I remember sitting with her, holding her hand, telling her the same information over and over again.  Finally, she lifted her head and said, I hear what you are saying. Within five minutes, she asked me the same question again.

You would assume the scene I am describing is one of tragedy. It is not. It is about an interaction in a healthcare setting, and it is about the ability of a human being to hear and process information when stressed.

Fight or flight, or the acute stress syndrome, is a common happening when a human being perceives a threat. Having consciousness that the acute stress syndrome reaction is an influencer when talking with families is the first step in awareness of the filter through which families might be hearing the information you are trying to share with them. The second filter is fear. You could argue that fear causes the reaction of fight or flight, and you would be correct. Fear is the trigger; the reaction is what you must deal with first. 

In a family’s mind are a million whirling thoughts when they are concerned about the one they love. They are looking for clues that will either support their fears, or alleviate them. It really is that simple. 

Early in my career, when I would meet with families, I was professional and factual. I would give them the clear clinical picture and what the team thought would be the course direction with always the qualifier of potentials. I was puzzled that they would not remember what I said, except for the parts that supported their fears. One burly rancher put it into perspective for me one day. He said, “Why don’t you ask me what I am worried about instead of telling me what you think I need to know?”

From that day forward, I changed how I spoke with families. I now work on how to be present to them, actively listening instead of actively talking. I put aside my phone, pager or other device so I am able to be all theirs for the moment. I remind myself of their loved one’s story. If I do not know it, I ask them to tell me about their loved one. Knowing the story opens up the ability to be empathetic. 

Furthermore, talking about the loved one brings a centering and grounding that creates a mutual connection. It sets the stage to ask the most important question that can be asked, “Tell me what you want to know first. What are you worried about?” In the time of COVID-19, such a question is critical.