Stepping back from issues of storytelling, I now return to basics. Why do we communicate? At a simple level we share data. Even for communication as simple as data transfer, there must be a connection between those who wish to communicate with each other. This connection, like a computer modem, may be strong and reliable or weak, with a fuzzy signal that occasionally goes down. Both sender and receiver must agree to certain standards of language for successful transfer. Even this will not guarantee that a message, successfully transmitted, will actually be understood. Understanding requires an ability to get beyond the data to meaning, which may or may not be shared between sender and receiver, and this is the simple part! For human beings communication is considerably more complicated. Communication involves relationships and contexts. We are not mindless terminals linked by cables. A certain glance can represent a threat or a come-on. We often communicate in order to get our way or to dominate a relationship. Communication can be about power. We may be less interested in the other person understanding our position than in his or her acquiescing to it. At times we reach out to each other for companionship and solace. Sometimes we talk just to talk. While a computer cable exists only for the transmission of electronic signals, humans use the means of communication and the "box" within which communication occurs as part of the message. Our choice, whether to call on the telephone, send an e-mail, speak in a hallway, or sequester ourselves in a family conference is not just a means of communication, it is part of the message.
Some observations about communication between clinicians (especially doctors) and patients and their families are:
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Palliative Care Perspectives
James L. Hallenbeck, M.D.
Copyright © 2003 by Oxford University Press, Inc.
The online version of this book is used with permission of the publisher and author on web sites affiliated with the Inter-Institutional Collaborating Network on End-of-life Care (IICN), sponsored by Growth House, Inc.