When Doctors Miss a Call

Posted on April 13, 2014
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Doctors tend to function like lords of the earth. Given their power to stave off disease and death, and all the training it requires, such lofty professional feelings are understandable. But the other side of professionalism is unstinting regard for people – in this case, the patients doctors serve.

A couple of Wall Street Journal reporters – Jennifer Levitz and Jon Kamp – deserve some recognition themselves for their reporting on a gynecological surgical procedure known as morecellation, in which women haven’t always been advised of the risks that may arise – chiefly, the spread of cancer that may not be known beforehand to be present.

A surgeon using a morcellator – a powered device with a whirring blade –  along with a tiny camera can remove a woman’s uterus via minimally invasive surgery. Great, except  that there’s a possibility, however small, that the tissue may be malignant. Gynecologists, the Journal advises, increasingly are recognizing that the procedure should be used with a bag to contain a uterus as it’s removed. But that complicates the surgery and adds to the expense involved.

Without a bag, though, tiny fragments that may be left behind may prove to be cancerous, and the woman involved finds herself at life-threatening risk because of a well-intended procedure. And that isn’t fair.

“I think it’s a misstep for us as a profession to have accepted morcellation without some containment,” says Dr. Bobbie Gostout, the Mayo Clinic’s chairman of obstetrics and gynecology. But Levitz and Kamp report that a Mayo spokeswoman “declined to say what impact those remarks had on the clinic’s (own) procedures.”

Geez, is medicine sometimes more posturing than protective of the patients it serves?  Sometimes you’re prompted to wonder, and the feeling isn’t a pleasant one.

Instead of defending their own professional standing as zealously as they often do, physicians and surgeons might better be focused fiercely on their patients’ interests. There are enough indications in The Journal’s morcellation story, though, to suggest that here’s a situation in which that proves to be not necessarily so. Neither Dr. Amy Reed, a 41-year-old anesthesiologist, nor her husband, a surgeon at the teaching hospital where Dr. Reed’s morcellation surgery occurred, were warned of the advisability of using a bag in the procedure or the possibility of cancer-spreading risk. Now, with Amy Reed found, as  result of the surgery, to have uterine cancer, the Reeds are lobbying for a moratorium on morcellation.

That may be, excuse the expression, overkill. But focus in medicine is everything. For doctors to be focused steadfastly on patients is a standard that isn’t always met but needs to be.


Awareness of the ‘Empathy Gap’

Posted on March 8, 2014
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Stations in life – are they way-stations, or for many, deadend locales? If more the latter, need they be desolate, hopeless settings? Or could neighborly concern help improve them? Such questions are prompted by a caustic column by Kenneth Horrigan in the St. Louis Post-Dispatch – “A Ride Through Empathy Gap with a Faithful Manservant.”

Yes, there is a gap in empathy – sympathetic feelings toward others – that may be one of the primordial aspects of human nature that remains to be more fully overcome.

“In politics,” Horrigan writes, “readily dismissing inconvenient people can easily extend to dismissing inconvenient truths about them. The insistence by some House Republicans in Congress on cutting financing for food stamps and impeding the implementation of Obamacare, which would allow patients, including those with pre-existing health conditions, to obtain and pay for insurance coverage, may stem in part from the empathy gap.”

Yes, we can unwittingly view people via the labels attached to them – poor, homeless, helpless, lost souls or, simply, uncouth – when consideration of their circumstances (if we actually knew them) might lead to gains for all. Some victims of life’s drearier circumstances might not respond, but others would surely be appreciative. Human nature isn’t decreed from birth; it’s capable of betterment even when circumstances seem fixed and frozen.

Fairness requires an earnest look at deplorable circumstances, yet too often we turn away from them. Horrigan quotes psychologist Daniel Goleman, author of “Emotional Intelligence,” as noting that “A growing body of recent research shows that people with the most social power pay scant attention to those with little such power.”

So it has always been, you may say. But need it always be? A premise of the Affordable Care Act is that people with pre-existing conditions deserve afforable medical attention for them. That isn’t so much radical as evidence of a willingness to walk in another’s shoes (or even our own) feelingly and confidently.

Need it be “Empathy Gap,” or more in line with our capacity as intelligent observers, “Empathy Awareness”? Especially when it extends to the halls of Congress, our congenital tendency to think in stereotypes and presumptions needs to be acknowledged and, finally, overcome. We can do better in terms of acknowledging and planning – not simply branding compelling social needs as giving rise to irresponsible spending.

Communication Is a Process

Posted on August 4, 2013
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Good organizational communication isn’t a matter of seniority or survival. (“I’ve been doing this for 30 years,” said a staffer at an organization I know.) It’s a matter of being clear about purposes, relating well to colleagues, of accepting feedback and practicing empathy – walking in another person’s shoes at times of questioning or crisis.

First off, you need to establish a clear focus. What business are you in, really? How might you develop it further? Then, by listening and sharing well, you and your associates can get to a new place together. That’s the aim of good corporate communication – to move ahead together, effectively and well.

Getting there. You don’t want to become mired in a situation because those you’re talking to or attempting to work with don’t have your background or experience. You need to listen, to seek to identify with the other’s position, suggest, listen again, and respond. Hopefully, it’s an ongoing process.

Reaching a conclusion before all the facts are in isn’t fair or even smart. It’s the nature of a process to collect the applicable facts, to develop and work with them. Only then can a satisfying conclusion be reached. And that, indeed, is the aim or good organizational communication.

Certainly in communication terms, the organizational world calls for far more than a smile and a shoeshine.


