How to communicate perfectly.

You can’t. That doesn’t mean you shouldn’t bother trying to.

I don’t know how to communicate perfectly but over the past few years and especially over the past few months I am starting to understand the keys and the benefits to effective communication. While I approach it from a veterinary/client point of view I imagine these points can be applied to nearly every relationship you have. Heck, I apply them to conversations with my three and four year olds as well. In the spirit of being a cliched blog fit for social media sharing, I am going to share my top five points on effective communication.

Be Honest. I mean honest when it hurts the most. When you just want to tweak the details a touch or leave out one piece of the story. Everyone feels like they are an honest person and I’m sure you are but there are those times where you might “spin” an issue or withhold a small but possibly critical piece of information in the hopes that whatever you are trying to communicate isn’t bogged down with concerns from the receiving party. In my world and practice it often goes like this, Fluffy is having problems a, b and c. To get close to an answer and formulate a treatment plan she needs testing x, y and z done. Then once we have that information we will be doing something. What I often find myself guilty of glossing over is the money part. If you’ve read my posts on this subject here or here you might understand that I am starting to get more comfortable with the fact that my services cost money. If you ever read my previous blog you might see how far I’ve come. By not fully preparing one of my clients for the costs associated with our services, I am not being one hundred percent up front with them. If someone is surprised by their bill at the end of a visit, I haven’t communicated effectively. It still happens to me but I’m getting better. The other area I think honesty can get a little cloudy is when people ask questions we don’t know the answer to. I remember telling someone I didn’t know what was wrong with their dog once early in my career, they went elsewhere. You can imagine how I felt about telling another client I didn’t know what was going on with their pet. Somewhere along the way I figured it’s just less stressful for me to be honest than to seem like I know everything. And then something amazing happened. I somehow found a way to explain things clearly enough so that people understand, it’s not that I don’t know what’s going on, it’s that what is going on is more complicated than it seems. Pets are really complex little systems and a lot of things can go wrong and cause very similar issues. By telling them I don’t know right now, it went from them thinking I had no idea what I was doing to them being able to appreciate how unique their pet’s problem was. It made communication easier and kept the lines open which always allows us to at least reach a point where everyone is satisfied with what we can or can’t accomplish.

Listen. It’s the most important and often the most overlooked part of effective communication. How can you convey the information the other person needs if you don’t listen for the parts the other person doesn’t understand? I try to spend less time talking in the exam room than the client. With some clients that is really easy, with others it can be like pulling teeth. It’s even worse on the phone. But when you stop and listen to what people are saying you find you are much better at providing them with excellent service because you actually understand what they want. It’s worth a lot to know what people want from you and when you can deliver it and see the results, it will really reinforce the benefit of you shutting up a little more often and listening to what people have to say. When I first got out of school and started practicing, there was so much information to convey, how was I going to get it all out and in a way people would understand? I needed to teach them how to take care of their pets. Wait, what? No, I had it all wrong. Yes, often people come to me with issues they want my expert advice and assistance with, that’s my job. But most of the time, people want me to provide the services they would like for their pets. And in order to know what those services are and to provide them effectively, I have to listen.

Slow down. If you’re talking so fast that someone can’t understand you or can’t get a word in edge wise, you are not communicating effectively. Think about an evening out with friends, everyone has a few adult beverages and starts telling stories. You have a great story that fits right into the conversation but by the time there is a space in the chatter the topic has moved off so much that your story seems out of place and kind of silly. A simple and amusing part of a night spent with friends, not so amusing when trying to communicate with your veterinarian about your pet’s health. Tied in to the problem I had early on with listening was in trying to get all of the super important information I needed to share with my new clients I would just blurt it all out whether they were listening or not. I would rattle stuff off so fast people were probably thinking that I was auctioning their pet off like livestock. Looking back I’m surprised no one ever made a bid. While I don’t currently speak with the same number of pregnant pauses as President Obama, I do try to stop talking for a few seconds every time I am changing the subject or about to make a recommendation. People deserve a chance to disagree or interrupt you and let you know what they are thinking. Also, you are going to be way more effective if people understand you. So slow down, catch your breath. Give the other person a chance to talk and tell you what they want. Especially on the phone. Stop making every phone call a race to hang up. Take the time to have the conversation. You’ll be amazed at how much better your service or outcome is.

Less filler speak. On of my least favorite things to hear when trying to communicate with anyone is a barrage of filler speak. Works such as; like, you know, basically or the uhs and ums of communication get in the way of allowing open communication and road block the other person from having a say. The author, debater and contrarian Christopher Hitchens put it nicely in his article for Vanity Fair, The Other L-word,  “People who can’t get along without “um” or “er” or “basically” (or, in England, “actually”) or “et cetera et cetera” are of two types: the chronically modest and inarticulate and the mildly authoritarian who want to make themselves un-interruptible.” Try to replace your filler speak with silence and you’ll be amazed at what people would like to say if only you’d give them the opportunity. I haven’t really ever been guilty of a lot of fillers in my conversation but it’s similar to talking too fast or omission. There have been times, I am afraid to admit, where I knew something needed to be done for someone’s pet but if I gave them a chance to start digging at my recommendations I might have given them the chance to talk themselves out of following through with them. So I talked too fast, didn’t include all the details and got the job done. Foreign body surgeries used to be like this for me. I see filler words used in much the same manner, they fill in the gaps that should otherwise be replaced with details or with a pause to give an opportunity for rebuttal. So again, shut up a little bit. Stop steam rolling the people you are trying to communicate with with ridiculous non-words and see how much better your communication skills get.

