Asking Deeper Questions
by Kalpana (Rose) M. Kumar, M.D.
“Asking the proper question is the central action of transformation- in fairy tales, in analysis, and in individuation. The key question causes germination of consciousness. The properly shaped question always emanates from an essential curiosity about what stands behind. Questions are the keys that cause the secret doors of the psyche to swing open.”
∼Dr. Clarissa Pinkole Estes
We are taught in our medical training to take a history from our patients so we can arrive at a diagnosis and then manage the associated symptoms. I have emphatically proclaimed for the past three decades that this is not enough. It is not enough to take a history based on symptoms alone and write a progress note as we have been trained to do, ‘close the encounter,’ and move on to the next patient. Unfortunately, these are the mechanics of today’s medical office visit. What has happened to the desire to ask, the curiosity to uncover, the longing to connect? The questions we have been taught to ask only scratch the surface of a patient’s life. I would venture to say that these questions perpetuate reductionism, not transformation. Facilitating healing requires a curiosity greater than we have been encouraged to access.
We must ask deeper questions. Questions like, “What do you think has caused your symptoms?” or “What do your symptoms mean to you?”. In cases of depression, ask, “do you actually feel depressed or do you feel tired? or “does it feel more like sadness, and if so, what caused it?” Or other questions, like – “Do you feel anxious or do you feel unsafe in the world?” The majority of sensitive people feel emotionally overwhelmed rather than anxious. This is mistaken/misdiagnosed as anxiety. Fatigue, depletion, grief, and sadness are mistaken for depression. “Are you sleeping well?” If not, “What kinds of worries are keeping you up at night?” “What can you do about them?”
These are a few examples of the kinds of questions that increase self-awareness in patients and also deepen their connection with their health care provider. They uncover causality and offer solutions for healing and not merely symptom management. In asking deeper questions and exploring them, patients begin to see patterns underneath their symptoms. Their symptoms begin to make sense when seen through a larger and deeper context. This empowers and validates them. These kinds of questions take longer than a five-minute office visit. They require presence and a curiosity about the patient’s process.
More complicated questions are, “What does it mean that you have cancer?” or “Why do you think you had a heart attack?” What about your life is not settled in your heart?”
These questions are alchemical. As Dr. Estes says, “They have the power to germinate consciousness. They indeed are “the keys that cause the secret doors of the psyche to swing open.”
Corporate medicine does not like these questions. They aren’t interested in answers, process, healing, or curing. Corporate medicine is production-line medicine. It does not validate or transform a patient’s experience. It requires physicians to generate a high volume of patient billings for job security. Consequently, physicians lose their sense of curiosity and enter into the realm of burn out.
What has happened to Medicine?
Our collective culture has assigned too great a value to money, productivity, and profit at the cost of what lives inside the hearts of every human being – stories and feelings -sorrow, joy, and the life process itself. In assigning this level of value to money, we have lost the soul of health care. It has fallen by the wayside.
The consequences of this have been grave.
Patients today are disillusioned and dissatisfied. They no longer trust the medical system. It has disempowered them and made them fearful. Physicians working for corporate medicine are depressed and disillusioned. They too live in fear. Their rate of burnout, depression, and suicide has skyrocketed over the past two decades.
Physicians are curious people by nature. They are investigators. They want to uncover what lies deep underneath symptom and suffering. Their curiosity is no longer valued by the corporate health care system.
Over the past two decades, the medical system has also suffered greatly from a deeper level of reductionism. Not only has this reduced the scientific context to mere mechanisms, it has separated the wisdom gained from life experience and the alchemical nature of healing from scientific method.
Medicine itself has been morphed into a ‘factory farm’ of sorts. Without curiosity, exploration is not possible. Without exploration, creativity suffers.
For those of us who have stepped outside this corporate box and work outside the corporate structure, the sickness inside corporate medicine is clear. Today it lacks the intention to transform and heal (the true mission of healthcare), in favor of profit. In fact, maintaining sickness is more profitable than healing.
The by-product of this mode of operating is fear rather than hope or possibility.
If we are to reform health care, it is this pattern that must be healed.
It will take enough of us, a critical mass of physicians who have chosen to practice medicine outside the ‘corporate box,’ to expand the context of medicine to include curiosity and healing. It will take a critical mass of patients to demand the kind of office visit that explores and validates, that deeply investigates causality with the intent to heal. Together, this can restore the soul of Medicine itself and create a health care system that once again encourages physicians to engage alchemy as healers and, as Rilke once said, “love the questions themselves,” and maybe then, we can help our patients “live their way into the answers.”
Now more than ever, we need to reclaim health care from the grips of corporate greed and restore its true intent. I am certain this will bring healing to both patients and physicians.
©April2016 Kalpana (Rose) M. Kumar M.D., CEO and Medical Director of The Ommani Center for Integrative Medicine, Pewaukee, WI Dr. Kumar is accepting new patients; call our office to schedule at 262.695.5311. www.ommanicenter.com Author of Becoming Real: Reclaiming Your Health in Midlife. 2011, 2014 Medial Press