Helen Osborne:Welcome to Health Literacy Out Loud. I’m Helen Osborne, President of Health Literacy Consulting, founder of Health Literacy Month and your host of Health Literacy Out Loud.
In these podcasts, you get to listen in on my conversations with some pretty amazing people. Today, I’m talking with two leaders of the Alan Alda Center for Communicating Science that is located at Stony Brook University on Long Island, New York.
Dr. Laura Lindenfeld is director of the Alan Alda Center and professor in Stony Brook’s School of Journalism. As a communication researcher, she helps scientists communicate in direct and engaging ways.
Dr. Lindenfeld’s goal is to advance meaningful, productive interactions with communities, stakeholders and decision makers by strengthening linkages between knowledge and action.
Dr. Susmita Pati is Chief Medical Program Advisor at the Alda Center. She not only is a practicing pediatrician, but also a nationally recognized expert in population health analytics, innovation and system transformation.
Dr. Pati knows well how important clear communication is to everyone involved in healthcare, including patients, parents, physicians and other clinicians.
I am always on the lookout for innovative, effective ways to communicate about health. Recently, a scientist friend of mine told me about communication tools she’s very enthusiastic about–using the acting technique, improv. She learned about this at a workshop at the Alda Center. I was intrigued and of course wanted to know more. And think you might, too.
Welcome, Laura and Susmita, to Health Literacy Out Loud.
Laura Lindenfeld:Hello. Nice to be here.
Helen Osborne:I am really excited about this and want to know more about the Alda Center. I know the actor Alan Alda from TV, from the old series “M*A*S*H” and then the program about science. How did it come about that his name is now associated with a center for communicating science?
Laura Lindenfeld:Isn’t Alan wonderful? We’re so lucky that we get to work with him. This is Laura, by the way.
Helen Osborne:Hi, Laura. Thank you for introducing yourself by voice because we all have that extra hurdle to go through with three women, separating who’s who.
Laura Lindenfeld:You bet. Alan Alda, it may surprise to know, is a great big fan of science. He did, I think, 11 years of “Scientific American Frontiers.”
He’s, for anybody who’s interacted with him directly, incredibly curious about science, loves to ask questions, really is deeply engaged in learning more and understands the value and wonder of science.
He had been doing these interviews for “Scientific American Frontiers” and it really struck him that the scientists with whom he was speaking could relax and engage and tell powerful stories when they were connected with him.
Then one particular woman, I recall the story of him talking about how she would then remember the camera and she’d look at the camera, freeze up and go into talking head mode. He thought, “I’m going to coax her back.” He would pull her back and she’d liven up and talk like this really engaged person. Then she’d see the camera again.
It occurred to him, “I wonder if we used the improv training that I had as a young actor,” started by Viola Spolin and her son Paul Sills. “I wonder how that would work with scientists if we used improv.”
Helen Osborne:That’s interesting.
Laura Lindenfeld:Not improv to make you become an actor, but improv really focused on fostering connection and empathy.
Helen Osborne:I’ve seen some of his interviews at the MIT museum in Cambridge. They have some of the scientific shows that Alan Alda was involved with. I remember being so engaged listening to the interviews. That’s the secret underpinnings, using that improv technique. That’s neat.
Laura Lindenfeld:Then that also became something that we applied to the area of health and medicine. There’s more in his book, If I Understood You, Why Would I Have This Look on My Face?
Helen Osborne:We’ll have a link on Health Literacy Out Loudwebsite.
Laura Lindenfeld:Fantastic. It’s a great read and it sounds just like he talks. He models what he preaches.
Alan Alda was on a mountaintop in South America and got very sick and wound up being operated on. The surgeon communicated to him in such a clear, direct and empathic way. Of course, Alan makes a wonderful joke out of the situation.
This really was a striking moment for him where he realized that science communication and medical communication, when they’re rooted in empathy and the ability to listen to your audience and put yourself in that audience member’s shoes, were going to have better results all around.
