The other day, my son, in all his 5-going-on-6 wisdom, stopped me mid-conversation and said, “Mommy, you’re not listening to me, you’re only hearing.” I paused, taken aback by the truth of his words. I had been nodding along, issuing the usual “uh-huhs” while mentally juggling a to-do list longer than my arm. It was a humbling reminder, not just as a parent, but as a doctor, of how often we confuse hearing with listening. And as we all know—especially in the medical field—listening can be the difference between a patient feeling truly understood and one who leaves the consultation frustrated, unheard, and disillusioned.
This toddler’s emphatic and adorable plea, 'Listen, Linda!' as he tries to get his mom's attention perfectly captures how we often feel when we're not being truly listened to. What makes the exchange even more relatable is how his mom also repeatedly tells him to listen, mirroring the back-and-forth of real-life conversations where both parties are hearing but not truly listening.
The Neuroscience of Listening: More Than Just an Earful
Hearing is automatic, like breathing—your brain processes sound without effort. But listening? Listening is a cognitive workout. Studies show that when we actively listen, multiple brain regions, including those involved in memory, language comprehension, and emotional processing, light up. Listening requires attention, effort, and focus; it’s an exercise in interpreting and making sense of the sounds we receive.
In clinical settings, effective listening can impact everything from diagnostic accuracy to patient compliance. When a patient feels genuinely heard, they’re more likely to adhere to treatment plans and follow medical advice. This is backed by research suggesting that active listening can significantly improve patient outcomes and reduce malpractice suits.
Empathy in Action: Listening As a Moral Imperative
"Listening is more than a clinical skill; it’s a moral act."
Think about that for a second. Listening doesn’t just make you a better communicator—it makes you a better human. In John Launer’s work on narrative-based medicine, he argues that true listening acknowledges the humanity of the speaker. It is the act of radical empathy, where we not only hear the story but also witness the emotion and experience that come with it.
For clinicians, this means listening isn’t just about gathering symptoms or taking down patient history; it’s about hearing the patient’s anxieties, fears, and expectations embedded within those symptoms. This is often the heart of the encounter, the part that forms the real connection between patients and doctors.
The Witty Side of Listening: Lessons from Talk Shows
Let's shift gears for a moment to the world of talk shows—because believe it or not, great listening happens here too. Take Oprah Winfrey, for example. Her genius wasn’t just in her interviews but in how she listened. She gave her guests space to reveal themselves fully, to express their thoughts without feeling rushed or interrupted. In a way, Oprah’s shows were masterclasses in empathy and the art of listening.
Now, contrast that with someone like Jimmy Fallon. Don’t get me wrong, Fallon is funny, energetic, and entertaining. But notorious for his habit of interrupting guests mid-sentence, Fallon often prioritizes keeping the energy up over allowing a guest to fully express themselves. It's endearing on late-night TV, sure—but in the consulting room? Not so much. Imagine interrupting a patient halfway through describing their symptoms with an enthusiastic “Oh yeah, totally!” It’s a quick way to erode trust.
The Science of Interruptions: How (Not) to Be a Jimmy Fallon
Interrupting is one of the most common barriers to effective listening. Studies show that, on average, doctors interrupt within 18 seconds of someone starting to speak. Many doctors unknowingly hijack the patient’s story, jumping in too soon to provide an immediate solution. But research highlights that when doctors allow patients to finish their thoughts, they disclose more important information, leading to better care.
To avoid being the "Jimmy Fallon" of medicine, here are some tips:
- Practice Intentional Pausing: Embrace the silence after someone finishes speaking. Silence can reveal insights.
- Summarize and Reflect: Reflect what you’ve heard back to the patient. Not only does this clarify understanding, but it also shows the patient that you’re actively engaged.
- Non-verbal Listening: Eye contact, nodding and even silence go a long way in showing engagement without interruption.
- Resist the Reflex: When you feel the urge to jump in mid-sentence, resist. Let the speaker finish their thought. Even if it takes longer, it’s worth it.
Listening in Medicine: It’s a Prescription, Not Just a Skill
In healthcare, listening goes beyond being just a communication tool—it’s a crucial part of diagnosis. When a patient says, “I’m not feeling right,” it’s often the tone, hesitation, and body language that reveal the full story. While many of us believe we’re excellent listeners— with over 80% of healthcare professionals rating themselves highly—a study published in the Journal of General Internal Medicine suggests there is room for improvement. The good news is that awareness of this gap opens the door to doing better.
This is where narrative medicine comes in: the belief that every patient has a story, and it’s our responsibility to listen deeply. Not just hear. By refining our listening skills, we can gain a fuller understanding of the patient’s experience—seeing not just the illness, but the person living with it. As we strive to be better listeners, we can improve the care we provide and the relationships we build.
Resources for Deepening Your Listening Skills
If you’re serious about becoming a better listener, here are some excellent resources:
The Why Factor by BBC SOUNDS: Why is listening different from hearing? What is the skill of listening and how can we develop that skill?
Deep Listening by Oscar Trimboli: This podcast is about creating practical tips and techniques to improve your daily listening.
The Ultimate Guide to the Art of Interviewing: Techniques from Oprah to Joe Rogan by Polina Pompliano: I enjoyed watching this very *spoiler alert * lengthy interview which explores different interviewing strategies.
Victoria Ekstrom juggles life as a gastroenterologist, narrative medicine advocate, and mom of two, all while being expertly "managed" by her opinionated dachshund. While her patients might think she has the listening thing down, her kids (and perhaps the dog) would say otherwise—especially when they call her out for hearing but not really listening. But like any good doctor, Victoria is a work in progress, continuously learning from both her little ones and her four-legged friend how to tune in better every day.