Go Straight For the Kill

Mrs. JK is sitting quietly in the room and she seems deep in thought. The waiting room is crowded with other patients and in my usual fashion, I just want to get through the morning workload without a lot of processing of extraneous information. Mrs. JK seems depressed, and I don’t have an inkling of why. What I do know is that she missed her last two visits. She has not been taking her cholesterol medications and she is still smoking. She has gained 20 pounds in the last 6 months and did not get her mammogram as instructed. What else could possibly be wrong?

I am a slow learner. After almost 20 years in Kenya, I should know how to start a conversation. Whenever you meet someone in the African market place, on a dirt road or even on a city street, you always have the courtesy of asking questions that infer your interest in their life and family. “In Swahili the question starts with Habari yako; which really means, What’s up? How are you? How is your family? Any news you would like to share?” The most common answer is ‘Hakuna Matata, a phrase made common in the Lion King movies which means, I have no problems, no worries. With all of this courtesy learned on the continent I forgot it after crossing the Atlantic ocean back to America. I have resumed my usual ‘straight for the kill’ approach in my every day conversation. It is appropriate when asking for the price of an item at the grocery store, or inquiring about my flight reservation. But in the clinical setting, it is not a good approach.

It is not the approach I should have taken with Mrs. JK. She needed me to listen to her. After my examination and explanation of the necessity of following my instructions and being sure to take her medicines I leave the room for a minute. My wife who is our clinic administrator pulled me to the side and quietly informed me to speak to Mrs. JK about the death of her husband two months ago. ‘Michael, be sure to express your condolences and try to be sincere.’ Ooopps!!

I answered, I have already messed that up. I went ‘straight for the kill’. I went directly to the objectives of the clinical encounter, completely ignoring the fact that Mrs. JK is not an object for me to manipulate and instruct, but a person who is in need of compassionate care. She did not need me to teach her about her illness and her failings to comply with therapeutic regimen. She needed me to reach out to her and acknowledge the pain in her heart and mind from her most recent loss. She cannot listen to me, unless I have taken the time to listen to her.

If Mrs. JK was in Jesus’ waiting room, He would certainly know how to approach her. He would do so with compassion. Matthew 9:36 When He saw the crowds, He was moved with compassion for them

The bottom line is, never go straight for the kill. Always take the time to observe, listen and when the time comes, counsel and treat. Habari yako?