Helen Osborne:Thanks, Laura, for putting that into perspective there. It’s empathy and listening skills as well as the strategy perhaps of improv. Is that the foundation of what this Alda Center for Communicating Science is all about?
Laura Lindenfeld:What’s at the foundation of this is always knowing your audience and understanding why they care, and then being really clear about your goal. What is it that you want to achieve?
It’s being willing to let the communication change you. It’s not going in with such a mindset of, “I’m absolutely dedicated to doing it only this way,” at the expense of listening to your partner.
In the case of writing, or we’re podcasting right now and I can’t see you, I’m trying to imagine what your listeners are interested in. I’m trusting you to guide us through this as a way to have a communication that will land with that audience.
There’s always a piece about this that’s strategy and thinking about what should you talk about, what might you not want to talk about and how you can prepare, but then really being present in the moment and responsive.
Helen Osborne:That’s sounding a lot like health literacy to me. I want to be building on those connections.
Susmita, you are also a practicing pediatrician. How does this resonate with you, these messages from the Alda Center?
Susmita Pati:The thing about healthcare providers, healthcare workers, is generally everyone went in to healthcare because they wanted to help people. They start from a position of empathy. Unfortunately, the system doesn’t necessarily promote the sustaining of that empathy.
Helen Osborne:It’s tough out there.
Susmita Pati:It has really come to a crisis, actually, for the medical profession where now 59% of physicians would not recommend a career in medicine to their children.
Helen Osborne:Really? Oh my goodness. I had no idea it was to that extreme. Wow.
Susmita Pati:It’s quite a crisis for the profession. What we do in the Alda Center is leverage these improvisational techniques to help rekindle that empathy and the connection to why folks went into healthcare to begin with and to build on team communication.
Team communication can really leverage these improvisational techniques to improve not just healthcare delivery, but the communication that underlies that really high quality healthcare.
Helen Osborne:I want to be talking about the healthcare concerns that are out there and what makes it so hard. But first, before we go any further, could one of you just give the quick version to describe what you mean by improv?
Laura Lindenfeld:I’ll take a first stab at what we do with scientists. Susmita, you can jump in about how we adapt this for the medical domain.
When we’re talking about improv, we’re talking about exercises that have some rules around them. I’m going to give you the two basic rules of improv.
The first one is you have to say, “Yes, and.” In other words, you have to embrace whatever comes at you. If I say, “There’s a pink elephant talking on this phone as well,” rather than saying, “Laura, you’re nuts,” you have to say, “Yes, and it’s got a good ear for this interview.” Then the scene goes forward.
Helen Osborne:You always say, “Yes, and,” and then you add something.
Laura Lindenfeld:Yes. If you think of life as a scene, it moves the scene of life forward. It gets us to the next stage so that we’re building on each other rather than tug-of-warring against each other.
The second rule is to make your partner look good. That’s your job, to support your partner. Even if that’s someone you disagree with, your job is to keep the scene going and to support them. The engagement moves forward.
We set up different activities and they build. We call it scaffolding. They build on each other. You start out with something simple.
When we work with scientists and medical professionals, it’s different than if you worked with actors. It doesn’t feel intimidating. You’re not on the stage. You’re not acting. You’re making eye contact.
Maybe you’re doing some classic exercises like mirroring each other, and really learning, “Can I be in sync with this other person?”
Then the activities build so that you may play out some different scenes with each other Try out different ways of interacting and see how that changes with “yes, and” and makes your partner look even better.
Helen Osborne:Let’s try it on. I’m going to put one of you on the spot. I don’t care which one of you, but not me.
You’re all about, and it even says on your website, “communicating complex topics.” Since we’re focusing on science and health–for the purpose of this podcast, can you give an example of something that might be complex and how you might include these improv rules with the “yes, and” and making the other person look good?
Just think of something that’s really hard to communicate. If you want me to come up with something, I just thought of something, which is the insurance copay.
