nervous monologues because I wasn’t getting the verbal validation that I was used to in conversation. SK always seemed happy enough to see me and gave me a warm smile at the end of every session, but I wanted to push myself to make a more meaningful connection despite the obvious communication barriers.
I made adjustments on several fronts over the subsequent visits. First, the monologue-like interactions with SK gave me the opportunity to hone in on many subtleties of my speech: the speed, the enunciation, the clarity, the volume, etc. In particular, I have always had the problem of speaking too quickly when I was nervous, and I made a conscious effort to slow down my dialogue and make sure that SK had the best shot at comprehending what I was trying to say. Apart from this, I considered activities that were more suited for a non-verbal patient, such as playing music or reading poems. These additions greatly improved my ability to keep SK engaged throughout our session, and it was much less intensive on me to come up with conversation topics.
All in all, I feel so much more confident in reading facial expressions and body language after all these sessions with SK. I initially regretted the fact that I was matched with a nonverbal patient, but it turned out to be a blessing in disguise. Leave it to obscure avant-garde modern art to put the pieces together.