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Embracing the awkward silence

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THROUGHOUT vet school, I imagined that veterinary practice would be pretty straightforward. Yes, sure, there would be scientific conundrums and clinical challenges, but those could be solved by judicious research and asking colleagues for help. I had been trained in communication skills, I had read the suggested consultation models, and I had practised eliciting the case history from willing actors.

How wrong I was. When I started in practice, I suddenly found that I seemed to be solving the wrong problems. I’d listen carefully to the client, ask for clarification, work out a diagnosis and treatment plan and proceed. However, my clients would still seem slightly ill at ease, a little uncomfortable, perhaps rather unsatisfied as they left.

My boss gave me some useful guidance. ‘Ask them if they have any questions. And you know how silences can become awkward? Make them awkward.’

I practised in front of a mirror. ‘Do you have any questions?’ I let the silence simmer, my face a rictus of interested anticipation.

And suddenly the floodgates opened. I found that my clients had a plethora of pressing questions that they were only too happy to ask. My consulting room became a confessional - I fielded questions from the straightforward to the confusing to the simply bizarre.

Some were blessedly simple. Like the young man who fidgeted through his dog’s claw clipping consultation, before finally bursting out with ‘So, you know dogs? Are they cold-blooded or warm-blooded?’ For once, I could answer a client’s question with absolute certainty.

Some had evidently required some preparation. I saw a happy staffie with his friendly Polish owners for his first vaccination. There was a bit of a language barrier, but I felt that I’d communicated well. I told them that I would see them again in two weeks, and that if they had anything they wanted to discuss, we could talk about it at the next appointment. The second vaccination was uneventful, and I asked whether they had had any problems with their new dog. The owner grinned delightedly, and rapidly searched his many pockets before extracting a crumpled piece of paper. On this scrap was carefully written, in capitals, ‘MANY FARTS’.

And some were downright embarrassing. I was examining a lovely young cocker spaniel for his annual vaccination. His coat gleamed with health, as golden as his owner’s beautifully coiffed hair. I asked the open question and let the silence hang. She smiled at me. ‘Well, there is one thing. He’s got really fishy-smelling breath. Why does that happen?’ I started to consider my response. However, before I could start speaking, the confessional atmosphere of the consulting room had its usual effect. ‘Do you think it’s because he eats my underwear?’

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