It's every doctor's worst nightmare - your patient suffers from a surgery complication, clinging for life by the slimmest margins, irate family members stomping the feet and the lava flow of hot emotion rushing in. During our lunch meeting today, my mentor told the story in such detail that our adrenaline was swooshing through the bloodstream with him.
"There is a great deal of emotion to deal with under such situation," he taught us. "First priority here is not to state your stand. Acknowledge the family's emotion before you say anything. The secret - if there is one - is to acknowledge and narrate their feelings, and then, once they calm a bit, it's your turn to say what you want to say."
And this is exactly what I've learnt to communicate with an "uncivilized" toddler who happens to be in a fit of outburst.
Harvey Karp, author of The Happiest Toddler on the Block, calls this the Fast-Food Rule when he tells a story about a guy who was pulling up to the fast-food restaurant order window. "May I help you?" "Yup," the man replied, "A burger and fries, please."
And what should the waitress say back to that guy? One might think that the guy is too lazy to cook (and he is), and should have ordered two burgers because he looks hungry (that too). Anything wrong with that? Nothing, except we should not say it. The very first thing, really, is to repeat the order, "Okay, that's a burger and fries. Anything to drink?" The key point is to let the guy know we understand exactly what he wants.
The magic of the Fast-Food Rule is that it works wonder for my daughter. The quickest way to show Jasmine that I care, whenever she's upset, is to describe what I observe: "You look sad." Then before I know it - pronto - my lovely kid begins to soften.
Good advice, that.
Wednesday, June 27, 2012
Wednesday, June 20, 2012
Vacancy Chain
What are common to hermit crabs and humans? A bit unsettling to hear that question? Sure. Much as I find the question difficult to answer, you might be more eager to tell me the difference between a layman and a sociologist. Well, that's another reasonably interesting question.
I find the answer to both questions after my recent reading of Scientific American article about hermit crabs, by Ivan Chase.
Most of us know three facts about hermit crabs: they're crustaceans, we often meet them near shorelines, and they've got their own mobile seashell homes. In that article, the professor of sociology gives us details of the animal so precise - and so easy to relate to what we're sharing the same behaviour - that I realize what is meant by professor's gift. It was a summer morning, children's footsteps everywhere at low tide along the beach. We can picture an avid sea kayaker wading into a shallow tide pool on Long Island. He was fascinated by a small hermit crab running toward an empty snail shell he dropped into the water a few minutes ago. The curious sociologist wrote, "almost quicker than I could follow, the crab pulled itself out of its old refuge (smaller in size) and thrust its vulnerable abdomen into the (more spacious) snail shell I had dropped." Before he left the scene, another hermit crab discovered the first one's discarded "home" and, after a most intricate three-dimensional inspection, worked out that the new lodging measured bigger than its own. Without second thought, the second crab exchanged his lodging. What next? Read on: "About 10 minutes later a third crab found the second's old home and claimed its prize, abandoning a small shell with a large hole."
I find the answer to both questions after my recent reading of Scientific American article about hermit crabs, by Ivan Chase.
Most of us know three facts about hermit crabs: they're crustaceans, we often meet them near shorelines, and they've got their own mobile seashell homes. In that article, the professor of sociology gives us details of the animal so precise - and so easy to relate to what we're sharing the same behaviour - that I realize what is meant by professor's gift. It was a summer morning, children's footsteps everywhere at low tide along the beach. We can picture an avid sea kayaker wading into a shallow tide pool on Long Island. He was fascinated by a small hermit crab running toward an empty snail shell he dropped into the water a few minutes ago. The curious sociologist wrote, "almost quicker than I could follow, the crab pulled itself out of its old refuge (smaller in size) and thrust its vulnerable abdomen into the (more spacious) snail shell I had dropped." Before he left the scene, another hermit crab discovered the first one's discarded "home" and, after a most intricate three-dimensional inspection, worked out that the new lodging measured bigger than its own. Without second thought, the second crab exchanged his lodging. What next? Read on: "About 10 minutes later a third crab found the second's old home and claimed its prize, abandoning a small shell with a large hole."
The curious sociologist doesn't stop at discovering the animal behaviour. He is eager to learn the beauty of a well-orchestrated "vacancy chain" - an organized method of exchanging a more desirable possession abandoned by another individual. By individual, he's referring to animals with relatively simple brains and nervous systems, say, hermit crabs, limpets, lobsters, fishes, octopuses and woodpeckers.
How about humans? Good. Is there room for a broader application of the same vacancy chain strategy among ourselves? Yes indeed. Automobile industry, I was told, depends a lot on this vacancy chain. That explains why car dealers have been so eager to take the old vehicles of any new car buyers in trade (and sell those old cars to yet other buyers).
Thursday, June 14, 2012
Prefrontal Cortex
"It's mine, it's mine!" was the first thing Jasmine blurted out on seeing another kid's grabbing her toy. What made her say so when the toys belong to neither of them?
The obvious answer: Jasmine has her own belief about the centre of the universe - and by now you should be able to guess who. It is Jasmine, hands down. The earth revolves around a kid rather than the sun.
That seemingly reference point, however, can change without my knowing it. She went to her favourite bookstore yesterday. Most kids would love that place. It was small enough to be comfortable, large enough that they can take a seat and play with building blocks, puzzles and read at leisure. At leisure, that is, except one: when another preschooler joins in. A boy came and took away my daughter's building blocks. But Jasmine didn't display even the ghost of a whine, quite the opposite really, because she went on and suggested, "Let's play together."
