Concise Communication

We just received an 11-word letter from son #3, who is away at a 12-day fine arts summer camp, playing bass in the jazz performance program.

You know how some people can go on and on and not really say much?  (Risky thing for a writer/speaker/blogger to point out, I know – something about stone-throwing and glass houses, or pots and kettles.  But I digress.)  My youngest son doesn’t have this problem.

Some narratives stretch on a little (or a lot) longer than they should.  Sometimes it’s because a person may be, like Dickens, effectively paid by the word.  In many circumstances, a person hasn’t yet learned what information to leave out for a particular audience.

You should watch the face of a general surgeon receiving a third year medical student’s verbal presentation of a patient.  That student has been taught to document every detail about a patient’s current medical situation, past medical history, family history, social history, positive and negative answers to a barrage of questions about symptoms across all body systems and state of mind, and every finding, including everything that is “normal,” on the physical exam.

What the surgeon wants to hear is: “14-year-old male with no significant past medical history presented to us with right lower abdominal pain and fever, has tenderness and guarding in this region, physical exam otherwise within normal limits, and ultrasound shows evidence of acute appendicitis.  There’s no personal or family history of reactions to anesthesia or of any bleeding or clotting problems.  He hasn’t had anything to eat or drink for over 12 hours.”  The surgeon may fire off a couple of questions on the phone, and she’ll ask anything else she needs to know when she goes to see the patient.  So when the medical student regales her with information about the patient’s mild acne, stage of puberty, visual acuity, dietary habits, or school activities, the surgeon’s eyes will glass over and may roll back far enough in her head that she can see her own brain.  This is why the emergency room residents don’t let medical students call the surgeon.

The surgeon in this example is being called to respond to a surgical emergency.  In this situation, the relevant information needs to be communicated in a clear, concise, and quick manner.  It needs to be complete as well, but complete within the realm of relevance.   The kid’s appendix could burst while the student is reporting on the child’s use of seat belts and bicycle helmets.  However, the above clinical description of the patient’s appendicitis presentation would be a woefully incomplete picture of that person during a well-child visit at a new pediatrician’s office six months later.

To communicate well, you need to tailor your communication to both audience and situation.  This is quite important within the field of medicine.  An internist generally needs a much broader and different knowledge of a patient than an orthopedist needs.  Both doctors and patients need to know what information to relay, the right way to phrase things, and the right questions to ask.  And that communication makes all the difference in the world.

So here is my child’s letter from camp, in its entirety:

“Dear People,

Birdland Combo.

Cabin’s awesome.

Kids cool.

Best counselor ever.”

He used fewer than a dozen words to convey: 1 – that he’s alive, 2 – which ensemble he’s in, which tells us how his audition went and enables us to look at the schedule to see what time his concert will be on pick-up day so we know when to show up at camp, 3 – that he’s happy.  Would I have liked maybe a little more detail?  Of course.  But he communicated what was important for us to know now.

Maybe my son thinks I’m a surgeon.  I think next year I’ll offer to pay him by the word for his camp letters.

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