Four Steps

The other day, around 7:00 in the afternoon, we had a patient arrive at the floor on our ward and was refusing everything under the sun.  Medications, vital signs, blood tests, you name it.  If we needed it, his answer was "no."  More than one nurse had gone in to see what they could do, but to no avail.  The nurse caring for the gentleman asked me to try to see what I was able to do.  Without even knowing his name or background, I threw on my fancy little N95 mask and opened the door.  All the lights were off.  The only light entering the room was from behind the blinds, which was limited at this point.

I introduced myself and followed four simple steps.  The same four basic steps when talking to someone who is rigidly partisan.  I should note here that being an ideological person, like myself, one can be persuaded through reason.  According to Amash, one will find a "partisan cannot be persuaded of anything countering the consensus of his tribe," which can be extremely dangerous.

The first step is assume good or neutral intent.  Assuming ill motives almost always instantly cuts us off from really understanding why someone does and believes as they do.  Odds are, especially when they have just met you for the first time ever, they don't have anything against you, there are other things going on that you aren't aware of.  The second is to ask questions.  When we engage people across ideological divides, asking questions can help map the disconnect between our differing points of view.  This also gives them an opportunity to point out flaws in our positions.  It can also signal to others that they're being heard.  Third up is to stay calm.  Don't forget that they're a human being with a lifetime of experience that shaped their mind.  The final step is to just go ahead and make the fucking argument.  One of the side effects of having strong beliefs is we sometimes assume the value of our position is obvious.  It's so painfully good or right and if someone doesn't get it, it's their problem, not yours.  Unfortunately, if things were that simple, we would see things the same way, yet we don't.  If we want change, we have to make the case for it.  Reaching out to someone we disagree with is an option available to all of us.  Go out, talk to people, and listen to them.  Prepare to be amazed.

I was able to, after going through a process like this, not only get him to at least pretend to show some respect, but allow me to check his blood sugar, an important step in getting back on track and allowing the nurses/doctors to do their jobs.  Nobody else was able to even get that far since he arrived on the floor, so I considered that a success.  This was accomplished within just a few short minutes.  I thanked him for his time and left the room.



Over the last four days, I've been obsessed with watching Louis Theroux documentaries.  This guy manages to look at home with everyone from Nazi-sympathizers to transgender children to alcoholics on the verge of death and even crazier nuts.

There's a shitload of people trying to defend bad ideas and defend them with aggression.  Louis then says the more you become a mirror image of whatever they're projecting, you reinforce them in their position.  From doing stories about people with extreme religious beliefs like the Westboro Baptist Church, he knows from people he's met who were in the church and then subsequently left that what short circuits their beliefs, what allows them to see something bigger than what they're in is when you treat them with kindness.  Instead of shouting back at them or hurling abuse back at them, which just reinforces their views, if you try to behave decently and attempt to robustly present your position, but in a respectful way, coming from a place of caring and empathy, instead of a place of hostile attitude, that can be much more effective.  As well as being humane.  Links will be available to appropriate Twitter accounts.