My doctor has a deep, friendly voice. He's clear and upbeat when he speaks. So, as I wait for his call, I imagine how he'll sound when he delivers the news.
Message One -- Safe: "Hello, Jill. How are you feeling? Any problems from the biopsy? The pathology report is good news. Every sample we checked was benign."
Message Two -- Trouble: "Hi, Jill. Feel okay today? Listen, we found some malignant cells. As I told you, we can take care of this. It's early, small and localized."
Message Three -- In between:"Hi. I'm happy to tell you we didn't find malignancy. But there are some pre-cancerous cells. We should take those out surgically as a precaution."
Which message will it be?
There's even a small chance -- 5 percent, he told me -- that the results won't be ready in the normal 24-hour turnaround. But even then, he promises to call.
And so, in the tense hours between testing and knowing, I decide to write about communication in uncertain times. Communication is a key part of leadership, or so I say in my teaching. Today I'm not the teacher. But oh, I'm learning how it can make a difference.
He gives details in person, not in cold recordings. I appreciated those small touches. They matter.Nothing my doctor or his staff might say could change the reality of my situation: my annual mammogram was questionable. This led, over several weeks, to a march of diagnostic procedures: mammograms, ultrasounds, a breast MRI and finally the big deal -- a biopsy.
Along the way, every person involved in these procedures seemed to understand a patient's vulnerability. That's what their communication style told me. It was more than a pleasant tone -- the greeter at Wal-Mart has that. What I really appreciated was their instructive approach and their courtesy.
Because of this, I learned
before I entered the MRI chamber that it was going to be loud --
really loud. Imagine a water heater on its side. You're prone within. Two beefy plumbers bang wrenches against the metal. Even the thoughtfully provided head phones couldn't mute the racket. (Note: I opted for CNN instead of the satellite radio's music channels. I didn't want any melodies to live on as my "cancer songs.") Throughout the procedure, the techs would override the audio and calmly advise me: "Okay, you'll hear noise for about three minutes now." Or two. Or ten.
I learned
before I left the MRI center that the report would go to my doctor, who calls patients personally with results. They asked for my husband's name so the doctor could address him personally should he answer the phone. They even asked permission for the doctor to leave a brief voicemail message if I weren't home. But it wouldn't be a detailed message, I was told. He gives details in person, not in cold recordings. I appreciated those small touches. They matter.
* * *
Years ago, when I was expecting my first child, a friend advised me that "there's no shame in labor." Modesty and good grooming aren't virtues in the delivery room; it's all about the task.
Thus it was in breast-biopsy land. Modesty takes a back seat to medicine. My Midwestern mores keep me from sharing the deep skinny of my stereotactic core needle procedure, other than to tell you the key elements are an elevated table, a face-down patient, and a tissue extractor. I'll let you
click and learn how they're done -- just promise you'll envision
your exposed torso instead of mine.
What was important to me during this adventure, once again, was communication -- by talk and by touch.
When those in control think not only of their duties, but of your fears, when they treat you not as an object, a child or a victim -- but rather as a partner -- it makes a difference. When I was appropriately trussed and tucked for the test, the doctor entered the room, leaned in and with that friendly voice, broke the tension: "Don't you have anything better to do today?" Then he told me, step by step, what
he was about to do today. He told me how it was likely to feel. When the feeling became a quick stab of pain -- a gloved hand, I don't know whose, gently rubbed my forearm. A tactile distraction -- and a comfort.
Strategically stationed on a platform for an hour, forbidden to move, neck aching, I could hear and feel this event, but not see it. Words and touch mattered. Small things mattered. A heated blanket in the cool room. The play-by-play narration of each new move. The question, repeatedly, "How are you doing?" The doctor alerting me that two people would briefly leave the room to examine computer images and one would stay with me. A reminder of how much time was left in the process.
Knowledge really is power. When those in control think not only of their duties, but of your fears, when they treat you not as an object, a child or a victim -- but rather as a partner -- it makes a difference.
Good leaders, whatever their profession, know how to communicate in stressful times. They anticipate people's concerns, listen to their fears and invite questions. They are optimistic and empathetic. They share their plans. They warn what may lie ahead, good or bad. They know when somebody needs a cold truth -- or a warm blanket.
And they repeat their messages. In times of high emotion, people don't hear well. Or they forget, just as I temporarily lost track of where I was supposed to go for that darn biopsy. Until I remembered they had written it down for me days ago, on my first visit, and I had it in my file folder.
* * *
The phone rings. I check the clock on my computer. It is 2:01 p.m., 24 hours since the biopsy. My waiting is over. The doctor is on the line. I grab a pen to record which of my projected messages he will deliver. I also know that if I don't take notes, emotion may again get the better of my memory.
"Hi. How are you doing today? I think I've got good news today. It's not a cancer." The man knows how to lead with the best news. But there's a little more.
In a kind tone, he adds, "It does fall into the category of pre-cancerous. We think, for two reasons, it has to be surgically removed."
The doctor moves from newscaster to educator, explaining that these "atypical," pre-cancerous cells can become malignant over time and that surgery also has the potential to reveal undetected cancer cells. Hence, the need for an operation.
It was Message Three -- not the best, not the worst -- but well-delivered, well-detailed.
He's encouraging and upbeat throughout, telegraphing the confidence he must know I crave about my prognosis. He answers my questions about selecting surgeons and welcomes any future questions. He wants to see me again 6 months after the surgery.
He reminds me emphatically, "It's better than my telling you it's a cancer."
He's right, of course.
I'm a little reluctant to end the call. It's like pulling the power cord. Yes, I'll go to a good surgeon, maybe a great one. But now I want more -- one who understands the gift of communication in uncertain times.
I developed a severe pain in my lower gut in...
