The apartment is stiflingly hot. The carpets are worn and stained, and the kitchen floor is ghastly in its filthiness. Cigarette butts litter the tables, and it's difficult to tell how many were put out in the overflowing ash tray and how many were simply snuffed out on the scarred wooden coffee table.
I am shadowing a psychiatric visiting nurse, learning the ropes so that I can help out with mental health visiting nurse visits on a per diem basis. She knows this patient well and seems able to easily understand his mumbling answers to her questions.
The next apartment we visit is relatively neat and clean. The patient is engaging and much more talkative. He likes to write, has a Master's degree, and uses a Smith-Corona typewriter that sits on the kitchen table. His psychosis has prevented him from working or otherwise engaging in a more active life for a number of years. I peak at the page still held in the typewriter's grip, and the first line says: "I like that the anagram for the word 'listen' is 'silent'."
I had never considered the relationship between those two words before, and sat contemplating the multiple levels of meaning inherent in that relationship as the nurse continued her assessment.
Listening does indeed involve a commitment to momentary silence, and any listening done without allowance for silence is not necessarily true listening. Sure, I can question a patient and pretend I listen to her answer as I filter her response through my own preconceived notions of what she might say (or what I want her to say). I can also listen to her response, already wondering how I can use it in my next blog post, essentially robbing her of my complete attention as I consider how to turn this visit into a story.
With patients---whether they be psychiatric patients or hospice patients---listening is a gift that we can give, and if we are able to listen---truly listen---we are wrapping that gift in the shiny material of our own humanity.
In my work as a hospice nurse and visiting nurse, I want to bring the gift of truly listening to the care I provide. I can check blood pressures, dress wounds, take temperatures and irrigate catheters, but when all is said and done, open-hearted listening without a personal agenda can be more telling than the most comprehensive physical exam.
"Silent" is the anagram of "listen" for a reason.