Saturday night took me to the winding, cobbled streets of Nygardshoyden. The area surrounds the University of Bergen and is home to many of the students who study there. Their social hub, the bar Ad Fontes, was my destination and the promise of a debate in English my bait. Determined to get a taste of what it really means to be a part of this community and indeed a part of this country from as many different perspectives as possible, I thought I'd tackle the young first and figured a talk titled 'Do voices of youth matter?' would be a good place to start.
The evening involved a panel discussion between a parliamentary candidate for Young Liberals, the leader of Changemaker, a youth organisation lobbying for political change, and a guest speaker from the Tanzanian exchange programme Communication for change. It also included a lot of free lemonade and savoury snacks: a win win situation.
The common room was full to the brim; leaving me half impressed at how many people had probably turned down a house party on a Saturday night to come here and speak about something they cared about and half distressed at having to perch soggy from the rain on a bin lid due to the lack of available sofa space. As the room debated the prospect of a world post Brexit and Trump and strategised ways in which more youth involvement in politics could be achieved, I was moved by the passion and thought that accompanied each comment; if this was an example of Norwegian society, I was very much liking what I saw.
The evening took on a more significant relevance to my own thoughts, however, with two questions put to the floor by a South African student, namely " Do we feel society listens to us? and if not, how do we get them to hear our voice?" It might be a different context but these are the very questions I am trying to answer in terms of the doctor-patient relationship: Do our patients feel listened to? And, if not how can we hear them more clearly?
The moment got me thinking about what it really means to be listened to and the barriers that might prevent it from happening. One of these barriers can simply be the physical inability to communicate your point adequately and this is certainly something I have experienced myself and reflected on a lot over the last week. One of the challenges of my current placement, one I hope to master, is becoming comfortable with being uncomfortable. This might sound strange but, in explanation, it is the discomfort of trying to be heard and understood by a group of people whom I can't quite meet on the same page in terms of language and culture. It's not a complaint, these differences are the reason I'm here, but it was only really on Saturday night that I realised how useful this discomfort might be in trying to understand what is important for patients.
Speaking from my own experience, not feeling completely understood can be incredibly frustrating; something as simple as making a phone call to a patient can become impractical or even impossible when you have doubts over whether you will be able to communicate with the recipient. Not being familiar with a language can feel alienating; jokes are often a little lost in translation, I've lost count of the times I've obviously laughed at the wrong point of a story! But the biggest challenge so far has been the difficulty in connecting with people, particularly patients, in the way that I would like to; it is very hard to get your personality across, to explain what you are about and why you are here, when you can't rely on your words as you normally would.
Trying to overcome some of these challenges has, at times, been a little painful. Choosing my first moment to ask a patient in English why they had attended and receiving the reluctant response of 'erectile dysfunction' made for a very long and awkward five minutes one afternoon before the GP returned to the room. However, at other times it has been really rewarding, as was the case last week when Friday morning brought a lady of 93 years to the clinic. Anne had doubted she would be able to speak much English, as is more the case with the older generation here, and we were therefore both surprised to be proved wrong. I was able to be of assistance as the lady struggled to get on the examination couch and on giving her my hand she turned to me and said 'I haven't spoken English in over 20 years, it feels good to try it again'. For me, it felt pretty good to hear that.
The experience highlighted for me that for a therapeutic relationship between doctor and patient to truly exist, both parties need to feel listened to and understood and it also reminded me of the many ways in which we can connect with patients in order for this to happen. Whether that be through words, a helping hand, our body language or eye contact. Usually, of course, it is a combination of all of the above and more.
As I continue on this journey, I'll be asking every patient I meet whether they feel listened to by their doctor and if they do what exactly that means for them. It is an exciting thing to travel to culturally and geographically differing communities and hear similar desires put into words and so far I'd say 'being heard' ranks predominantly high on peoples' lists of needs. It's something I'd always thought of as obvious and probably taken for granted but after experiencing my own barriers the past few weeks, I think I'm really beginning to understand what that means for me.