The patient is your only focus

It was another weekend of training in Hakomi. We were working on figuring out our resources (those things in our lives that help us get through tough times). It was the second day of training for this block, and my student therapist asked how things were going “day by day, usual days, the usual stuff.”

“Why don’t you take me through a usual day then, how do you start seeing your patients? “ I begin to recount how I work without a nurse, and that I go up front to pick up my patients. She asked me to stop, slow down, and really focus on what I do when I prepare to get a patient, and as we work through that, I came to see what a resource I have built over the last 10 years.

When I moved to Prince Edward Island, I had already been working on understanding a bit more about the way I thought, the way I went about my business. I’ve been approaching it from a Zen Buddhist perspective, trying to simply understand what was before me right now. As part of that, I was working on letting go of something when I was done with it. I could not imagine walking around all day carrying a hammer that I did not need, but I would often find myself caring around patients. I would carry them around with me in my head all day long. They were just there, I have not asked them to take up residence — but they did.

I begin working on clearing my mind for each patient. It was a bit of a ritual at first, and it was not that dissimilar to some of the meditation I was doing at that moment. I would turn my attention to what was happening in front of me. And every time my mind strayed to something else, I brought it back to this moment — to right now. I was disciplined with this practice and worked very diligently to keep myself at the moment. This meant that I eliminate distractions from my office: the clocks, the wristwatch, and the phone went to silent (I checked them between patients). In the exam room, the patient was my entire world.

By the end of the visit, my notes would be completed and out of my head. I would walk the patient up to the front desk. In that process, I allowed any thoughts of this patient to begin to leak out of my mind and into the environment so that when I called the next patient, I was an empty cup ready to be filled again.

These days, it has not changed very much since I came up with it, I work with the front desk clerk, and I bring the patients back on my own. As I sat there with my therapist, I begin to describe the process once more of how I “see patients.” It starts from the state of emptiness, I look down at my roster for the day and noticed the next name on the list, look up and call that name. It is at that moment that the patient begins to fill my system, I watch them arise from the chair, walk towards me and pass me towards my office just down the hall. I see them come and go. I notice how they move, how they walk, and as they come past me, I begin to notice how they feel to me. Do they feel sick, do they feel sad, do they feel out of sorts, am I greeted with a smile or a grimace? Is the look on their face congruent with the way their body moves?

Little bits of data filter into my system. I am watching with my eyes and my doctor brain. As I settle into the chair in the exam room, I begin listening with my heart to see what it is that lies just beneath the surface. What is it that I feel coming from them, what is the question that remains unasked, the unexpressed need, the unspoken fear? It is listening with my heart that provides the magic. And once my brain has been satisfied with the needs that are medical, there is always time for my heart to ask us questions. And so, it does, looking to see if there is an openness on the other side of the answer. If there is, we step into it. If there is not, then we acknowledge it with a smile and move on. At the end of the appointment, we stand and begin moving back towards the door and the hallway. At that moment once again, I begin to empty all that is inside me from that visit so that once again I’ve become a glass ready to be filled with the next encounter. This moment, this patient, right now, they are all that all that I can change, all that I can touch, and in giving myself fully to them, I find myself again and again in a state of grace.

Gil C. Grimes is a physician and can be reached at Doc Grimes.

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