The power of pills and good patience

We certainly do seem to believe in the power of good pharmaceuticals down here in San Jose. And I think we have good reason for that belief. We see, on a regular basis, albuterol nebulizers make asthmatics go from labored wheezing to easy breathing. Ciprofloxacin does wonders to cure those of us Gringos afflicted by "la diarrea"--just two doses later, several of us are back to normal. Which is a great thing, because diarrhea is not so fun when you have to put your toilet paper in a bag beside the toilet... My patient the other night with unstable angina was remarkably cured (her chest pain stopped and her EKG normalized) after just 2 tabs of nitroglycerin, an aspirin, and metoprolol. For the lady who came in with malaria today--diagnosed by Giemsa stain of a blood smear--we feel confident that chloroquine will cure her ailment. And you'd be amazed at the power of a little tylenol to cure almost any "dolor" (pain) that a patient has.

But, for all the good that dispensing meds to our patients does, I think a lot of them benefit the most from just having someone listen to them. For many of the tired, worn out mothers of 7 kids here, I doubt that there are many people who do sit down and listen to what is on their minds hearts. We have a chance to be that person, and this matters perhaps almost as much as the medicines we are able to dispense. And yet, sometimes we get frustrated because patients here are not "well-trained" to give us answers in the way that we have been trained to expect. They have a "laundry list" of complaints that seems overwhelming to the clinicians here. They have not been taught the "language" of the physician-patient relationship here in San Jose, you see. But perhaps we are the ones who need to learn something... how to listen better, how to sort through a laundry list of seemingly unrelated complaints, how to discern what it is that bothers them the most. How to have patience with our patients and the humility to be willing to adjust the way that we approach people to fit their particular culture and needs. Perhaps the verbal language barrier can even be a gift to us in this process; since some say that 90% of listening involves interpreting non-verbal cues, let's hope that all of us are able to use this time as an opportunity to really hone our skills of non-verbal communication. Despite the long-winded and confusing patient stories we hear, I think there is something beautiful about the interaction. It stretches us, and maybe we'll be more able to truly listen to our patients while learning how to effectively and efficiently communicate once we return to the states.

-Krista (Cristia)