Sunday, March 7, 2010

Two Medical Moments

On Tuesday morning I had the unusual opportunity to offer coaching and support to two women, one from Egypt and one from Sudan, who are heading a unique program in cultural competence for medical students in one of the Persian Gulf Emirates. Across cultural differences (I am, after all, from Israel), without any training in NVC, we connected, and they learned how they could change outcomes by imagining from the inside the experience of people with whom they were in conflict.

Why were they here? The students in the program they teach are generally open and receptive. But the doctors in the hospital, themselves from many countries, have been consistently expressing doubt and impatience towards the concept of cultural competence, even towards the idea of medical interpreters being present when there is a language barrier with the patient. What could they do, these women wondered, so that their students could get support when they are doing medical rotations at the hospital?

Can Conflict Be Transformed into Partnership?

I invited the head of the program to enter the shoes of a doctor, to say what they have heard them say so many times, and together to understand what their experience is. They learned, with astonishment, how different it would be for the doctors if they tried to form a partnership with them in addressing concerns rather than trying to convince them that the program is essential. We learned that the doctors are struggling with an immense load of patients who are often migrant workers and can’t see how they could take the time to engage in understanding the patients beyond just figuring out the symptoms and reach a diagnosis.

Then I invited the other woman to offer empathic reflection to the doctor that the head of the program was inhabiting. This took us deeper into discovery. We now, through listening carefully, discovered that the doctors wanted to be trusted in their ability, despite difficulties, to understand and carry out their mission to support the patients’ health; that they care about the patients; that they wanted respect; that they wanted choice about how they and their students would practice medicine. These women found out that the doctors would more likely be open to support them if they expressed directly and clearly what the experience of patients was that would lead them to create the program rather than by using the language of rights.

Increasing Resilience through Connecting with Vision

Then we talked about how they could nourish themselves and have more hope and resilience and less stress by connecting empathically with each other, understanding and being with the vision of what they wanted to create instead of “venting” and maligning people who didn’t support them. They experienced how the vision could be a source of energy, fuel for the work that is less likely to be toxic to them than the anger that sometimes arises in them in response to the obstacles they have been facing. Lastly, we equipped them with some materials and ways of learning NVC from afar, and with tips for how they could support and empower the students in these difficult conversations.


That same evening, I visited a friend’s mother who is dying. No longer able to go home to die because the transportation would be too painful and too stressful for her frail body, she was in a hospital bed, surrounded by loving people. I walked in the room, let her know I was there, and she opened her clear eyes and smiled fully.
I talked to her, but she was no longer able to respond except with her eyes and her smile. She is a woman of immense light, and I felt blessed to be in the room with her. There was dignity and love in the room. This is what I know the women I saw that morning want for all patients. I was glad to experience it.