Intended for healthcare professionals

Opinion Talking Point

John Launer: Ask a good question

BMJ 2023; 381 doi: https://doi.org/10.1136/bmj.p1212 (Published 30 May 2023) Cite this as: BMJ 2023;381:p1212
  1. John Launer, GP educator and writer
  1. London
  1. johnlauner{at}aol.com
    Follow John on Twitter @johnlauner

Around 20 years ago I had a consultation with a cardiologist that I’ve never forgotten, because of a single question he asked me. I’d never seen him before, and he took my history in a fairly standard way, barely looking up from his notes. But when he’d finished he looked me directly in the eye and asked, “Is there anything else important I need to know about you?” My eyes welled up. Without pausing to think, I said, “Yes, my wife and I have 3 year old twins, and I want to live to see them go to university.”

I’ve told this story many times over the years, often when I’m teaching trainees or medical students. It’s a perfect example of how a single good question, asked with real curiosity, can evoke a patient’s trust and transform a humdrum consultation. I’ve no idea if the cardiologist used it with every patient or perhaps had learnt it on a course himself. But I still remember how effectively it sent the message: “I’ve finished my task. Now I want to connect with you as a person.” It also taught me how little it takes to create that impression.

There’s a sequel to this story. With the help of a great deal of medication and a pacemaker, I did indeed live to see our twins go to university. It gave me great joy, not least because I remembered setting that objective all those years ago. Our daughter, the older twin by three minutes, now has a degree in anthropology and has gone into social work. Her twin brother is at medical school and approaching qualification.

By the kind of coincidence that logic cannot explain, my son was doing some work for a voluntary medical organisation when he met the cardiologist in question, now retired and also volunteering there. Since I’d told my son the story and mentioned the cardiologist’s name, he passed on the news that I was still alive and kicking, telling him that I remembered the consultation and the question he’d asked me. The cardiologist obviously had no memory of me but conveyed his good wishes.

Of course, there’s a sequel to the sequel too. I was so struck by this coincidence that I posted a brief account of it on social media.1 To my surprise it went viral, and several million people saw it. Among them was the cardiologist’s daughter: she’d already heard from her father about his meeting with my son, so she recognised him from the story I posted. She wrote to me to say that she herself was a twin, as well as a doctor. So, my cardiologist had had boy-girl twins himself, a little older than mine.

Synchronicity, it seems, never comes singly. And good questions, asked with authenticity, can reverberate down the years, whether or not you ever learn how much they have affected people.

Footnotes

  • Competing interests: None declared.

  • Provenance and peer review: Commissioned; not externally peer reviewed.