[December 2005 journal entry]
Safe and stable medical practices and hospitals expect their physicians to be fluent (in the full/rich sense of vocabulary and syntax so deeply imbedded, instinctive, readily at hand that the speaker/writer can focus completely on the subject and the one addressed) in three professional languages – i.e., clinical/scientific language, legal language, and business language. Fluency in these three languages remains fresh due to daily use with patients, with support staff members, and in peer-to-peer exchanges.
It has been my experience/observation that medical practices rarely expect their physicians to be fluent in a fourth professional language – i.e., what I call the language of caring (e.g., language for reflection on being gentle, minimizing harm, making an appreciated difference, facing failures, respecting self-determination, seeking fairness, acknowledging/resolving conflicts of interest, . . . ).
Perhaps the reason is the time and energy required to maintain fluency in the language of caring. Learning/using the language of caring must not diminish fluency in the other three professional languages. In fact, fluency in the three required professional languages must be exceptional in order for seeking/maintaining fluency in the language of caring not to be criticized.
Perhaps the reason is the depth/quality of caring to which a medical practice is actually committed. Where in most medical practices does the language of caring appear to be (thought in fact is not) a priority? The marketing and public relations departments. Medical practices striving for profit and/or for their physicians’ lifestyle interests do not encourage or give incentives for meaningful discourse using the language of caring.
Perhaps the reason is the self-examination – e.g., transparency, vulnerability, disappointment, accountability, vision, passion, . . . . Meaningful discourse using the language of caring probes/stimulates one’s sensitivities – e.g., “What is the link between caring deeply and becoming jaded/cynical?” “Can I end up giving less by trying to give more?” “Dare I admit times when my capacity to care is fatigued?” “Can I practice very good medicine without caring for the patient?” “When my capacity to care is low, who around me bear/s the consequences?” “What would cause my spouse and children to think I care more for my patients than I care for them?” “What conclusions about my professional character would be drawn by observing how I handle my most difficult patients?” “How do I protect myself without sacrificing why I became a physician?” “When does scaled back care cease to be care?” “How do I recover my capacity to care?”