Let the other person end the conversation. If you are the one making a recommendation, providing a service or trying to convey information, the other person is the customer. They chose you out of all of the other options to help with their problem and they are working with you and letting you do your job. They get to decide when the conversation is over. And they will, trust me. No one wants to be on the phone longer than they have to, no one enjoys being stuck in your windowless exam room. You’re not that entertaining. But giving them the chance to say everything they wanted to say leaves them satisfied and if you need me to help you understand the importance of a satisfied client or why having people enjoy communicating with you should matter to you, this blog isn’t for you.

Most importantly, communication is a skill. Like any skill, you will have good days and you will have bad days but as you work towards your goal your skill set will improve. Over time. Don’t try to rush these things. Take the time to master the fundamentals and then work on the implementation and make it your own. Remember, “slow is smooth and smooth is fast.” Baby steps. You’ll get there and you’ll like the results.

Thanks for reading.

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Euthanasia Aftermath

I struggled with writing about this situation. I struggled with posting a blog about it. Please try to understand.

A few weeks ago a very good client of mine passed away unexpectedly. She had a little toy breed dog who had been battling some significant but non life-threatening medical issues for the past few years. We had developed a fairly good client-veterinarian relationship and the little dog had gone from being terrified by my presence to being quite happy to see me. I always did have a pocket full of cookies for him after all. Quickest way to a dog’s heart.

I was notified on Wednesday of the woman’s passing and the daughter set up a visit for the coming Friday to have the little guy put down. Apparently, no one in the family could take the dog and with his medical conditions the owner had left instructions to have him euthanized rather than have him surrendered to a shelter or rescue group.

I expressed some concern about the visit when it was scheduled and my employer and I discussed the dog’s history. He was 13 years old, had multiple health issues and could be aggressive when he was not feeling his best. We foolishly decided that I would have a conversation with the owner’s daughter when she brought him in for his visit.

The morning of the visit came. Not that these details are important but they play into the narrative so bear with me. My family was planning a trip to visit my wife’s family in New York. When we do that, I typically drop everyone off in the morning and then pick the kids up from daycare and then get my wife from work so we don’t have to leave a vehicle at her office over the weekend. As would be expected when you are getting five people together for a weekend away from home, I was running late that morning. Veterinary medicine is one of those professions where if things start getting a little out of hand, it snowballs quickly and getting caught up can be a challenge.

I arrived at work to a fairly busy appointment schedule. I am pretty decent at compartmentalizing my work, so there was no thinking about the four hour drive I had ahead of me until 4:30 that afternoon, but also when I’m in an exam room with a client, that’s all I think about. I didn’t plan ahead as much as I would have liked for the euthanasia visit coming in at 10:00 am.

The time came and a very distraught woman brought in a happy but slightly disoriented little dog. The woman was sobbing, able to get a few words out about her mother’s wishes and was in no place to discuss other options. We fell back on our training and guided the woman through the euthanasia process. We put the little dog to sleep and prepared his remains for cremation and because we were running behind schedule we went right into our next appointment. For some reason I feel like it’s necessary to inform you that this whole process took nearly thirty minutes and as we were preparing out back we weren’t happy about it but at the time I did not see a reasonable alternative.

I went for a walk that lunch break to process my thoughts, something was weighing on my mind. My wife called and she was in the middle of a pretty difficult situation and having one of the worst days a veterinarian can have. Little did either of us know she was about to have the worst day she has yet experienced as a veterinarian and in my opinion the worst kind of day a veterinarian can have. Not that that particular detail is important but it plays into the narrative.

I got back from the walk just in time for the first appointment of the afternoon. With appointments and callbacks I didn’t have a chance to even think about anything else until I got in my car that afternoon. When I got in the car I was on a schedule. I had to get home, pack the car for the weekend, I had a list of chores that needed doing before we left. The dogs had to be fed and they needed to do their business before we took off for a four hour drive. I packed the car and picked up the girls. We (they) talked about their day from the daycare to the practice my wife works at. Once at my wife’s practice we started discussing her day and it was such a horrible day the conversation took up a good section of the drive. It wasn’t until we were on the thruway, there is this place on the right hand side when you’re heading south that has log cabin homes on display it was there that my own thoughts started creeping into my consciousness. Like fog settling on a highway at night, they did not bring with them anything good. By then my wife was trying to get a nap in and I was left alone with the radio. I started playing back the day in my head and was overwhelmed with grief as I thought about the small dog I had euthanized that morning.

I still think about him a little bit almost every day. These are the thoughts that run through my head: I wonder if I had brought him home how long he would have really had left. I could have brought him everywhere with me and I’m sure eventually my wife would have come around. I’m just manly enough so that carrying a small white dog everywhere would have looked cool or ironic. How many times in my career is something like this particular situation really going to happen to me? This could have been a once in a lifetime opportunity to make a dog’s life a little better and I missed it. Not only did I miss it but I was the instrument that ended his life. I wish I’d had more time or had reached out to the owner’s daughter a little earlier. Maybe she would have been adamant that we follow her mother’s instruction but maybe we could have come up with a solution together. I’ll never know.

Self pity aside, this is not a situation that is all that unusual in veterinary medicine. We are often faced with the request of euthanizing a pet for reasons many people might disagree with. The idea of euthanizing a pet to meet the request of an owner after they have themselves died is also not that unusual. It happens. At one point in my career we had a patient whose owner had left him a trust fund and the remaining inheritance wasn’t to be released until the pet passed. You can imagine how the lawyer felt about those veterinary bills. But ultimately, decisions like this are always going to be a part of this profession. Some of them will be a struggle and some of them won’t. This one was and still is. I don’t think that the owner’s family did anything wrong by him, I just wish it had played out differently. Hoping there’s not a next time.

Thanks for reading.

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