Ok, I admit it, I'm on a bit of a historical rant...first King Canute, and now St. Benedict.  And no...I'm not trying to have every allergist in the country forgoe their practice and join a Monastery...but there is something to be said about the St. Benedict and the "wisdom of the ancients" that I think is relevant today.  My thoughts on this started out when I saw a new patient in my office recently; she presented to me a beautiful EMR printout from the preceding allergist she had seen.  There it was--beautiful computer template after template of information.  I commented that it seemed like the doctor had been very thorough...she looked at me with penetrating eyes and said "yes, but he didn't LISTEN to me..."

I think allergists at their worst tend to think of our patients as merely "dermal appendages with a life support system attached" to which we apply skin tests.  We seriously study our skin test results, but how seriously do we take our listening?  True Listening (with a capital L) is hard work...but it is so critically  important in our specialty (as well as in every walk of life.)  I had been reading a series of articles on monastacism when the words of  St. Benedict of Nursia, popped out at me in relation to the patient mentioned earlier.  In his Prologue of St. Benedict's Rule, St. Benedict opens with the simple but powerful words "Listen carefully, o son".  

Check out these proverbs on listening, and re-interpreting them from a patient's point of view 

 Proverbs 1:8--"my son, hear the instruction of your father (patient) , and do not forsake the law of your mother..." 

Proverbs 4:10--hear my son, and receive my (patient's) sayings...

Proverbs 19:20--listen to counsel and receive (a patient's) instruction, that you may be wise in your latter days ...

Proberbs 23:19--hear (the patient) my son, and be wise... 

Truly Listening to a patient brings its rewards to the doctor as well as the patient.  We make better diagnoses, and gain better insight into the uniqueness that comes with everyone we see.  Two questions I have found especially helpful in taking a history--and listening carefully to the responses are the following:

1.  "What are your goals that you would like to accomplish as a result of seeing me?"  The answer to this question never ceases to amaze me.  In one patient, who presented with chronic hoarseness, I mistakenly believed her principal goal was to relieve her hoarseness.  Wrong.  Her main goal in seeing me was to be able to sing in the church choir again.  She couldn't do that while she was hoarse.

2.  "What about your allergy condition are you most fearful of?"  One patient recently, with relatively mild exercise induced asthma, seemed unduly anxious.  When I asked this question, she divulged that her grandfather had died from a terrible asthma attack, and she was terrified of the same fate for herself.  

The better listeners we are, the better questions we will learn to ask of patients, and the more we will enjoy their visits.  Talk less.  Listen more.  Remember St. Benedict.  And no, don't enter a monastery...an allergy office is alot more comfortable!