I’ve just been to the chemist to collect last night’s (many) prescriptions. Whilst I was waiting, a young woman came in, very dishevelled, a little dazed, carrying a giant meds bag. The following piece describes the encounter and highlights what happened next.
‘My dad died’, the girl said to the assistant behind the pharmacy counter.
‘These are his medications’.
‘Are there sharps in there?’ the girl asked.
‘No. My dad died.’
‘What drugs are there?’
‘He had cancer. My dad died,’ the woman said.
Each answer began with ‘my dad died’. Not once did the assistant behind the counter acknowledge it, no matter how many times it was said. No matter how many times.
How many times would it need to have been said to acknowledge the girl’s distress?
It’s easy to see how voices are missed when no one listens when it’s so obvious someone is desperate to be heard. I’ve been that woman with a meds bag, and it’s horrific. Every encounter is remembered. No matter who it’s with.
A consultant in a distant office or returning morphine to a pharmacy. You forget nothing. No one.
You can’t teach empathy (I truly believe this), but when someone begins each sentence with ‘my dad died’, they are asking for someone to listen.
The thing is when you take a history in psychiatry, you are almost an archaeologist of words. You sift through a narrative to find the fragile pieces you need. You try to make sense of the story.
This though, THIS, was a barn door. This was someone desperate to be heard. Anyone, ANYONE, who is dealing with patients, in whatever capacity, needs to be a listener. Because you never know when those fragile pieces will surface. And it might be your only chance to collect them.
You really need to ask yourself why someone is delivering their answer to you in this way?
Why are they choosing these particular words?
Listen to the beat of the narrative and ask yourself if something is wrong. If you are in a job where you meet patients you might be the only person who hears those words. What you decide to do with them can change the course of someone’s life.
Can you teach someone to listen? I’m not sure, but if you’re on the front line, dealing with patients, it’s the most valuable skill you’ll ever possess.
Joanna Cannon is a psychiatrist and a writer. She lives in Derbyshire and has a successful blog. This blog originated from a conversation on Twitter initiated by Joanna.
This very thing happened to me as a pharmacy student when my father died. I still remember it and now as an experienced pharmacist I hope it has made me more empathetic, a better listener and probably contributed to the career I have had.
The example you have described is extreme, much more than my personal experience and quite shocking to me. I struggle to defend someone who works in healthcare, but apparently has no listening skills, but I can relate to it. The first member of staff most people meet in a pharmacy is usually a counter assistant, and while they have training (NVQ 2 is mandatory) are not generally highly educated and usually quite young as the job does not pay very well. I could add that some people don’t know what to say or how to react when dealing with serious illness or bereavement, especially if it is not something they have faced themselves, but I don’t think that is the heart of the matter in this case.
If I had witnessed what you have described, I would have spoken to the pharmacist in charge and asked that they speak to the member of staff about the incident and that they or the pharmacy manager put some training in place for all of their staff, but it is very easy for me to say that. The business demands in community pharmacy mean that a pharmacist manager has a lot of pressure on them to generate sales (or script volume) and profit and very little time to ensure professional standards. That’s why I stopped working in this area of practice after a few years. I’m an ex. NHS Primary Care Head of Medicines Management, now working as a consultant to the NHS and the pharmaceutical industry.
I encountered a very similiar situation which haunts me & resulted I my never stepping foot in this pharmacy again! I was a regular locum in a pharmacy for 4/5 years & my father whom lived far away became very ill in fact we were told its only a matter of a few days….I explained to the pharmacy manager of my circumstances & how I was unable to fulfill the remaining bookings for the next few days – he was extremely rude & gave me an ultimatum of either honouring all the shifts or never working there again!! Adi was speaking to him I was driving with tears falling into my lap…it was never a choice & one I shall always stand by!!! I lost my beloved father only a few days later…..& have never been short of work on my return!