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Enrique Sueiro, PhD in Biomedical Communication from the University of Navarra and consultant of Internal Communications in organizations.

Communication, therapy for patients and companies

Wed, 21 Jul 2010 08:52:46 +0000 Published in Cinco Días (Madrid)

If you were the family member or the doctor who had to inform a terminally ill patient of his condition, what would you tell him, should you tell him the whole truth with the utmost scientific rigor? In mathematics the formula works, 2+2=4, but we are not talking about exact sciences.

In El buen adiós: cómo mirar serenamente hacia el final de la vida, Silvia Laforet and Jesús Poveda relate the experiences of a physician experienced in palliative care from which suggestive ideas can be drawn. The first and forgotten one is that medical science fights against disease, not against death. Goodbye is irremediable, but the farewell can be pleasant, or at least bearable.
For those who are going through this final moment, knowing and feeling accompanied greatly attenuates the suffering. The mere presence is already palliative, although the perception of time varies according to the position with respect to the bed. That is why it is so important to synchronize our watch with the patient's, because all his time is only a little of mine.

Starting from the novel premise that communication begins with listening, it is easy to conclude that "communication can be painful, incommunication... much more so". To hear, we need our eardrums; to listen, we need our heart. This fine sensitivity allows us to grasp the abysmal difference between what we know, what we transmit, what the patient hears and what he truly understands.
The patient may not despair if he knows what awaits him (preventive communication). For example, not knowing what tests and analyses consist of generates avoidable anxiety. In addition, all the time invested in communicating with the patient and offering explanations beforehand is saved in justifications afterwards.

After the progressive information on diagnosis, prognosis and evolution, when the time comes for decisive communication, the authors state something that is also obvious: the information must be adapted to the patient and not the other way around. But what should the patient be told: "The bearable truth", i.e. the true information that he/she can understand and tolerate.

This complex reality of patients is millimetrically adaptable to organizations because, in a way, companies are like people: they think, feel, have illusions, grow, get sick and, if they are not cured, die. This is illustrated by one of the greatest contemporary management experts, Javier Fernández Aguado, in Pathologies in organizations. He estimates that the three most widespread in the institutional environment today are myopia, stress and osteoporosis.

It is time for a few guidelines that I have developed and whose effectiveness has been proven in a short time: the Internal Communications kit (compass, watch and sensitivity), the PePa principle (people first, then roles), the 80/20 of listening/talking for an effective management of perceptions, the elementary premise that Internal Communications starts at department of communication, the 11 words core topic (say what you do and do what you say), the CCC formula (communication + consistency = trust), the possible transition from KO to OK in crisis situations and the oxygenating reference letter of rectifying (always make new mistakes).

Anecdotal and eloquent that one of the most renowned universities in the United States officially publishes in its guidebooks that the sculpture of its founder that presides over its campus is the statue of the three lies. It refers to the legend at the foot, which reads: John Harvard, Founder, 1638. Neither the figure corresponds to John Harvard, but to a student that served as model; nor the character founded the university, but was its first benefactor; nor the date coincides with the origin, 1636. So, three lies in four words. Not bad for an entity whose motto is, precisely, Veritas (truth).
It is a minor detail that, statement by the institution itself, does not go beyond a sympathetic anecdote. Moreover, it deserves praise for its transparency. The same reality, if concealed, and worse if denied, can easily provoke internal distrust and undermine public reputation for life.
Leonardo Castellani must have thought something like this. In How to Survive the 21st Century Intellectually, he states that "there is no worse scandal than wanting to suppress the truth for fear of scandal". Good communication works as a therapy, sometimes as a shock therapy, both in patients and in organizations.