that from a long way off look like flies.

By impactEDnurse • Jul 25th, 2010 • Category: reflective practice., the nurses desk:

Each of our eyes sees the world from a different side, but it is by accepting both views as real, we see the true depth of things.

In his famous book ‘The Order of Things, Micheal Foucault describes a passage from “a certain Chinese encyclopedia” that, he claims1, divides all the animals belonging to the Emperor into the following categories:

a) belonging to the Emperor
b) embalmed
c) tame
d) sucking pigs
e) sirens
f) fabulous
g) stray dogs
h) included in the present classification
i) frenzied
j) innumerable
k) drawn with a very fine camelhair brush
l) et cetera
m) having just broken the water pitcher
n) that from a long way off look like flies

To most of us, such a view of things is totally illogical, ridiculous even, and we cannot imagine how someone could possibly see reality prioritized in such a way.

And it is just so with our patients, who are often experiencing a reality that may be so completely, unimaginably different to the one we think they should be experiencing.
I am not talking here about delusion or delirium or confusion, which as nurses and doctors we are pretty good at recognising, but rather the completely different point of reference that a person who is suffering illness may experience.

Working from our own professional reality, we often tend to slot patients into various taxonomies based on say, diagnosis, and evidence-based medicine, and priorities of care, and how very busy we are and our own myriad lists built on previous experiences.
After all, this is our business….and we know our business.

To us the patient lies before the Emperor of medicine.
But through the patients eyes of pain and discomfort and fear and uncertainty, the whole thing may seem to be drawn with little more than a very fine camelhair brush.

Call it empathy, call it sensitivity, call it what you will. By remembering to look out of another eye, we can overlay our separate worlds, producing an altogether different picture.
We can see that in those patients that from a long way off look like flies, there is a newfound depth and texture and meaning that can improve our practice and enrich our life.

  1. in fact this taxonomy is probably fictitious, said to be the invention of the Argentinian short-story writer and poet Jorge Luis Borges. []

impactEDnurse is also known as Ian Miller, a nurse with over 26 years experience working in a busy emergency department in, Australia. This site in no way reflects the opinions of that hospital. All stories (although based on actual experiences) have been changed to protect patient confidentiality.
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One Response »

  1. Well said, Ian. I think nurses but docs especially would be a lot less frustrated and infinitely more effective as care givers if we just looked with another eye.

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