Unencountering

By Chris Tiplady, MD, with Michael Atkinson, MEd, University of Sunderland, England

A favorite book of mine from the 1980s was “The meaning of Liff.” The authors use strange and wonderful place names from around the world to create a dictionary of feelings and objects for which there’s no current English word. For example:

Nantucket (n): The secret pocket which eats your train ticket.

My colleague and I recently wrote a short blog about a phenomenon we observed in medicine—something that also appeared to have no name. We needed a word to describe, teach, and discuss something important. Healthcare professionals are trained to encounter people, situations, issues, and problems, but we don’t appear to train for “unencountering.”

Unencountering (v): Moving on after a particularly intense conversation and being ready for the next one.

Patient encounters can be intense, deeply personal, complex, momentous, and sometimes pivotal. They require your immediate undivided attention. Medical training prepares us with tools like empathy, reflection, active listening, transference, and verbal and non-verbal cues, all while taking into account issues like power difference, anxiety, and vulnerability. Sometimes patient encounters leave an emotional mark that’s important to shed before seeing the next patient. You can’t carry over issues, you can’t confuse issues, and you must watch that you start anew with the next person.

How we do that isn’t really taught, but here’s something I’ve learned in my career: I let go, I move on, and sometimes I deliberately and consciously forget. Meaning, I forget much of the encounter but remember the tasks, the details, the plan, and the next steps. I write those things down then forget them again, but they’re in some kind of file in my brain that will be activated the next time I see that person or open their notes. This is what I mean by unencountering.

My colleague, Michael who has a background in philosophy adds,

A wise sage once said—well, Master Oogway from “Kung Fu Panda”—“The past is history, the future is a mystery, and the present is a gift (that is why it is called the present!).” There’s something rather profound in this, particularly for anyone whose working day is made up of one intense human encounter after another. The present moment is, after all, the only moment we can actually experience. We need to learn from the past and anticipate the future, but neither needs to accompany us into the next room.

Every encounter will influence our next moment to some degree. But we have some choice about how tightly we hold on to that influence. If we ruminate on what’s happened, replay the conversation or anticipate what might happen next, our perceptual field can become narrowed by the previous encounter. If we can acknowledge it, learn from it, and let it go, we create a little more space to meet the person in front of us.

For me, this is where mindfulness has something useful to offer. Mindfulness isn’t about emptying the mind or pretending that what’s happened hasn’t happened. It’s about recognizing what’s present —thoughts, feelings, memories, and bodily sensations—without automatically allowing them to determine what happens next.

Perhaps that’s the real skill of unencountering—not forgetting the person we have just encountered but becoming sufficiently free of the previous encounter to genuinely encounter the next one.

We’re both quite pleased to see that Googling “unencountering” suggests we really did invent a new word.

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.