With COVID-19 still rampant, you hear a lot these days about doctors, their responsibilities and their sacrifices. But for those of us whose duty involves handling an unending stream of emergencies, the pandemic is just a painful reminder of the emotional component at the core of everything we do.
Watch any good emergency room drama and the moments of crises would likely be portrayed as a ballet of technicalities: Someone yells “Code Blue,” and then physicians and nurses rush to the patient’s bedside, shouting dosages and instructions until the danger has passed. In a real-life hospital, however, emergencies don’t come off as mere procedurals; instead, they’re fraught conversations between caregivers and patients, and they often involve having to gain the patient’s trust without much time to spare.
If you think about it, that’s a challenging proposition. The men and women who see me every day often don’t think of themselves as my patients. They didn’t choose to consult with me the way they would with their primary caregiver. And none of them started the day imagining that in just a few hours they’d be sitting on a stretcher in an ER somewhere, sick or injured and in need of intensive care from a stranger.
They’re also in shock, which means that our conversations aren’t calm and fluid. More times than not, the information I convey to them and the answers they give me in return could mean the difference between life and death. A great intensive-care doctor’s superpower is not diagnosing or stitching, but talking. That’s true for other caregivers as well.
Thankfully, it’s a superpower that can be taught with some facility. Working with younger doctors, I focus on a few key components of successful communication. I firmly believe that if they work at getting through to people in the most stressful moments of their lives, they could be just as effective when tried in just about any other situation.
While it sounds basic, the first thing is to make sure you always look the other person right in the eye. That means getting on their level, rising up if they’re standing or sitting down if they’re slumped. Second, don’t shy away from whatever it is you need to say, even if it’s impossibly grim. Be honest with the other person and understand that while a dire prognosis may elicit a howl or cry of disbelief, it will eventually lead to clarity and action. Third, open up: You’re talking to another human being, and what that person wants to hear isn’t just a medical professional but an empathetic person. Say something like “I don’t know what I would do in your shoes, but here’s all the information you need to make your decision, and I understand just how difficult it is.” Finally, always give choices, which means delivering not only prescriptions but also the pathways to healing, making sure your patients understand what course each decision they make might take, risks and all.
While these are some of the skills I emphasize with younger doctors, they could apply to teachers, coaches or anyone whose job depends on being able to communicate in the throes of emotion. This also applies to other caregivers such as mental health professionals or nurses, who have more interactions with patients than most in healthcare. Connecting with the other person, delivering all the information at your disposal simply and clearly, and charting out possible courses of action, making the final decision a joint pact between you two—that simple sequence can make every complicated undertaking smoother, healthier and more successful.
Sadly, it’s not currently taught at most medical schools, which is an oversight that we should correct. But maybe a worldwide pandemic that brought so many who normally would have no idea of what goes on in the ER to our sudden care will begin to change all that. Maybe doctors and patients will find a new way to talk to each other, a more empathetic way we can then teach to everyone else.