Verbal Judo

January 30th, 2007

As we get more skilled at interviewing patients, we discover that some patients are very easy to interview and some are very hard.  The really quiet and really talkative patients are always the most challenging because they don’t provide us with the easiest flow of information.  Very talkative patients are especially interesting to me.  Without any encouragement the interviewer will quickly learn about what that person had for breakfast, how many pets they have, and why they are mad at one of their friends.  While learning about another person’s life is a wonderful and fulfilling experience, we unfortunately only have about 20-30 minutes to cover all relevant medical information.  Our teachers encourage us, in these situations, to gently guide the patients back on to relevant topics in order to learn as much medically relevant information as possible.  It occurred to me that this is a lot like verbal judo.  Judo uses the momentum and strength of an opponent to achieve one’s desired end.  While the physician-patient relationship is not an adversarial one, it is one where this theory of guided momentum can be used.  The physician wants to take the chatty patient’s momentum and guide it towards a productive direction without impeding the volume of information that the patient is willing to provide.  Wikipedia says,  ”The word Judo is composed of two kanji: “jū”, which means gentleness, and “dō”, way or road (the same character as the Chinese “tao“). Thus Judo literally means “the gentle way”, or “the way of giving way”, and may also be defined as “the way of suppleness”, “the way of flexibility, or “the way of adaptability”.”  Given the name’s meaning, it seems even more fitting.  I can only hope that someday I will possess those traits and the ability to be a verbal judo master.

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