Saturday, September 27, 2008


One of the most important things I've learnt this past year is how crucial it is to communicate well. Caring for patients involves planning out a course of treatment and this needs to be communicated not only to families but also to nurses and social workers and healthcare reps and, of course, your colleagues. So, in the course of the day, I end up talking to several different people, each of whom require me to adapt the conversation based on their level of engagement. For an introvert like myself this was a hard thing to learn. I prefer to just do stuff and leave the talking to others but now I can't afford to be so passive. Miscommunication, or an absence of communication, runs the risk of lost opportunities and the off-chance that a patient may actually suffer from their stay in the hospital. So not talking is not an option.

As I think about it now a lot of this applies outside the hospital as well. In any relationship, one of the most important things is the ability of individuals to communicate well with each other. Self-help guides abound with platitudes about understanding the other person, about talking things out but I notice that in South Asian, or desi, culture people seem to be somewhat averse to the idea. Some of this has to do with an innate stoicism and the need to shield our feelings from others but a large part of it is just a passive-aggressive attitude to relationships. Instead of openly discussing problems with one another, people internalise their aggravation and vent it out in subtle, less obvious ways. An example of this would be someone inviting me to their home for dinner for an important occasion, say his wedding anniversary or a child's birthday. If I'm busy that night and casually brush off the invitation without deference to that individual's feelings or emotional investment in the situation, my inappropriate response will insult him but he won't confront me about it. I won't even realise I've done something wrong. However the next time we meet, he may ignore me or may make some stinging remark in response to an innocent question which act is meant to alert me to the fact that he has been wronged. This is a dysfunctional social dynamic and, truth be told, it pisses me off. I think that, by indulging ourselves in these convoluted forms of expression, we waste a lot of time and emotional energy over what are essentially misunderstandings. We also run the terrible risk of ruining precious relationships as misconceptions multiply and the rally of passive-aggressive responses escalates into a permanent rift.

I don't have any easy answers to this. I know how hard it was for me to start communicating and I can understand that reluctance in others. At the same time, I think that if you really care about a relationship, it's important to sit down and talk things through when differences arise. By opening yourself up you do run the risk of being hurt, especially by the other's locked-up resentment and reactionary criticism, but at the same time you also admit the significance of that association. Even on a less personal, more societal level, I think we could all benefit from being clearer in expressing our expectations and disappointments, if only to articulate and make public the standards of good behavior we all privately acknowledge to be true.


Anonymous Anonymous said...

Only one thing comes out - the necessity of clear communication. It could have been said in one sentence or perhaps a paragraph instead of long uninteresting prose which you have attempted! I think you still haven't overcome the habit of keeping yourself silent and this is reflected in the way you have taken such a long route (by way of digression)to bring home the point - the necessity of good communicated. It still could have been communicated in a crisp manner!

9:59 AM  
Blogger Owl said...

Word. I must have inherited my communicativeness (or lack thereof) from my desi side. Sharing 'feelings' is still hugely difficult.

10:12 AM  
Anonymous Anonymous said...

Same goes for you anonymous no. 1.

Measure your comment and take a chill pill.

6:13 PM  
Blogger aisha said...

Intewestingg discussion : )

Recently I wrote on not speaking. Sometimes thoughtless banter gets you into more trouble. As you say it exposes you more to others and if not in the right company it may cause you dire consequences in da future.

Hmmmz....mager to speak correctly..appropriately that I can totaaaaaaallyyyy agree with :D. Recently aik dost say misunderstanding hogayi. It came to the point of fine....i shall not talk to this individual ever again...what kharaKhtagi he has used in response when he "knew" i myself was upset. But thats the thing. One does not really know how one truly feels when they speak under anger or emotional distress. When in such a situation you do have to share the emotions. We had such awesome seminars on using the "I" language. So in essence giving up I did try it..
when you left...I felt unhapppy and felt that you did not that how it truly was?

and waLa :D things work out!! ONe must speak to have another speak.

And darn this is long...

in advance :d


7:34 AM  
Blogger karrvakarela said...

anonymous: point taken. thank you for your comment.

owl: i guess it's just something you learn with practise. i know that i do a better job of it now than i did in the past and that's only because it's part of my responsibilities now. i guess if we see it as a responsibility, it acquires greater importance.

anonymous 2: thank you for your comment.

aisha: khair mubarak!

3:38 PM  
Blogger mystic-soul said...

Half of the Medicine is "communication", a lesson taught to me by ICU director in residency !!

Here US graduates have 'huge' advantage...

"Welcome to club"

2:23 PM  

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