Communication Compass – Perspectives

Cancer Care – Communication Compass – Perspectives

“You’re lucky,” the oncologist tells his patient with breast cancer. “Your tumor seems to respond well to the hormone therapy. And we still have a lot more possibilities in the future.” “Does that mean that I am going to be cured after all?” the woman asks. After the consultation the doctor sighs: “How is it possible after all the explanations I have given, that the patient still has not understood that this therapy does not have a curative intent?” The first axis in the compass is the axis of perspectives. Who is lucky in the above-mentioned example? It is the doctor who is lucky, because his therapy is working. From the perspective of the patient, being lucky has a completely different meaning. She does not know the doctor’s other patients. For her, being lucky means to be free of cancer. That is how she understands her doctor’s statement. Doctor and patient look at the same situation from a completely different perspective.

Our scientific mind is not familiar with thinking in perspectives. On the contrary, the essence of science is to approach an objective point of view, independent from perspectives. The weight of an object is measured independently of the one who has to carry it. What is heavy for one may be
light for another, but expressed in kilograms it is the same for both. In communication, we have little use for this objectivity. Reality is different from a different perspective. Both perspectives are equally important. Perspectives are the raw material of communication.
The first point in communication is the recognition of the perspective of the other. The key question is: what does the world look like through the eyes of my patient? The problem is that we only have access to our own perspective. We are not wired to our patient. We will never know what it is to be him or her. The question remains open, and has to be put over and over again without ever getting a final answer. In Zen there is a saying that when you have not seen someone for more than two minutes, you no longer know him. The miracle of communication is that without having direct access to the other’s perspective, we can have a feeling of mutual understanding. Communication is based on the recognition of two perspectives. That does not mean it always implies agreement. We can achieve mutual understanding and still realize that our experience of the world, our values and beliefs are completely different.

An important caveat here is not to lose sight of your own perspective. This sometimes happens when, with a lot of goodwill, we try to empathize with the perspective of the other and lose ourselves in that perspective, temporarily forgetting our own view. Our patients do not benefit from our absence in the communication process. When either one perspective gets lost, mutual understanding is lost.