Listening beyond the stethoscope

For years, I worked as a family doctor at the CLSC René Cassin in Côte Saint-Luc. The community clinic is located inside Cavendish Mall, an unpretentious shopping centre catering to middle-class residents who live nearby. The mall abuts a vast parking lot. It sits among colourless high-rises, single-garage townhouses and double-garage duplexes.

Cars, there are cars everywhere. Outside of Shabbat, only students getting off the 161 bus or Filipino nannies rushing to their afternoon shifts grace the lonely sidewalks. It is against this suburban greyness that I listened to my patients' ills.

Two afternoons a week I also worked at the Clinique communautaire de Pointe-Saint-Charles. In the days before gentrification, the neighbourhood was one of Montreal's poorest. The community clinic on Centre Street faced a run-down used furniture store. Dépanneurs on treeless streets opened late into the night. It was easier to buy Pepsi and chips than to find fresh fruits.

Cheap rent in dilapidated houses attracted a colourful mix of people: artists, small-time drug pushers, day-jobbers, teenaged mothers pregnant for the third time and refugees. These were also my patients.

Separated by a mere dozen miles, Côte Saint-Luc and Pointe-Saint-Charles were as different as night and day. Yet despite their varied backgrounds, patients' hearts beat to the same rhythm. Rich or poor, pure laine or immigrant, the tears they shed in the face of diseases were identical. Under stress, the rise in their blood pressures followed the same curves. Their sighs of relief after the unloading of secrets sounded eerily similar.

Invariably, they all wanted a sympathetic ear.

My patients' stories move me. The patients from Côte Saint-Luc and nearby Hampstead, the Pointe-Saint-Charles patients, I love the way they opened up to me. From the torment of a Holocaust survivor to a mother's anguish at losing her child to social services, I've learned so much. From the successful adoption of a baby flying in from China to the thrill of a five-dollars-an-hour raise, I'd so cherished those shared moments. These stories shaped me as a doctor. Thanks to them, I've become a better listener, a more humane person.

I left my native Vietnam at age 11. In a small Connecticut town, I was stared at in school. My naturally tanned skin stood out from a sea of tofu-coloured faces. I was obviously different. Yet nobody wanted to hear my story. No one bothered to ask me questions. What was the war like? How did I get out of Vietnam? Where's the rest of my family? Those questions never came. I wished they did.

Older, I promised myself I'd inundate people with questions. Why? How? When? Where? Undaunted, I'd go digging for a hidden anecdote, searching for a forgotten story. Without shame, I'd encourage friends to unmask themselves, to let their tales of regret be heard.

With the right questions, I help patients unlock their past, share their narratives. It is the only way to treat root causes, to go beyond the alleviation of symptoms. My stethoscope may magnify heartbeats, but it remains deaf to words of longing. Only through compassion could I hear what was behind that pain. Only through fellowship could I offer patients permanent healing. Listening with empathy vs. listening with a stethoscope. That's the difference between light and dark in medicine.

The spectre of COVID did not change my practice. While many colleagues prefer telemedicine, I continue seeing patients in person. In these days of lockdowns, patients' need for connection trumps all. To the stories of loneliness, I am ready to lend an ear.

This article is part of the CBC/QWF Writers-in-Residence program. More information can be found here.