As the boy continued to grab every piece of building block, Jasmine relaxed, leaning back against her chair. I was expecting a tirade from that boy's father, but Jasmine said first, "Playing together is happier than playing on your own."
The boy didn't listen. In that sense, tension was building, and fast. Yes, at first blush, it seemed to foretell spine-tingling screams and shrieks, wild thrashing, and a fight ahead. No, nothing goes as smoothly as one would hope.
Jasmine made a sigh, and told her mother, "Okay, mom, let's move to read."
The obvious answer: Jasmine has her own belief about the centre of the universe - and by now you should be able to guess who. It is Jasmine, hands down. The earth revolves around a kid rather than the sun.
That seemingly reference point, however, can change without my knowing it. She went to her favourite bookstore yesterday. Most kids would love that place. It was small enough to be comfortable, large enough that they can take a seat and play with building blocks, puzzles and read at leisure. At leisure, that is, except one: when another preschooler joins in. A boy came and took away my daughter's building blocks. But Jasmine didn't display even the ghost of a whine, quite the opposite really, because she went on and suggested, "Let's play together."
As the boy continued to grab every piece of building block, Jasmine relaxed, leaning back against her chair. I was expecting a tirade from that boy's father, but Jasmine said first, "Playing together is happier than playing on your own."
The boy didn't listen. In that sense, tension was building, and fast. Yes, at first blush, it seemed to foretell spine-tingling screams and shrieks, wild thrashing, and a fight ahead. No, nothing goes as smoothly as one would hope.
Jasmine made a sigh, and told her mother, "Okay, mom, let's move to read."
Wednesday, June 13, 2012
Wrinkles
"Elephants have wrinkles, wrinkles, wrinkles. Elephants have wrinkles, wrinkles everywhere." My two-year-old came back from her dancing class, uplifted and energetic.
"On their toes. On their toes." I joined in the dance and raised my foot to touch my toes. If I am candid, I do believe that the original exercise should be keeping my knees locked and banding over to touch the toes - of which I no longer believe I, 41, can manage.
Of all the movement songs of children, "Elephants Have Wrinkles" has surely given us the pleasure of dance with words.
"What is meant by wrinkles?" my daughter asked.
Good question - to which I'm afraid not being prepared to be asked. Much to my chagrin, I found it difficult to explain the word to my two-year-old. I wasn't sure what to say. Picture me at home sitting with my daughter, wrinkling my brow in concentration to find a good answer.
Two final words occurred to me. Crow's feet.
How adroitly the words crow's feet sum up the concept. But hey! There are many more in English. Think about goose eggs, hives, bear hug, goose bumps and ponytail.
"On their toes. On their toes." I joined in the dance and raised my foot to touch my toes. If I am candid, I do believe that the original exercise should be keeping my knees locked and banding over to touch the toes - of which I no longer believe I, 41, can manage.
Of all the movement songs of children, "Elephants Have Wrinkles" has surely given us the pleasure of dance with words.
"What is meant by wrinkles?" my daughter asked.
Good question - to which I'm afraid not being prepared to be asked. Much to my chagrin, I found it difficult to explain the word to my two-year-old. I wasn't sure what to say. Picture me at home sitting with my daughter, wrinkling my brow in concentration to find a good answer.
Two final words occurred to me. Crow's feet.
How adroitly the words crow's feet sum up the concept. But hey! There are many more in English. Think about goose eggs, hives, bear hug, goose bumps and ponytail.
Saturday, June 2, 2012
Lost in Translation
Some time ago I read an article on communication. It was, in the dry prose of a medical journal article, a reminder for doctors to spend time on talking. The lecture about communication can drone on and fill the pages of the academic journals. It isn't easy to follow.
Listen to our real stories, though, and you'll tell what we don't know the patients don't know.
A friend of mine recently shared a story on the Facebook. She is working in the medical outpatient clinic, where elderly patients aren't quite sure where they should go, what the doctors say, or what they should ask the doctors. Near the end of a busy clinic day, the doctor glanced at his wristwatch, the steady sweep of the second hand ticking off precious time. For one thing, the doctor was hungry. For another, he thought he had covered everything except the instruction for his patient to return for blood test.
The doctor wrote on the blood test sheet: "One week before the clinic appointment fasting blood test."
The patient picked up the paper, and was startled. This was obviously an instruction she'd not been expecting. She stared at the doctor. "But, doc, how can that be the case? I would have died of starvation if I follow your instruction - to fast for one week before my scheduled blood test."
Listen to our real stories, though, and you'll tell what we don't know the patients don't know.
A friend of mine recently shared a story on the Facebook. She is working in the medical outpatient clinic, where elderly patients aren't quite sure where they should go, what the doctors say, or what they should ask the doctors. Near the end of a busy clinic day, the doctor glanced at his wristwatch, the steady sweep of the second hand ticking off precious time. For one thing, the doctor was hungry. For another, he thought he had covered everything except the instruction for his patient to return for blood test.
The doctor wrote on the blood test sheet: "One week before the clinic appointment fasting blood test."
The patient picked up the paper, and was startled. This was obviously an instruction she'd not been expecting. She stared at the doctor. "But, doc, how can that be the case? I would have died of starvation if I follow your instruction - to fast for one week before my scheduled blood test."
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