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Knowing What to Say and When to Say It

Often in life, our ability to connect or estrange people lies in the language we use. Body language plays a part, as do tone of voice and inflection. And then there is the issue of word choice. What we say and how we say it can make a lasting impression in any relationship, but it is the communication that takes place within the confines of the hospital that can be the most vulnerable and important to get right.

On a hospital ward where some patients are very ill, even dying, the importance of compassionate language and communication is crucial, yet all too often it falls by the wayside. Doctors often are so busy when making rounds that they give the impression they are halfway in/halfway out the door before they’ve managed to say hello. Nurses – especially those who are contracted by the hospital but not on staff – send the message that they are overworked and underpaid by ‘underperforming’ and remaining aloof on the job. Of course there are exceptional doctors and nurses as well, but in general, there is room for being more aware of establishing a rapport and building trust by communicating clearly and taking the time to do so.

This morning I was visited by a Liver Transplant Coordinator, someone I would have expected to be well-versed in the skill of communication. I had two conversations with different coordinators in the phone previously whom I found helpful and kind. The woman who came to my bed was pregnant and seemed friendly enough, albeit young. When we spoke, she invited questions, and one of my questions was how long should I expect to wait? As a B+ bloodtype, she told me the wait is the longest. I replied that I couldn’t imagine having to wait a year in the amount of pain that I’ve been in for the past 6 weeks, to which she replied, “for B+ some wait longer than two years, and some die while waiting in the list.” After breaking into an inconsolable sob, I gathered myself for long enough to respond,”imagine your obstetrician reminding you that you may die in childbirth, preventing you from seeing your child grow up?” She tried to apologize by saying she didn’t realize I was a mother, but my desire to continue a discussion with her vanished. I spent the rest of the morning in a miserable, depressed state.

The thing is, the transplant coordinator didn’t tell me anything I didn’t already know. My doctor explained the risks to me, and it’s spelled out in all the literature. It was the way she communicated it that was hurtful. My doctor told me the thing to avoid most is getting depressed about the situation, and that is exactly what the woman did; she focused on a couple of negative potential outcomes without thinking of how it may affect me. She could have equally focused on the positive, and even have been more selective of her language choice. When it’s a matter of life and death, there is no ‘right’ way to communicate, only a wrong way. I assumed in a hospital ward dealing with transplants, the coordinators, the epi-centers of communication, would be skilled at navigating through a conversation dealing with mortality. It goes to show that we all may benefit from being more thoughtful with what, how and when we choose to communicate something of importance. The recipient of the message is probably more fragile than they’d like us to believe.

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