Patient Inspired

Patient Inspired*: “Some People Can’t Talk.”

March 11, 2015

We were connecting over Skype, she in her temporary apartment in Chicago, me in my office in Newport Beach. The cold, bright sunlight flowed through her windows, lighting the tall table for two that was covered by a makeshift tablecloth. The cat, quietly present, weaved in and about the space, occasionally stepping across the keys of her computer.

The bookshelf was full of books, odds and ends, spilling in all directions, threatening to topple off at any moment.  Even through the computer, I could sense the energy of her creative spirit, her artistry, that translated into her way with words, and her way of being in the world.  It was palpable.

She looked at me earnestly, her hair piled into a messy bun.  We were at the end of our time together.  She had been crying, but now looked fresh.  Her smile was bright and unburdened.

“I was thinking of you last night, ” she told me.  “Like what you do?  It’s like this.  You know how everyone has a voice?  Some people have a loud voice.  But some people can’t talk.  Or they talk too quietly because they don’t know how to speak up.  They don’t know that they deserve to speak up.  That’s like me.  But people like you give people like me a voice.  And then one day, some time from now, maybe I will do the same thing for someone else.  Kind of a chain reaction.”

I was touched and blown away.  In a few words, she had honestly and poignantly summarized how I felt about therapy.  As a psychiatrist and psychotherapist, if I am able to give volume to one person’s words, evolve feeling into expression, then I can leave my office knowing that I had done something important and powerful that day.

There are so many reasons we become quiet.  Shame, guilt, uncertainty.  Or because no one seems to be listening.

In therapy, eventually, an individual speaks aloud that which has felt dark and silent.  And if those words are received with a sense of privilege and non-judgment, a little light is let in.  Like the dim glow that shines in through a mostly closed closet door. Things seem a little clearer because two sets of eyes and ears are focusing in together, carefully, on that which needs undoing.  And the work can begin.

There are many days where I may not hear if or how I have helped someone.  And I try to rest in the knowledge that, in my field, movement happens in the smallest of ways.  Until one day we look back together, and see that we have actually traveled miles, through the arc of the past, into the present, and even ahead into the future.

But today, I didn’t have to trust that change was happening, or that I was making a difference, however small, to someone.  She told me, loud and clear, in her own words.


*Names and identifying details have been changed to protect patient confidentiality, and permission has been sought from patients to share their stories.


  • Reply Caroline Mawer December 9, 2015 at 3:42 am

    Thanks so much for this – which I just stumbled upon.
    I really like what you wrote about “people like you give people like me a voice”
    I’m a family doctor, and I’m just about to retire early from clinical practice.
    Unsurprisingly, I’ve been thinking about my career.
    I’ve always thought – and you just reminded me of this so well – that giving voice to important stories was a little bit of magic. Sometimes, when someone came to see me, not feeling right, they either weren’t at all sure why this might be, or told me it was because of something which I privately might (or might not) think irrelevant. And sometimes we, together, made enough space that they found themselves telling me a story which was very important to them, but which they hadn’t / couldn’t remember or think of – and which was clearly the key to their feelings.
    They always looked so surprised at knowing their own key to their own problem!
    But – as I always reminded them – of course, they were themselves the miracle-worker.
    Though I was a close second – since in the UK, where I work, we have 10 minute appointments.
    Thanks for your excellent article!
    Best wishes

    • Reply Monisha Vasa December 13, 2015 at 4:59 pm

      Thank you so much Caroline for taking the time to read and comment! I am amazed at what you and your patients were able to accomplish together…in such a short amount of time, nonetheless, and while also dealing with many other medical issues I am sure. They were fortunate to have a physician like you, and I am sure you too feel fortunate to be a part of the “magic” that you so articulately describe. I wish you all the best in your early retirement, and all that is yet to come. Thanks again for visiting my blog.

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