Dialogue Volume 15, Issue 2 2019 - Page 36

PRACTICE PARTNER doctor teach you about communicating with patients? He can if it’s Alda, who played Dr. Hawkeye Pierce on M*A*S*H from 1972- 1983. Alda is actually a doctor, of sorts. In 2017, the University of Dundee in the U.K. gave him an honourary Doctor of Laws for his work promoting good communication in science. Beyond his acting career, Alda advocates for clarity. For 11 years he hosted Scientific Ameri- can Frontiers on PBS. He’s a visiting professor at the Alan Alda Center for Communicating Science at Stony Brook University (aldacenter. org/). The centre has developed a series of programs and workshops taught at medical schools and universities, and have Think of what trained over 14,000 scien- patients want tists and doctors. Alda wrote a 2017 best- and need to know seller called If I Understood most, and give it You, Would I Have This Look to them first. on My Face? about com- munication in science and life. In 2018, he launched the podcast Clear + Vivid, featuring conversations with guests about how to relate to and communicate with others. In his book, Alda cites a meta-analysis that showed how effective communication with patients improves adherence, satisfaction and even health status. What has he learned about what goes right and wrong in doctor-patient interactions? Here are four valuable lessons gleaned from Alda’s book and podcast. 1 Make listening an action As an actor, Alda says you don’t say your next line just because it’s in the script. You say it because the other person in the scene behaved in a way that makes you say it. “Real conversation can’t happen if listening is just my waiting for you to finish talking,” he writes. Understanding that on stage or in front of the camera affects your acting. But he says it’s also a first step in figuring out what has to oc- 36 DIALOGUE ISSUE 2, 2019 cur between doctors and patients. Alda refers to responsive listening. It’s not a passive activity. Unless you’re willing to be changed by the other person talking, you’re probably not really listening. But if you do lis- ten openly – not just to someone else’s words, but their tone of voice and body language too – Alda says “there’s a chance that a true dialogue will take place.” 2 Pace yourself There’s an improvisation exercise called mirroring. What can it teach about being better commu- nicators? Alda has done it with the scientists. In the exercise, there’s a leader and a follower. The leader has to do a series of slow move- ments, like stretching an arm or scratching a face. The follower has to mimic it with no delay, so that you can’t even tell the leader from the follower. It’s just like looking into a mirror. In the beginning, the pairs can have trouble. The follower has a slight lag time. The leader is going too fast. The follower can’t keep up. So the leader has to deliberately slow down. Once the two people have got it, the exercise switches up. Now the follower becomes the leader, and the leader becomes the mirror. Again, they can struggle, but get the hang of it more quickly. The lesson? The person communicating (the leader) is responsible for how well the other person follows. It’s the follower’s responsibility to catch up; it’s the leader’s responsibility to go slower. Then you can be in sync. Think of how this applies to not only the pace of information but the nature of it. Are you in danger of overloading your patients at times? Do they want all the detailed facts? Are they able to process them in the moment? Sometimes, Alda writes, patients “need presence more than knowledge.” He shares the story of an internist who told a patient about her metastatic lung cancer. The patient listened, but didn’t seem to understand. So a medical student along on the rounds asked