Listening is Loving

I once watched a movie about a depressed psychiatrist named Hector who traveled the world in search of happiness. The theme is nothing new- Lost Soul takes drastic measures in order to discover himself, finds out that answers were within him all along, etc. Nothing else is pertinent about the film except to say that Hector collected wisdom that he attained throughout his adventures in the form of a list, which was slightly kitschy, definitely cheesy, but nonetheless profound. And while thinking about what I would write about for this blog post, I was reminded of a one-liner from Hector’s list, which is: listening is loving.

Let me digress for a moment to say that I don’t want to dwell on the requirements of my specific role as a patient advocate in the Prescription Assistance Program (PAP), as my fellow Corps Members have already done a wonderful job at explaining the role of a PAP member, which exists in multiple Philadelphia Health Center locations. See Olivia or Emily's blogs. But to sum it up in a sentence, I act as a liaison between low-income, uninsured patients and prescription assistance programs run by pharmaceutical companies that provide certain medications for little to no cost.
 

There are a lot of ends that must come together for an application to be complete and for a patient to receive his or her medication from these programs. Most of the active time in my AmeriCorps role is spent obtaining, organizing, and passing along the correct information between patients and pharmaceutical companies. But it is the time I spend meeting and chatting with my patients that I find the most important and unique aspect of my service. I’ve come to find that although I serve only a small pool of patients and essentially give the same spiel each time I introduce a new patient to our program, each and every interaction provides a unique space for me to practice the art of compassionate listening.
            
Patients come to me for one reason: they need their medication and they can’t afford it. In theory, each patient could be met with the same exact service by me. And yet, by listening not just for the direct pharmaceutical needs of patients, but also to the information they share explicitly and implicitly, I am able to be a better provider. Through compassionate listening I can refer clients to other services that might be helpful and valuable to them, such as the benefits counselors or Behavioral Consultant.  I can also better address their concerns and questions, and, perhaps most importantly, I can make some of their experiences at the health center better and more comfortable. This, in turn, will encourage these same patients to come back and utilize the center, ultimately resulting in the betterment of their health outcomes.
            
In the first few months of our service term, I have learned that compassionate listening differs from the “usual” listening by its intent. When I listen to a patient just as much as I need to I am serving from a task-oriented state-of-mind—of acquiring the necessary information in order to get the patient his or her medicinal needs. This is a future and goal-oriented type of listening. When I am listening to what is said and unsaid, when I am aware of the patient’s body language and overall presence, I am serving via an interaction-based presentist perspective. In this scenario, the patient will also receive medication, but is also free to express and show who they are and why they have come to my office. In the second scenario, the patient is no longer just a patient that I am helping, but a fellow person who I am meeting. This is quite validating for both parties.
            
To underscore the importance of compassionate listening may sound trite, mushy, and even unfeasible —for example, even if providers wanted to work with their patients in this way, many of them are constrained by the ten-minute appointment slots built into their schedules.  But considering time is not a limiting factor for me, I have taken to practicing compassionate listening as often as I can. And although I cannot quantitatively prove its effectiveness, I have plenty of anecdotal evidence to suggest that this is the case. A number of patients have confided to me their unhappiness, their shame, and their vulnerabilities, all while displaying their incredible strength, bravery, and perseverance. To give a sampling: I have met a former millionaire who lost it all, a woman whose husband's death ignited a crack-cocaine addiction which she self-cured despite lingering depression and the loss of most of her material possessions, and a single-mom who takes care of her severely disabled son despite her markedly limited resources. 
            
So listening can be compassionate, but why do I have to bring the “L” word into this? Why is listening “loving”? I’m sure this quote can be interpreted a number of ways, but to me it represents actively acknowledging a patient as the person who presents his/herself to me without judgment for the duration of an interaction. Listening is loving because it enables the speaker to openly be who he or she is, imperfections, shortcomings and all. Listening is loving because when we truly listen we empathize instead of analyze and foster long-term healing rather than adequately solve short-term problems.

The benefit of listening is equally as important for us National Health Corps members. Our year of service is exciting, challenging, and eye-opening. But it can also be tiring and discouraging. By shifting our interactions from task-oriented to interaction-oriented, and by listening compassionately, we can find joy and meaning in the service that we do. Each moment is another chance for us to be fully present, to connect us to more people in our neighborhoods, to see and feel the small but positive work we are doing in our communities, and to inspire us to continue to do this work for the duration of our service terms and beyond. 
 

This blog post was written by NHC Philadelphia member Annie Maxwell.
Annie serves as a Patient Advocate with the Philadelphia Department of Public Health-Ambulatory Health Services: Health Center 4.