I have to share an extract from Dr. Bach’s final NYT article about his wife’s cancer. His reflections about how the experience of him and his wife, Ruth, with their cancer has changed his own behavior should challenge all of us to think more about how we deal with the lives we impact.
But I did change one small part of my routine, so small I doubt my trainees even noticed. Sometimes going into a patient’s room, I would position myself to face the other doctors. I’d ask to sit on the bed beside the patient, or walk around it to the other side.
Until now I had always stood with my fellow physicians, just far enough into the room that we would all fit. We’d form a kind of cabaret line, minus the high kicks. Stoop-shouldered, all in our white coats, stethoscopes variously hanging around necks or out of lab coat pockets. All in a line.
Sometimes, I’d even cross my arms. Ruth calls it my doctor pose.
In that pose, I saw myself as a consultant, an expert coming in to scope out the problem and make decisions. But by positioning myself so I can see both the patient and the other doctors, I can focus not only on my own concerns but theirs — on what they are hearing and seeing and feeling.
The shift in perspective matters. I’d always viewed patients as visitors in our hospital. But after a year of being on the other side of the desk, I’ve realized that we are the ones who are visitors in their lives.
Of course, its different in law than medicine, and dfferent for a court staffer or judge than a hospital staffer or doctor. But our ideology of neutrality is less different than we think from the medical professions theory of distance. See my prior blog on resources for being engaged and present without creating an implication of non-neutrality.
One possible thought — in designing and operating self-help centers, there has been an understandable conscious use of open public space to emphasize that there is no attorney client relationship between staffer and litigant — with the counter between them emphasizing this further (see SRLN Leadership Package Module on design). Maybe there is a physical way to keep the message of lack of confidentiality from open space, while showing engagement — one way might be going to the end of an open counter to talk so that both are on the same end, rather than opposite sides. Moreover, as people become more used to self-help services, they will understand the limits on the relationship, and we may have to be less vigilant in that area. Anyway, I hope we will think and talk more about this. We may have a lot to learn about this from library and social service design and processes
I hope the idea by analogy of being visitors in the lives of those who some to legal aid or court will stay with me, and inform my thinking about the subtleties of these interactions.