See, Hear, Understand

I’ve written 2 posts on communication this year.  I’ve deleted both – the only two posts I’ve ever deleted thus far after over 6 years and 182 (soon to be 183) posts published on this site.  The first I felt people weren’t ready to hear.  The second didn’t feel true to myself.  But I’m going to make a third attempt because in the past 9 months, the subject of communication persists, from politics to healthcare to social media and relationships, and weighs on me heavily.

Two years ago I consulted with a company on the meaning of “patient-centricity.” At one point, the vice president of the company asked me what I thought patient-centricity meant.  I remember telling him that patients want to be seen, heard, and understood – that these values are at the heart of patient-centricity.  But in truth, every person wants these things.  I’ve come back to this several times – the idea that we want others to listen, understand, and respect us; that we want to be seen, heard, and believed.

Yet while we want these things, we forget that that’s what others seek too.  And therein lies one of our greatest obstacles to communication and ultimately understanding.  We raise our voices desperately wanting to be heard only for them to be met with voices equally wanting to be heard – often times leading to a never-ending struggle to fight to have the loudest voice.  

I am no stranger to this very human condition.   Nor am I exempt from the effects.  In this fight to be heard, I easily fall into the traps of raising my voice louder and louder, becoming more reactive and defensive.  My ability to listen is compromised and a visceral impatience can cloud my ability to convey my message overrides the consideration I should take for what another person may be saying.

We have all encountered this before.  I grew up surrounded by it.  Disagreements that would escalate quickly and dramatically, emotion feeding into emotion, until everything fell apart.  At its extreme I would dissociate because there was no way to be heard – only to collapse within.  Perhaps that is why I even more desperately want to be heard now, and why I have a hard time expressing myself at times.

On the other end of the spectrum, law school taught me discourse.  There I learned that thoughtful disagreement and debate was possible.  In fact, that’s the art of trial law – to listen and absorb a message and quickly be able to process what you have heard in order to provide a rebuttal and make your case.  Emotions may still be high, the stakes higher, but civility must be maintained.  You cannot shut off, you must be fully engaged.  And you will likely see the other lawyer again, you cannot block them from your lives.

With these two models of communication most ingrained in me, it is then interesting to turn to social media where communication is ostensibly democratized –bringing all voices together on an equal platform to discuss any and all topics.  I can really only speak to twitter as I do not use facebook or other platforms but I think perhaps my observations may still ring true across them all.

I like Twitter precisely because I get to interact with people who I do not know and may never meet.  I know people in Australia and Minnesota, in Ontario and Boston – truly I can and try to engage with every part of the globe, whether by tweetchats or seeing an interesting tweet come across my timeline.  Some of my dearest friends, friends who have become family, I met through twitter.  To engage at this scale is an immense privilege – both fascinating and enlightening.

Unfortunately, evermore – and particularly in the last year or so – I fear that social media has taken a turn.  Whereas I once felt that all were welcome, where many could have dialogue with respect for differing views, now I see social media distancing us as our emotions take over and our defensive nature shuts others out.  Before I felt heard.  Now I often feel hurt.  I’ve been told I “need some behavioral care” and demeaned for my openness of mental health issues.  I’ve been told I’m too negative and complain too much.  I’ve been “shadow banned” from certain communities.  I’ve been muted and disregarded and disrespected.  Just tonight I was told I have no credibility because I make generalizations about doctors.  I’ve been told I’m a troll.

I’ve seen much worse lobbed at friends (and frankly, mostly female patients).

It’s an interesting thing to have such negative feedback, and insults, thrown at you again and again for trying to engage with others.  For trying to have discourse and assert opinions.  If I’m honest, at times it does make me want to kill myself.  Mostly because I feel so desperately misunderstood.  A few targeted replies can leave me fee as if all the world sees me as a horrible person.  I’m sure I’m not the only one who feels the pain of such misunderstanding.

