In every argument, there’s a moment when you choose to fight. It may not seem a choice, because the moment is fleeting and the decision may not be a conscious one.
But choose you still do. I call such moments “choice points,” because with awareness, you can notice them and make a thoughtful choice about how to proceed. Unlike, for instance, the doctor in the following story.
My friend and fellow mediator, Vickie Pynchon, has been blogging the experience of her father’s end of life in an emotionally wrenching and deeply loving series of posts, Negotiating Life’s End. The following excerpt, from Part Two, begins with Vickie’s learning that her dad has been taken to the hospital. She rushes there too.
I arrived at my father’s hospital room at the same time Dad’s primary physician, Dr. X was making his rounds. I introduced myself as Don Pike’s daughter and asked about my Dad’s condition. For reasons I didn’t understand, this seemed to irritate Dr. X.
“What do you want to know?” he asked, eyeing me suspiciously. “Your step-mother has already decided what will happen.”
“And what is that?” I asked, not having yet had the opportunity to speak with my step-mother since our cell-phone conversation fifteen minutes earlier. Something must have changed in the interim.
“It’s quite simple,” said the doctor, as if he were speaking to a child. “Your father can’t swallow. His wife doesn’t want the hospital to insert a feeding tube. We’ll send him home with morphine to ease the pain. Without food, he will quickly die of renal failure.”
They say anxiety interferes with the functioning of the brain’s higher “executive” functions. So I wan’t thinking very clearly.
“You’re going to let him die of starvation?” I asked. “I mean,” I was almost stuttering now, “you’re gong to starve him? Why? What is his prognosis?”
Though the word “starvation” carried the most emotional wallop for me, it appeared to be my use of the word “prognosis” that disturbed Dr. X.
“Prognosis?” he asked, glaring at me now. “Prognosis? He’s in the last stages of Parkinson’s disease. That’s his PROG-NO-SIS.”
Did you notice where Doctor X chose to fight, transforming what was about to be a pivotal and important conversation into an escalated, emotionally charged event? It was when he said, “What do you want to know?…Your step-mother has already decided what will happen.” When I first saw that line, I knew it for what it was and felt such pain for what would come next.
Vickie, no doubt very distraught, had asked about her father’s condition. Instead of answering her question, the doctor chose to fight with a message carrying these subtexts, which Vickie heard loud and clear:
- I’m not going to answer you because doing so may open the door for you to think you have some decision making power here.
- You have no legal standing here. Only your stepmother does. So I’m going to point that out first, lest you are clueless.
- I am suspicious of you. Are you one of those people who’s about to make my job more difficult?
Ironically, of course, the physican made his own job much more difficult all by himself — and upped the suffering level for Vickie in the process.
Did he do it intentionally? I doubt it. But benign intention doesn’t sanitize bad impact (with a generous nod to Stone, Patton and Heen for the succinct phrasing). He did it reactively, operating to protect himself and control where he thought the conversation was going. I imagine he did so because of difficult prior experiences with other patients’ families. Families that were not Vickie’s.
What could and should this physician have said instead? The options are almost endless. A few that occur to me are:
- Vickie, you must be upset. Here, let’s sit down a minute…
- Vickie, your stepmother is here too. Let’s talk this through together.
- Vickie, I have an emergency down the hall and promise I’ll be back as soon as I possibly can so I can answer all your questions.
- Vickie, let me give you a hug.
At the next choice point you face, will you notice it? And what will you say instead?
Thank you, Vickie, for allowing me to write about your story. Big, warm hug that reaches from New Hampshire all the way to California, my friend.
Conflict Zen® by Tammy Lenski is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License. Based on a work at ConfictZen.Lenski.com.
While I think your first 3 suggested responses are good suggestions….
Unless the doctor in question was a long time doctor for the family and had known me for many years I would find your last suggestion insincere and patronizing.
The danger of giving examples of what the doctor might have said instead is, of course, that no single example could ever be used in all circumstances. As you rightly pointed out, Ken, my last example is only suitable if the physician is known to the family or, perhaps, the physician is of the nature to reach out empathetically to people s/he doesn’t know well.
The guiding principle in any response is to be genuine. Otherwise, you’re “technique-ing” someone and that’s just useless.
Tammy,
Thanks so much for this and for the well-wishes you have expressed privately from the first.
And you’re soooooooooooo right about generalized advice for spontaneous human interaction. I, for instance, am a touch-y but not a hugg-y sort. In this kind of situation, where I’m feeling threatened, I would recoil from physical contact. Yet I know there are others for whom a gentle touch from the right person at the right time, coupled with the responses you suggest, would both sooth a family member AND provide the information she is seeking.
As my friend the settlement Judge Alex Williams says, it’s all about RESPECT, a word laminated on a plaque that he always points out to litigants, lawyers and visitors to his courtroom.
As to knowing when it’s appropriate and inappropriate to use touch, there are two answers. The first is “ask.” The second is this: we already know how to respond to people. We instinctively know what to do. We need to train ourselves to do so because there are too many other voices clamoring in our heads and because we come from too many other cultures (Dr. X, whose ethnicity I did not want to highlight, is from a foreign country; and I have NO doubt that there was a cross-cultural mis-step here by both of us).
At the end of the day, there are always these too excellent words.
“I’m sorry.”
“I’m sorry I was so abrupt. I’m sorry about the hug; you were in so much distress that I just naturally reached out to you.”
Followed by these words, that I use less often than I should in every mediation I conduct.
“Is there anything I can do for you that I’m not doing?” or “Am I missing something?” or (if you’re paying attention to 80% of the communication in the room — body language — “you seem distressed or irritated or uncomfortable (etc., etc.”). Am I right? Is there something I can do for you that I’m not doing?”
Here’s the thing. We cannot go wrong if we stay in the moment and keep asking questions with the genuine intent of finding the heart of the matter.
People WANT to tell you.
In a crisis (and transformative mediators DEFINE conflict as a “crisis in human relations”) we need to approach one another a little like we approach frightened children and animals. Slowly and with the clearly expressed intent — verbal or otherwise — to — at a minimum — do no harm.
If there is ANYTING I’ve learned from these last weeks of my father’s life it is this: if you slow down; surrender to the moment; and, listen with your heart instead of your head, the service you can be to another presents itself with indisputable clarity.
Sorry to ramble so on YOUR blog.
Thank you for doing me the honor of turning your fine heart and wise head to my loss.
Love,
Vickie
Vickies last blog post..Negotiating Life’s End: the Coming Crisis and Likelihood of Litigation
Wow. During such an emotional time, how do you stay out of your head and think clearly?
I would react to the hug, as I am a “huggy” person — but not all are. Movement – like sitting down. Or just touching my arm — would have a similar effect of helping me stop and listen.
Yikes. Things escalate so easily.
Thanks for sharing something so personal.
Chris Browns last blog post..Using all the “Senses” in Marketing for More “Cents” with Sales
Vickie, I so love your words, “If there is ANYTING I’ve learned from these last weeks of my father’s life it is this: if you slow down; surrender to the moment; and, listen with your heart instead of your head, the service you can be to another presents itself with indisputable clarity.” I can’t imagine anything that could more honor your dad than that sentiment, that intention, and that act. Ramble anytime you please on my blog!
Chris, yes, even a simple touching of the arm can make such a difference, whether someone’s a huggy type or not. I was thinking about your comment that things escalate so easily. Yes, true. And I also think this doctor had multiple points in the interaction where he could have retrieved things if he’d attended to what the person before him needed and was really asking. Thanks for taking the time to leave your reaction…always so appreciated.