Tending to everyday and BIG conversations in teaching and practice

Abstract

Throughout our professional lives, there will be patients and families whose journeys affect us deeply and shape our development as practitioners and teachers. When recalling our most challenging times in practice, we remember patients and families whose memories have sat quietly undisturbed within us, only to be brought to the surface when prompted. For us, our memories include difficult discussions held with a conscious ventilator-dependent gentleman unable to be weaned from life supporting therapies and facing stark choices about limited treatment options available, or conversations held with a son struggling to come to terms with the imminent death of his father whilst knowing that the resulting inevitable loss was unconceivable, or speaking with a family who did not know how to say goodbye to their dying child and who simply asked of the clinical team, “What kind of a God would let a child suffer so?” In reminiscing about patients long passed and their families, it strikes us that there is something that all these situations hold in common. The thoughts that pervade these events are not related to how well the “I’m sorry I’ve got some bad news” talk went with families. They are not even about how well a particular “formulae” worked in discussing treatment planning or in preparation for withdrawal of life support. Rather, the memories recalled speak to the smaller, everyday seemingly inconsequential conversations and acts of kindness shown by and to patients, families and practitioners, and to the resilience and bravery of the human spirit. They speak to the importance of cultivating rapport over a short period of time in time-critical circumstances. And they speak to comfort, presence, humility, and connection in moments of silence and shared sorrow.