Our Brains Can be Tuned for Fairness

Posted on August 3, 2013
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Being fair may sometimes require special effort, maybe more often than not.  That thought occurred after reading that doctors have to make a special effort to be both analytical and empathetic to their patients.

It seems that identifying with patients (empathy) while methodically analyzing their ills works at cross- purposes with what a physician’s brain (all our brains, in fact) wants to be doing. Says a post by Brandon Glenn on Medical Economics, “The more active the region of the brain responsible for analytic thinking is, the less active the region governing empathy becomes. In other words, the brain’s analytic and empathetic systems operate in constant tension with one another.”

Interesting! Fairness often requires giving extra thought, or walking at least briefly in the shoes of another, to fully appraise a situation. And that sort of identity with someone else is virtually the definition of empathy.

These brain research findings are from the Brain, Mind and Consciousness lab of Case Western Reserve University, where scanning technology is used to chart brain functioning.  “We know that when we engage in analytic thinking, such as making a medical diagnosis, then we suppress brain areas involved in thinking about others’ experience,” says  brain-imaging expert Anthony Jack, PhD.

Identifying with others, of course, is the very definition of empathy.

It isn’t necessarily hard to to develop empathy while being analytical – the brain can be pretty malleable. But it takes awareness of the two modes of functioning. We can all too easily get stuck in styles of reacting to people and we need, instead, to pause a moment to ask “What’s really going on here?”

Other studies, too, are showing that empathy is important to better patient outcomes. So maybe if all of us, doctors and patients alike, made an effort to be a bit more reflective in situational terms, we’d have healthier relationships. And practiced en masse, we’d likely have a fairer society. In key respects, our brains deliver what we prompt them to.

News Bypassing the Pulitzer Muster

Posted on January 10, 2012
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One has to have great sympathy for the members of the juries that award the Pulitizer Prizes – editors and other newspaper people – as they watch their craft being contracted, not only in numbers, but technique, too. They seem to be trying to draw the line, of all places, at Twitter, and that’s an unfortunate stance. When word gets around that some breaking event or other is being reported on Twitter, a tweet at a time, that’s likely to take the edge off traditional reporting, it’s true. But tweeted dispatches are no less valid as timely input, just untethered to newsdesks.

As Andy Weiss notes on the Digital Pivot blog, NPR’s Andy Carvin might have reason to be unhappy over the Pulitzer board’s stance, though broadcast news outlets have never been eligible for Pulitzers in any event. During the Arab Spring demonstrations last year, Carvin relayed tweeted reports, some of them pretty graphic, from the demonstrations, scooping everyone else. But again, broadcasters aren’t eligible anyway.

It doesn’t seem, though, that a guild system can hold much longer for reporting the news. We say reporting, rather than covering, because it’s a more actively pertinent term. “Covering” can be interpreted as who’s assigned to view, or dig into, an event. And that can have little immediately to do with when information actually starts arriving in another town or on another continent. So the Pulitzer Committee’s Breaking News category is for “breaking news” of its choice and definition, not necessarily events as they unfold.

Things were simpler when a couple of reporters relied on “Deep Throat” to keep them advised and there wasn’t any competition from Twitter or other forms of social media.

Postings From the Other Blogs We Do

Posted on March 13, 2011
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Despite my best intentions, I haven’t gotten to restarting my Beetle’s Beat blog, largely because of the time involved in gathering and writing up posts for the other blogs I do – Flack Me, Encore Insights and Barrier Briefs.

But it’s occurred to me that a way of priming the pump for Beetles Beat is to post links to my pieces on those other blogs. They certainly reflect my views on such matters as public relations and crisis communication, technology and security.

Wherever Beetle’s Beat may be headed into rarified areas of communication, these other posts are markers along the way – and I’m pleased, henceforth, to be noting them.
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Back on the Beat – Reporting on #blogchat

Posted on August 22, 2010
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I haven’t posted to Beetles Beat since last October. Been too busy with other blogs, but have been wanting to get back to my own. And, now, here’s the perfect incentive: to recognize and pass along the word about a Web community on blogging.

The last post I did was about community in my old neighborhood on Long Island during World War II and the post-war years – I’m big on community. Where it exists, it needs to be cherished and extended.
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Before TV, We Communicated; Social Media is Such an Opportunity Now

Posted on October 12, 2009
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I went to a seminar on social media today and both enjoyed and bemoaned it – enjoyed it because I got reaffirmation of what social media is about, bemoaned it because the presenter didn’t make that clear enough. It’s about a change in life and listening style.

Social media is about attempting to recreate the wonderful lives we had before television. That is, the way we interacted with friends and neighbors in the suburb I grew up in on Long Island, N.Y., N.Y., before television arrived in the early ’50s.
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Be Wary of ‘Emotional Hijackings’

Posted on July 31, 2009
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At their next meeting, Harvard Professor Henry Louis Gates, Jr., and Cambridge Police Sergeant James Crowley might consider forming a “Cool It Club” that should have chapters in every community in America – especially in Washington, D.C.

I wasn’t there, but by all accounts, what appears to have happened at the Cambridge home of Professor Gates shortly after noon on July 16 was, in Daniel Goleman’s term, an “emotional highjacking.” While complicated by race, the incident seems to have been an emotional flareup that could happen to any of us, if we’re not mindful of what may be occurring. That’s because we all have human emotional systems.
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Crisis Communication Becoming Locally Global

Posted on May 18, 2009
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The best laid plans of corporate and governmental communicators for providing – and controlling – information during a crisis are being undone by the growing use of social media.

People building personal networks on Twitter, Facebook, Craigslist, Flickr and other social media today would be turning to them tomorrow to ask questions and spread information should a crisis strike.
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