At other times, I’m able to look upon the feedback with curiosity as to why another might throw insults and try to degrade someone – is it that they feel hurt by what I’ve said?  Are they pushing back with critical thought in the same way I push back?  Have they misinterpreted my words and intent?  Might they simply be uncomfortable with my comments?  Could they be projecting their own issues upon me?  Am I wrong and perhaps need to reconsider my stance?  If I can stay in this place of curiosity, I might be able to come to a place of compassion for the writer and ultimately a place of understanding.  And I wonder if we could all come to that place?

I am by no means good at this.  It is a constant battle.  I was on an intense tweet thread with nearly 30 other people (side note: in my opinion, the reply all function on twitter has caused more problems than not) that devolved into a back and forth where I was frustratingly trying to defend my position.  It was not “professional” and it did not end well.  At one point, I accused another of having white-male privilege.  I didn’t know this guy but for his profile and the interaction we had in that moment.  Turns out he was Puerto Rican born in Spain.  That was a low moment for me.  I apologized, as did he for calling me a whiny 12-year old and assuming that because my handle is GilmerHealthLaw that I’m a wealthy attorney (a regular assumption mostly doctors make), and we had a decent conversation thereafter.

But the assumptions between individuals on social media continue.  We all make them.  How then do we stop to listen, understand, and respect another?  And how do we more rationally proceed with those whom we vehemently disagree, particularly when discourse devolves?

I think more and more the most common thing we do is to throw insults, call that person a troll, and block them.  Blocking is easy.  And while at times warranted to escape emotional and verbal abuse, I think blocking is often used to shut off someone we don’t agree with.  But what does that really do?  Doesn’t it further circumscribe us to the “bubbles” we are said to inhabit? Doesn’t it lead to more negative emotion and pain because people feel even more hurt and misunderstood?

I believe the initial use of the word troll was meant to describe someone who was intentionally posting provocative material in order to upset or harass others.  Trolls have no intention of conversing or adding to the conversation.  They simply want to hurt others.  Unfortunately, it seems to me that troll is used to describe anyone we disagree with – anyone with a differing point of view who persists with their stance.  At this point, many have had someone think they are a troll for expressing their opinion online with any modicum of tenacity.

And I think perhaps that is one of our biggest problems in communication.  People want to be understood and instead of understanding we block and dehumanize others as trolls.  Not only is it dehumanizing, but it is pervasive.  I think, at least on twitter, we are increasingly less likely to consider that the person tweeting is actually a person – full of emotions, hopes, ideas, and great complexity.  It’s easy to forget that the people behind twitter handles are people when many, some for good reason (and at times ironically to avoid harassment), have taken to having avatars as their profile pictures and their bios must be short (I gave up on describing myself and simply put quotes).  It’s easy to eschew an idea that is 140 characters long.  It’s harder to believe a tweet when you know there are really trolls out there and bots meant to disrupt the order of our democracy.  And it’s harder to accept a divergent opinion when we all feel so emotionally raw and defensive given our current political climate.

But what if we came into each social media discussion with the idea that the other person is not a troll with mal-intent?  What if the only assumptions we had were that the messages are being posted by another human with as many flaws and imperfections as ourselves wanting simply to be seen, heard, and understood?  What if we tried to change the tone in which we read posts to ourselves – instead of reading posts as attacks or filled with snark, rudeness, and disdain we read them with a different affect?

I know I could do better at all of that.  I could leave the assumptions aside.  And perhaps instead of reading others’ tweets as if they are said with vitriol, read them from a more compassionate stance.  They may very well be typed with vitriol and I can recognize that emotion, but to really understand, to really listen, I have to not let the emotion overwhelm me.

That doesn’t mean we don’t allow ourselves to have emotion or communicate with emotions.  EMOTIONS ARE STILL IMPORTANT AND SHOULD BE EXPRESSED!  Speaking with force and resolve and allowing our messages to be imbued with our feelings is okay.  Emotions should not be feared.  Anger should not be demonized. Frustration and criticism should be welcomed insight.  Perceived negativity should be met with curiosity and openness not disdain, defensiveness, and a request to change or be shut out.  We do not need to be “professional” at all times and appease others’ sensibilities.  A well placed “fuck that!” can be warranted and should not preclude any and all future interactions.