It’s not that long of a word, and for our international audience, you’re lucky you don’t have to deal with this. It’s the amount of money we have to pay for a clinical appointment even if we thought we had adequate insurance. I just threw that out there as an idea.
If you were trying to communicate that complex topic, how would you do that with “yes, and” in an affirming way?
Laura Lindenfeld:I’m going to give you an example. We have an exercise where we split the group in half, and to half the group we say, “You’re a group of hobbyists,” and to the other group we say, “You’re a group of specialists. You are yourself.
“You’re going to take a turn and have a minute with each person, and you’re going to have to explain this concept in a conversational way, so you can talk with each other, based on this person’s hobby.”
Then I might ask you, “Helen, what’s your hobby today?”
Helen Osborne:Playing bridge.
Laura Lindenfeld:I don’t know much about playing bridge. I’d hit the timer and I’d say, “Start.” I might jump in and say something like, “When you play bridge, you play it with a team, right?”
Laura Lindenfeld:Then we bat this around and I’d keep asking you questions, you’d talk to me about why you care about bridge and I’d find a way to link this idea of a copayment to something that you care about so it makes sense to you.
Then we say, “Your time is up. Switch,” and you go to the next partner and you have to make them look good too.
Helen Osborne:Thank you for that example. I actually use something very similar when I do a workshop on how to create metaphors and analogies, finding what’s important to the other person and putting that into context.
Already, I’m seeing how our worlds are interconnecting because we all care about communicating more clearly.
What about you, Susmita? From your perspective, what’s complex and how might we do it a little bit better?
Susmita Pati:I think the other piece of improv that we really use a lot is the idea of stories. Storytelling is so important in healthcare. Obviously, when patients are coming in with concerns and complaints, they’re there because they’re worried about something.
Even though from our perspective it might be a common cold and we know that very quickly, from the patient’s perspective, they might be really worried that it’s pneumonia, cancer or something else like that.
Health care workers are working in this area all the time to understand patient stories and communicate those stories not just to the patient, but also to each other, so the entire team can help that patient take care of themselves and be healthy.
Helen Osborne:It sounds like it’s your listening skills as a clinician, as a physician. Somebody comes to you with a sick little baby and you as a doctor know it’s no big deal, but you want to affirm that parent’s worry. Is that what you might do, that “yes, and” part?
Susmita Pati:You’ve got it. Exactly. You hit it on the head.
Helen Osborne:Then you have to affirm the worry, but you’re getting to where you know it needs to go, which is to communicate to the parent, “Your child will be better in a few days,” or something like that.
Susmita Pati:Yes. Then the other piece of it is I don’t just need to communicate to the parent, but I need to communicate it to the whole team so that when that parent leaves the office, they leave with information that they understand about what to do if things are not getting better, how to call our office, what to do after hours and all of those pieces.
That’s the entire team involved in that effort, not just the physician. It’s our front desk staff and our nursing staff. It’s everyone.
Helen Osborne:It sounds like setting a real tone. It’s a team at the professional end. I have this image it’s also a team on the family end too.
Susmita Pati:Of course.
Helen Osborne:That parent probably goes and tells other relatives or neighbors about the child, or the babysitter or daycare. There are so many people involved in the conversation that we might’ve thought in the old days was just between two people.
Susmita Pati:I think particularly for children. It’s not just the families, but also the schools, the school nurse, and the coach. There are a lot of different people who are part of that child’s world that need to all be on the same page.
Helen Osborne:That’s quite a challenge. I’m glad your center is there doing that.
Laura Lindenfeld:We are too.
Susmita Pati:We are too.
Helen Osborne:Our listeners could be anywhere in the whole world. We come from different walks of life. We have different professions, different parts of the communication puzzle, but we all want to communicate more clearly, simply, respectfully and in ways people can understand. What tips or strategies would you share with listeners of Health Literacy Out Loud?
Laura Lindenfeld:I love what Alan says. He says, “We don’t give tips.” We can give some guidance and some thoughts.
