Gathering intelligence: not just for spies

It simply involves paying attention to the details of your patient's home, office, clothing and appearance


During the third day of fighting in the Battle of Leyte Gulf during World War II, a Japanese Kamikaze pilot dove into the deck of the aircraft carrier USS St. Lo, penetrating the foredeck and setting off the forward ammunition supplies.

The explosion rocked the ship and engulfed the flight deck in fire. 30 minutes later, the St. Lo slipped under the surface of the Pacific, taking 113 of her crew with her. It was the first major military vessel lost to Kamikaze attack.

I knew nothing of the USS St. Lo or the battle of Leyte Gulf for most of my adult life until one brisk October morning when I was called to help an elderly male who was having some persistent aching in his chest. This patient was aboard that ship on that fateful day in Leyte Gulf, and he told me all about it.

(To be fair, he didn't tell me all about it. He told me some things about it, and I filled in the rest of the details later, with the help of Google.)

Of course, our conversation didn't start with my patient introducing himself as a survivor of one of the greatest naval battles in history. He told me about his service because I asked. And I knew to ask because I paid attention.

While I walked through his home, I gathered intelligence. I knew he was a Navy man before I ever even saw him.

Gathering intelligence is a great tool for developing your patient rapport. It simply involves paying attention to the details of your patient's home, office, clothing and appearance. Once you learn to develop a sense of who your patient is, you'll find it easier to develop social "common ground" and shared experience.

What gave my patient up as a Navy man were the photos on his walls. Midway down the hall on the right was a group of black-and-white photos of several naval vessels. The simple, understated group of 4x6" photos in plain black frames told me that he was probably a former sailor. Photos are great for gathering intelligence, but they aren't necessary.

The next time you approach a patient, pay attention to his or her clothing, especially insignias on T-shirts and hats.

Look at tattoos. The things people permanently mark upon their body are often very significant to them.

Check out his or her shoes. Do they fit their environment? Are they new or worn?

Also look at living spaces, when they are available. How well-kept and organized are the spaces? What do they choose to display?

Even people's hands (especially their nails) can tell you stories about their work, their lives and their health.

Once you've gathered a sense of who your patient is, you'll have a better idea of how to approach and interact with this person.

Once I had my sailor friend loaded for transport and his chest discomfort under control, I respectfully asked him, "So, are you a Navy man, sir?"

He smiled and confirmed my suspicion. He didn't ask how I knew. He probably suspected I'd been looking at his photos.

He asked if I was Navy also and I told him that, while I had never served, I was the son of a sailor and I had learned a few things growing up about ships and the sea.

And then he told me that amazing story.

Those are moments that make our job so worthwhile. There on my pram was one of the most fascinating people I've had the privilege of meeting. My time with this elderly man was short, but his story was a wonderful gift.

Of course, I never would have known anything about it if I hadn't paid attention and gathered intelligence.

Gathering intelligence can help you make that all-important transition from patient contact to human contact. You encounter people every bit as interesting as my patient from the USS St. Lo.

Gather intelligence, and you'll be amazed at some of the people you'll meet.


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