We live in a world of action where the songs of sirens lure us to do things, often without thinking, even when our interventions are useless or counterproductive. Sometimes it´s better to tie ourselves to the mast, listen carefully, and resist an impulse to act recklessly. Thus, we can avoid our harm or that of others.
In medical practice we are frequently confronted with problems for which we don´t have a solution. Accepting our impotence in those situations, we mighty doctors, is not an easy task. Furthermore, our patients (who might be needy and dependent on us), the institutions that employ us, and society at large look up to us to deliver, to give something that instils hope. All too often we end up trying some ineffectual remedy to see if it works. The results of this can be harmful to the patients or, at any rate, wasteful in an environment of limited resources, which is another way of being harmful.
Sometimes, the best course of action is to sit on our hands and refuse to sell smoke. Dependent patients might feel disappointed or frustrated with this, but they get an opportunity to stop putting their hopes in us when we don´t have a solution, and to empower themselves. This non-action is harder than it seems. It requires an active effort to resist the pull towards problematic manoeuvres. Also, it challenges the pride of the professional by confronting him with his own impotence. Frequently, it is necessary to do some psychotherapeutic or spiritual work to be able to hold one´s place instead of going with the flow.
When we avoid giving a patient a treatment that wouldn´t help him, and we face our own lack, we open the way for something else to happen. These new possibilities might emerge from the patient, but also from the professional. Chief among these new options is that, rather than trying to solve the problems, we might listen to the person who suffers them.
Listening to another person, really listening, is not easy to do. Listening to someone in pain, who also expects us to do something we can´t, is even harder. However, it is a very powerful (non) action which can promote very important changes.
Being listened to prompts a person to speak. When one starts talking, he builds a discourse and begins uttering surprising things, frequently ideas or feelings one was previously unaware of. By talking, we don´t only become aware of what was previously unconscious. We also build new links and meanings, we develop ourselves as subjective beings. Besides, we deploy a relation with the person who listens to us, projecting in it assumptions that shape other relationships in our lives, irrespective of the reality that embodies them. We can learn from it and change for the better. By talking to someone, we both develop our subjectivity and get to know it better.
While we grow as talking beings (parlêtre is the Lacanian buzzword) we whirl around a hole we can´t fully apprehend, something we can´t really put in words, let alone solve. We are confronted with our limits and forced to do something with them.
The patient who, in pain, succumbed to the fantasy that his doctor was omnipotent and would always heal him, by being denied a magic remedy and being listened to, may come to face the reality of his lack. All of us, human beings, are mortal, fallible and limited. When we stop deluding ourselves, we can start to find ways to live with the lack and do something with it.
Thus, we can develop certain habits to reduce the pain, realize our limits and reduce excessive efforts that worsen it, work on our bodily posture, accept suffering and use it as a source of empathy and compassion towards others, express it in artistic endeavours. Whatever the path one builds, it better start by facing our reality.
An omnipotent doctor who can´t accept his own lack and tries to mask it by selling unfounded hopes, not only might harm with his treatments, but also forecloses the patient dealing with his truth. Having the courage to do nothing, listening to the patient, allows for revolutionary changes. Outside the consulting room, doing nothing can also open new roads.
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