First of all, we see communication as a philosophy. Communication only happens when your message lands with the other person.
Things don’t travel perfectly from one brain to another. It’s not like we package up these neat little gifts and I throw them across and they land exactly on your ears as I meant them. Often, when we’re talking about communication, we’re talking about miscommunication or slight miscommunication.
The idea is the more that we build empathy and the more deeply we listen . . . The more difficult a conversation is, the more slowly we need to go, the more likely we are to be able to connect. That’s really what communication, in this sense, is about. It’s about relating.
If I were to give advice and guidance, don’t work with a checklist of, “Did I make eye contact? Did I look at the patient before I looked at my screen?” Really take that moment to feel like, “Do we have some kind of connection here? Am I understanding what’s going on in this room? Am I present?”
One of the things I find most powerful, and this might sound a little funny, is to meditate in this job. What that does is it makes you really present with the situation you’re in. It really makes you aware of where you are and who are with. It’s that same focused attention that great communication demands of us.
Helen Osborne:Thank you. I really like that term focused attention. I have to do that in these podcasts as well. I can’t see you. We’ve never met in person. It’s how to be fully present at that moment. I feel that now. I feel that connection and I think that’s an important way of having a meaningful conversation, so thank you for that.
What about you, Susmita?
Susmita Pati:I think for us in healthcare, again, being present and showing empathy is part of what most folks came into. We’re finding that not just handling patients, but handling each other is so important. It’s what brings meaning. It’s what brings sustenance to your work life. It’s being able to rely and trust that you know what the other team members are doing.
Particularly in medicine, you get three doctors in a room and you’re going to get three different opinions, so it’s to talk through those things in a respectful way and to connect with others.
Even within the team between nurses and physicians, there may be differences of opinion on how to handle something. Communication within the healthcare team is so important.
Navigating those differences of opinion and understanding we’re all there to do the best we can for the patient, that is so important.
These are not skills, unfortunately, that are necessarily a core piece of medical or nursing training. The experience of the Alda method actually experiencing these improvisational techniques really can lead to a shift in philosophy, again that rekindling of meaning in work and all of those things that are so important in healthcare.
Helen Osborne:I get that. It gets back to what you stated in the beginning about how difficult it is being a healthcare provider today. Many people wouldn’t choose to do this again.
It’s remembering why we went into this work. We went into it because we care about others and we want to help. It sounds as though that the Alda method very much is doing that. I’m feeling very soothed listening to both of you. I hope many people can learn more.
Talking about learning more, we’re going to have some links on the Health Literacy Out Loudweb page for you. Anything you want to highlight for listeners right now?
Laura Lindenfeld:Please feel free to visit our website, www.AldaCenter.org. I’ll add that we travel all over the world to conduct workshops. We do work here in New York, but we go all over the place, and we’ve worked with such different groups of individuals from scientists to medical professionals.
One of the things that I think both of us really love about this job is that we help people rediscover their passion for their work. That is such an honor to be able to do that.
Not every day is a great day in any job, even the best one in the world, but when I see what a difference this work makes in people’s lives, in the context of medical work, the patients and families and communities that medical professional serve, I really feel honored.
Helen Osborne:Thank you. Thank you both. I am truly honored that you both agreed to be guests on Health Literacy Out Loud. I am delighted to do our part to share this with the world. Thank you both so much.
Susmita Pati:Thank you for having us.
Laura Lindenfeld:Thank you. It was fun.
Helen Osborne:As we just heard from Laura Lindenfeld and Susmita Pati, it is so important to communicate health and science messages with empathy, clarity and truly being present. That’s part of health literacy, too. But it’s not always easy to do.
For help clearly communicating your health message, please visit my Health Literacy Consulting website at www.HealthLiteracy.com. While you are there, feel free to sign up for the free monthly e-newsletter, What’s New in Health Literacy Consulting.
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Until next time, I’m Helen Osborne.