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Listening with open ears

Yale Medicine Magazine, 2001 - Spring


Fundamental to listening well, says playwright Anna Deavere Smith, is “to understand that what you’re hearing from a person is not something you’ve ever heard before.” For a doctor, that means listening to each new patient “every time, every time like it’s the first time, because it’s the first time for the patient,” says Smith. The diagnosis may be familiar, even routine, but the illness is unique to the patient.

“The doctor’s job is not only to have the answers. Sometimes as patients we want doctors to hear the spectacular thing we just said as if they had never heard it before, because they haven’t. That would be one of the hardest things for a doctor to understand,” says Smith. A professor at New York University, Smith has made a career of listening to people under pressure and using their words and ways of speaking to create documentary theater. Her Obie-winning piece Fires in the Mirror: Crown Heights, Brooklyn and Other Identities grew out of in-depth interviews with 50 people, of whom she portrayed 26. Smith developed her presentation at Yale by interviewing 21 people and incorporating excerpts from 11 of the interviews.

“The people I interviewed in Crown Heights, on the heels of a race riot, were really quite like the patients I heard here. They had a certain urgency. They really wanted to be heard and felt they had not been. I have a particular interest in worlds that are upside down. When a person is ill, that’s their life upside down,” she says.

Smith distinguishes between empathizing with a person and identifying with that person. “It is the most precious moment to realize that the person sitting in front of me is not me. To listen or to have empathy means being able to remain present as a witness to something that is happening that is unusual to me” as the listener, she says. A physician ... or anyone ... who connects deeply with others does not remain unaffected, however. “None of us who are doing our work well really can say that we just observe what is happening around us and just move on. The older we get, the more experienced we get having it affect us, using it as a resource in helping us connect with others more and more. People can see whether you have experienced suffering, experienced joy. The more they can see that in you, the more they can share their lives with you, the more they can open up and feel they are giving their lives into good hands.”

Faced with another person’s pain, we can rise to the occasion and “absorb it as part of a larger understanding of who we all are and the predicament we are all in: that life is transient, and it is a gift.”

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