BAM What inspired you to write The Lonely Patient?

Michael Stein Most people donít know how to talk to sick people, and sick people have trouble talking about what they are feeling. The book is meant to offer an emotional vocabulary for sick people.

Leah Fasten
Michael Stein treated patients for years, but it wasnít until his brother-in-law developed terminal cancer that the doctor began to understand what illness feels like.

BAM What makes serious illness so lonely?

MS You are traveling apart from people and you have something that no one else can take away from you or essentially share with you. That is the existential problem: illness is an individual, not a team, sport. There is no one else you can send into the CAT scan tube to take your test.

BAM So illness exiles you from the ordinary, everyday experience of people who are not ill?

MS Yes, to some degree. Even when you are in that world and people say, ďYou look fine,Ē you probably do look fine, but it doesnít mean you feel fine all the time. You think, ďHow do I explain to you that tomorrow I have to get radiated and you donít? There is something different about me.í Ē

BAM How helpful are such things as support groups or attitude or spiritual practice?

MS There are ways to mitigate [this experience] for sure. But I think loneliness is the essential experience of illness. I donít think you can ever really escape it. There is nothing you can do to stop feeling lonely except get better. As long as you have some remnant of illness, loneliness never completely goes away.

BAM Why does it seem so difficult to find a truly sympathetic doctor?

MS Imagine going to the office of a stranger, in any other setting in your life, and disclosing intimate details to somebody you know nothing about. It would be a miracle if it worked out very often. We donít date like that. We donít make job choices like that. There should be a lot of mismatching. You should feel lucky when you match, and you should move on and find another doctor when you mismatch. I also donít think that either patient or doctor quite knows how they are going to handle an individual relationship until sickness is actually upon them. You might think that you have quite a good relationship with your doctor until you are actually ill. And then you have a different view.

BAM Does being a doctor have anything in common with being a writer?

MS As a doctor, you hear stories all day. And you hear stories on all of the great themes of literature. People come in and they talk to you about sex, and they talk to you about death, and they talk to you about loneliness, and they talk to you about their bodies, and they talk to you about what itís like to be away from home in the hospital and what it is like to go home.

Also, both doctors and writers are trying to tell a coherent story. A doctor will be presented with facts that need to be cohered in some way. And when you are writing a novel you are trying to do the same thing. You are trying to tell a coherent story. 

- Linda Heuman

Comments (2)
I have been a fan of Dr. Stein's writing for many years. Brown is lucky to have such an insightful and prolific humanist/doctor on faculty. I'm looking forward to reading the book. Thank you for the interesting interview, I look forward to reading the book
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I was a chaplain at what was then called Columbia Presbyterian in NYC. The chaplain's job WAS NOT to proselytize or offer Christian comfort. Our job was to listen and be present with suffering. 
I learned to open a door for patients to speak. One man, who had just had a by-pass and claimed to be "fine", was weeping within minutes and telling me how he felt his heart had been broken. 
It was the chaplains who talked to relatives, who broke the bad news, who helped patients make their last wishes known, who sat with the dead. 
The loneliness of the patient can never been healed, but at least someone can sit with that loneliness in her own loneliness and share it. 
I'm glad that the doctors being trained differently today than they were when I was a chaplain. But I still believe that a specialist in listening is a better choice than a specialist in by-pass surgery to hear about a broken heart.
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