Healing from the Heart: A Practical Guide to Creating Excellent Experiences for Patients and Their Families.

Media Review

CJEM 2007;9(6):474

Timothy Dawes. 2005. Published by Interplay Press, LLC. Paperback, 172 pp, US$21.97. ISBN 978-0978 824709

It's a truism: most botched encounters in medicine are attributable to poor communication. As any Canadian Medical Protective Association (CMPA) lawyer will tell you, if you get your message across as empathetically as possible, then your chance of ever needing their service is reduced.

Medical school addressed the issue of communication early with videotaped interview simulation. Eye contact and empathy were scored, and we were followed over the years to see if we improved. But over time our supervisors became more interested in how we gleaned data than on the message we conveyed. Boxes were ticked for asking the right questions, but rarely for style. It's not that we're great communicators; it's that, in medicine, the focus is on medicine first, and human faculties second.

Books on communication can be assessed according to 2 basic criteria. First, how do they communicate their message? If it's lost or garbled, then its credibility is undermined, if not entirely compromised. Second, what is the best audience?

As for the language, this text is free of self-help jargon. The writing is clear, reasoned and practical; the prose is cogent but soft (consider the warm-fuzzy title). If there's any glaring deficiency, it's in the matter of the intended audience. I'm not sure doctors are the best audience, because the message of this book, how to care and how to show you care, already seems part of the professional equipment for most of us. To be fair, Dawes admits:

Of course, you're already compassionate. You made that clear when you chose healthcare as your field. You prove it every day in the level of care you provide, the effort you put in, and the things you do to help people and make them comfortable. And you're already a healer, a skillful one.1

Thus the capacity for empathy is already assumed as a given. Those of us who lack this capacity are unlikely to recognize their deficiency and pick up this book on their own.

The complementary and empathetic style of the book is exemplified in the excerpted passage above. Style matters in a book about communication, but Healing from the Heart is not all style. There is a framework of applied theory underpinning it; it's not just deep thoughts from an empathetic mountain.

Dawes' book can be boiled down into a few simple sentences: Listen first, and show that you're listening. Then speak as if you care, and make sure you're understood. Through it all, show interest. And although the message is old, it is timeless, and this book provides a framework, a necessary step. It reminds us of what Dawes says we already know, but does not provide an actual practice. This book is ultimately best as an adjunct to a communications seminar or a preparatory text; and Dawes urges his readers to seek out other resources to supplement his book.

As to whether this book would improve all of us average communicators out there, well, this is a workbook, and it would be unfair for me to say that there weren't any useful tips. But will it, as I've been taught to ask, cool and mercenary-like, change my practice? Yes, it made me rethink my style in subtle ways. In the future, I'll say things like, "I'm concerned about…" or "That must be very hard for you," all of which I was told, long ago, in those med school seminars. Hopefully the videotape of those Excellent Experiences has been destroyed.

Shane Neilson, MD
Guelph, Ont.

Reference

1. Dawes T. Healing from the heart: a practical guide to creating excellent experiences for patients and their families. Bellevue (WA): Interplay Press, LLC; 2005.