The first time it happened, I thought I was having an out of body experience. I had recently finished a communication skills training course, and was back in my VA clinic talking to a patient. I suddenly noticed that, although present with the patient, I was also quite aware of myself – it was as if I was watching us both from a third perspective, as on a television screen. I saw the way I was sitting, my facial expressions, and how I responded.. Also, I saw the way the patient was sitting, his facial expressions, and what we was saying. Weird. I felt extraordinarily self-conscious and a bit uncomfortable. What’s more, is that I was thrilled--with this newfound ability to observe myself in real time. I could assess my own communication behaviors, even correct myself mid-course—it was the beginning of a new, and powerful, kind of learning. Many years later, this self-awareness has become routine. Now, when I sit with a patient, I accept that there are three of us in the room: the patient, me, and “mini-me,”—the mini-me hovering over the encounter, observing and providing feedback, like a favorite uncle. And while mini-me may not always keep big-me from sticking my foot in my mouth, he’s often helped me extract it before I leave the room.
James
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