At the same time, it doesn’t mean we patronize another’s expression by staying stoic.  We must actually hear them and understand the person expressing themselves.  This is not comfortable and takes deep compassion – and compassion is painful.  It takes setting aside our ego when it is far easier to blame, shame, and tear down another.  It takes admitting we may be wrong or allowing for other views when it is easier to dehumanize and label as a troll.  We must exert great effort to see through the pain, anger, fear, hurt, and range of emotions that another human feels and the complexity of the language we use to articulate them.

We very well may feel deeply scarred when someone says “fuck that!” But perhaps it’s better not to escalate, by throwing back a “fuck you!” or “you’re being a whiny 12-year old.”  Instead, as we try to teach children, we can try to directly express how we feel.  Instead, we could consider saying  “that really offends me” or “that really hurt” or “I think you’re misunderstanding me” or “I hear you. I disagree, but I hear you.”  Personally, I’ve been trying to end more of my tweets with emoji’s or question mark or start with “Awesome! But…” hoping it will defray some of the perceived negativity.

Easier said than done of course to think through our responses when emotions are high and topics are polarizing and personal.

We’re human.  We’re emotional and imperfect and capable of both hurting others deeply with our misunderstanding and healing with kindness.  Our language isn’t sufficient to communicate all we need to say.  The limitations of 140 characters devoid of intonation and prosody makes it harder, but not impossible.

And so I want to try.  I want to try to do better.  In a world where people are becoming more entrenched in their ideas and worlds, where facts are questioned, where people stop engaging respectfully, I want the opportunity to change the narrative and the disintegration of conversation.  I’d like to keep engaging with those who have different views – to see and hear and understand others.

And, honestly, I want this in part because I also want others to listen, believe, and respect me.  I want us to stop calling each other trolls, shadow-banning, blocking, muting, ignoring, insulting.  I want to still be able to share my thoughts with passion and push back with fervor against things I believe deserve to be questioned.  I want to disagree but be able to move forward.

I will fail at communicating.  I’ll probably fail most of the time.  I’ll do my best to keep trying though.

My question is: can we do this together?  If I try to listen to you, will you try to hear me? If I believe you, will you respect me?  Can we see and understand each other as simply humans and not trolls to be insulted and marginalized?  Can we lay our assumptions aside or at least admit when we get them wrong?  Can we have compassion for each other even if we disagree with each other?  Can we express ourselves and our emotions and still connect and communicate?

And if we can’t, what then?



*First picture: Screenshot of notes I took in February 2017 for an upcoming speech; Second picture: Anonymous quote; Third and Fourth pictures: Screenshots of Ian McEwan quotes from Atonement.

*Updated 7/30/17, 2:50 pm: added links to tweets and a few grammatical corrections.

*Post Note 8/1/17: I was going back through old posts and realized that Sarah Kucharski’s Stanford MedicineX ignite speech also stated “See Me. Here Me. Feel Me.”  I honestly wasn’t thinking of her talk when I wrote this but I’m certain it’s been in my mind since she said it.  Her talk was amazing and I posted it when it was released.  I highly recommend you watch it here.


2 Responses to See, Hear, Understand

  1. lisadavisbudzinski says:

    Hear hear! 👏👏👏 This is an important issue that could be added to educational curriculum around the world. When reading posts, texts or comments on social media there are many factors to take into consideration.

    For example:

    -Consider the mood you are in that day or at that moment you are reading another’s response

    -If you know the person, read it as they would say it, not how you would say it. This is most difficult since a majority have never spoken on the phone to each other or met in real life.

    There is so much to take into account but the basics remain; be respectful, polite & understanding.
    Take a moment to think before responding/posting.

    Thank you for writing this Erin✨

    Lisa Davis Budzinski

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