Microlecture 020: Should Clinicians Engage in Small Talk with Patients?

Should we do small-talk with patients to set them at ease? This may be a standard expectation in some cultures. In fact, by making patients comfortable, we can expect them to engage more meaningfully and be willing to participate and take an active role in their care. Having said that, is small talk the best use of the 10-20 min of face time we have in a typical clinical encounter? It is precious time and we want to use every drop of it to improve the health and well being of patients. Given that time is limited, what are some simple strategies to connect with the patient, set them at ease while still being mindful of limited time?

Microlecture 021: How Rituals Promote Healing at the End of Life

Biomedicine is in the business of doing ceremonial things unceremoniously. As clinicians, we bear witness to solemn life milestones of patients and families including birth and death. However, we often fail to bear witness to the joy and sorrow that manifests during these events. In keeping our safe, scientific distance, we may become inured to the human need for ritual to mark the passing of any solemn milestone.

In caring for thousands of seriously ill patients, I am yet to meet a family with no rituals. Every family– the deeply religious, the atheist, the agnostic, the non-religious spiritual– they all have some type of ritual they practice to honor a life milestone.

Rituals take an wide array of shapes. In fact, most rituals are not really based in religion but can often be a repetitive act that is deeply personal and gives them a sense of control during times of heightened emotion.

I once took care of a wonderful lady with breast cancer who used to bring Godiva chocolates to the hospital staff anytime she had a procedure or test and got bad news. That was her ritual. When I asked her about it, she said that ” I feel sorry for you guys because it must be very hard to have to always give bad news to people like me. I want to take care of you so you feel appreciated”.