Over the years I’ve significantly improved my relating abilities. Whether or not you give credence to the Myers-Briggs Personality Types, it has been my Rosetta stone. INTP. Probably one of the more misunderstood personalities, in a woman it has much more brutal implications. Unfeeling, aloof, blunt, overly analytical, indecisive. It’s not all that bad, most of the time, and especially since I’ve unlocked the mysteries surrounding my affect and those around me. After several conversations and with enough information, the four letters of my acquaintance beg me to label them. I’m not a savant, just a studier.
When I “rescued” a puppy from the farm several years ago, as a studier I immersed myself in all things Dog. Puppy training classes, dog parks, clicker commands, Animal Planet, socialization, polite introductions, enzymatic urine cleaner, and so on. All of this training was actually for me, not my dog. As a human, I had to learn to interpret and relate to my dog. To anticipate her behavior in certain situations and to use her psychology to our mutual benefit (“sit”, click, treat) was a skill I didn’t realize I desperately needed. Even the simplest of gestures and one that makes me most proud as a dog mother (ick, hate that term), is when she goes to the back door when she needs to do her business. She also goes to the door for about 13 other reasons that infuriate me, but at least she doesn’t relieve herself indoors. Raising and training my dog, my protector, created a new facet in my comprehension of the world. It made me more human and bilingual.
Make that trilingual. I studied Spanish for a few years in high school. It was enough for me to test out of my college credit requirements. While most people forget the languages they learn, I think the reason I held on to much of Spanish is because English was always intuitive. A second language is inherently more difficult and requires logic, at least for me, the INTP. A few times in my career I’ve attempted some translation at the bedside of a Spanish-speaking patient, but I never advertised. Completely rusty and insecure in my overall ability to speak it, my attempts are generally feeble. A resident physician turned to me in a patient room, indicating I spoke Spanish. I never told him this, so, I really think he jumped to a conclusion in an attempt to deflect attention from him not securing an interpreter before rounds. “Tiene usted dolor?” I asked. A confused furrow of the brow and darting eyes from me to the resident confirmed my fear that I should practice more, or at least not try to be the hero anymore.
At times conversing across disciplines requires overcoming a language barrier as well. Words typed into a chart may hide true intent, feelings, or conclusions and instead provide only facts and clearly defined outcomes. Although electronic medical records improve the quantity of communication, I argue that the quality lacks, especially for third parties like me who scour the pages like forensic scientists trying to piece together a mystery. Adding a complication, pharmacists are precise when it comes to pharmacology, especially when communicating with physicians. Prophylaxis and prevention on the surface connote similar meanings, but guidelines use them differently in specific scenarios. Patients admitted to the hospital usually receive some sort of DVT (deep venous thrombosis) prophylaxis, and it’s often enoxaparin or heparin at prophylactic doses, not therapeutic anticoagulation doses. A patient who’s had a blood clot in the leg (a DVT) in the past may continue on long-term anticoagulation for DVT prevention. This is not the same as DVT prophylaxis. A prophylactic dose is much lower and ineffective for anticoagulation. This is the language of pharmacology that prevents misinterpretation, but not everyone speaks it. Not everyone realizes the breach exists. So, when I hear from someone that a patient is on DVT prophylaxis but are taking a therapeutic anticoagulation dose, I first have to translate for myself the intent of treatment so I can then evaluate therapy (and on the down-low, suggest alternative verbiage).
Resting somewhere among the pillars of interpreting behaviors, words, and intent, is the practice of effective teaching. I lecture pharmacy students in the classroom several times a year, but I mostly teach, instruct, and guide them in a clinical setting during their last year of school. Real, live patients are the case studies, self-directed research is the lecture, and patient presentations are the exams. Translating classroom knowledge into clinical practice in the hospital presents some level of difficulty for students. I question the students to assess foundational knowledge, ability to evaluate known and potential factors affecting pharmacotherapy, and critical thinking. I explain concepts to reinforce or to correct deficiencies in knowledge. Sometimes I ask questions that yield left-field answers that I have to admit my students would have to be clairvoyant to answer correctly. (I’m working on my Socratic method.) Frustration strikes when a student commits the same errors over and over. Either I am not conveying information in a way they grasp, or they are drowning in a sea of unfamiliarity. In the case of the latter, my INTP-lack of compassion kicks in. (How did they make it to their 4th year of pharmacy school?) But if it’s my inability to uncover the disconnect, to focus the blurry lens, then I have to find alternative inroads. I study my students, their behaviors and reactions, to identify the cause and whether the fix should be my responsibility or theirs. Ultimately, I can’t force a student to learn (clicker-treats are not appropriate in this scenario), but I do my due diligence to bridge the language barrier.
Interestingly, INTPs often become professors…of the absent-minded variety. I wish.