Maya Angelou once wrote, “There is no greater agony than bearing an untold story inside you.”
For all the freedom that storytelling entails, it takes two to tango: it requires a speaker, but also a listener. We don’t just want to tell our stories; we want them to be heard.
And where better to offer an open ear — to help turn “agony” into relief — than in hospitals, a place devoted to alleviating pain?
At UCLA Health’s Companion Care program, volunteers are invited to offer hospital patients something deceptively simple: companionship.
For James Liao, a fourth-year applied mathematics student on the pre-medical track, the experience changed his view of medicine.
Like many others, Liao initially joined the program to gain clinical experience. He was drawn to the program’s mission to “provide individualized companionship to older patients while they are hospitalized.”
The broad program description explains its diverse volunteer experience. Liao, who volunteered at hospitals in the Los Angeles area, is tasked with walking through approved hospital floors, looking for open doors and patients who could use some company.
Liao initially found the task daunting, especially because of the program’s unstructured nature.
“It was scary,” he said, “asking someone if they’re willing to spare some of their day and talk to you.”
Many of the patients Liao speaks with are inpatients staying in the hospital for several nights while dealing with serious illness or cognitive decline. During his very first shift, he confronted this reality.
As he walked into his assigned room, James saw a flower on the room’s door frame. The flower signified that the patient had dementia or was confused. This quickly became apparent.
“The first thing she told me,” he said, “was that her husband had disappeared, her children had disappeared and she didn’t know why she was in the hospital and that she wanted to go into the street and get run over.”
Flustered by the sudden outburst, Liao attempted to shift the conversation, changing the topic from something so grave to one more gentle and mild.
At the time, James had joined the program in hopes of helping people process their fears and vulnerabilities. This experience taught him, however, that he shouldn’t have the same expectations for every patient he approached; each of them had their own needs.
For dementia patients suffering from forgetfulness, Liao typically tries to steer them away from sensitive topics, especially since an exploration into these topics doesn’t produce any long-term benefits: the patients inevitably forget about their conversation and resume their previous, distressed state of mind.
For other patients who are more lucid, steering away from difficult conversations isn’t always the best way to help them.
“Sometimes it’s good to sit with it. To talk about it openly,” he said.
To be open, for him, meant being careful not to excessively affirm the patient’s pessimism, which could further discourage the patient. But it also meant not being overly optimistic. He doesn’t want to promote “toxic positivity” and assure the patient that everything was alright when it was not.
Finding ways to navigate these complicated interactions required curiosity and empathy.
“It was really just trying to be human,” Liao said. “Trying to understand.”
And sometimes that clashes with the natural human tendency to form assumptions, even if the assumptions feel positive or respectful. This can occur when dealing with older patients, where they are often seen as benevolent or peaceful — it can be shocking and humbling to learn about the anguish they hide underneath.
One patient in particular told Liao about her life and background. From his initial questions, it seemed like there were many positive aspects to the patient’s life: she was part of a large family, held a high-status job, and enjoyed a luxurious living arrangement.
The patient was admitted to the hospital because she tried to take her own life.
For Liao, these moments make it “really hit home … how little you can tell about someone from looking on the outside.”
People often withhold their worries, opting to stay silent instead of talking about their ongoing struggles. Liao has heard a variety of reasons for this: because others wouldn’t care, because they would be bothering their friends and families, because this is not something worth caring about.
For the aforementioned patient, when Liao asked if she would be willing to share more about why she attempted suicide, she responded, “I don’t know … I have to be stronger.”
While heartbroken by her reply, Liao was also touched by her willingness to share. It underlies a larger point: strength isn’t found in isolation, but in community. People who aren’t afraid to talk about pain and the various forms it assumes.
That is the kind of community that Liao wishes to cultivate in the medicinal field. He noted, “In medicine, there’s a big focus on the objective view of the patient’s disease.”
From his perspective, doctors often concern themselves with a patient’s heart rate, temperature, body scans or other empirical measurements. Measurements that, unfortunately, can take away from truly knowing the patients’ lived experiences.
It isn’t the fault of hospitals, Liao admitted, because of how understaffed hospitals are. Too few employees and too many patients leads to shorter visit times, which in turn gives less time for doctors and nurses to understand their patients.
He reflected on his own life, living with eczema. Doctors prescribed him topical treatments, but “really I wanted someone who understood what it was like … I think that sort of empathy would have gone a long way.” For those undergoing even more debilitating conditions, he can only imagine how much more reassuring it might be.
Despite his thoughts on the current healthcare system, he was hopeful about its future: “I think we’re heading towards a more heterogeneous view of medicine, one where everyone deserves their own specific care depending on their lived experience.”
Companion Care, he believes, is a step in the right direction. A program less focused on “solving” suffering, but on being present throughout it.
“Some patients you talk to, it’s clear that their illness has caused them a lot of pain. Sometimes, the best you can do is sit with them.”
It is a modest act, almost invisible beside the machine-like drudgery of hospitals. An act often neglected or overlooked because of its mundanity. But it is precisely this — an offer to fill what should be commonplace — that makes listening so important.
