Imagine a situation where you are in a conversation about something that matters deeply to you. Suddenly, out of the blue, an opinion you vehemently oppose is put forth. What happens?

Adrenalin pumps. The hairs on the back of your neck stand.

Millenia of evolution have primed your body to react singularly- fight or flight- and blood gets diverted to your muscles in preparation. However, in today’s world, the body’s response to deal with a sabre-toothed tiger falls hopelessly short when facing a colleague, patient, or loved one.

So what do we end up doing when our brains are drunk on adrenalin? Most of us end up doing or saying things that make perfect sense at the moment, but later on, make us feel stupid.

What just happened is a crucial conversation. In one line – some crucial conversations have a definite impact on the quality of our lives.

As medical professionals, we are expected to be proficient at communication- after all, we are taught to begin with a history for every patient we meet. We may ace a majority of the patient interactions we have daily but are we taught how to deal with the rare difficult situations that may arise?

I had this book recommended to me while musing over this lacuna.

Crucial Conversations– When the Stakes are High!

Ever since the first time I saw this book – ‘Crucial conversations: Tools for talking when stakes are high’, its scarlet cover seemed to hold secrets that I desperately needed.

I finally got around to reading this book after a particularly irksome encounter with a patient during my clinical posting with the hope of learning a few tips I could use… and thus began my journey to master crucial conversations.

The authors, Kerry Patterson, Joseph Grenny, Ron McMillan and Al Switzler, define crucial conversations as having three specific characteristics: high stakes, high emotions and varying opinions. Typically, we tend to handle crucial conversations in one of three ways. We avoid them altogether, we face them and handle them poorly or we face them and handle them well.

Ironically, the more crucial the conversation, the less likely we are to handle it well.

We have all felt the toll it takes on our mental health when a conversation goes downhill. Repeated conflicts contribute to increased stress and can also weaken our immune systems over years. When we feel unheard, we become disillusioned and frustrated with the work we do. We try to push our points aggressively, which in turn breaks down rapport.

This scene is reflected time and again in our hospitals, in our wards, between colleagues and even with patients.

Tools to Achieve Effective Communication

This book is based on the concept of achieving open dialogue. Through a total of 10 key steps, the authors describe tools that help achieve the goal of a conversation where both parties feel comfortable, understood and satisfied. It explores what we must work on before, during and after a conversation, to create a safe environment and clear outcomes.

‘ At the core of every successful conversation lies the free flow of relevant information. People openly and honestly express their opinions, share their feelings, and articulate their theories. They willingly and capably share their views, even when their ideas are controversial or unpopular. It’s the one thing that, and precisely what … Now, to put a label on this spectacular talent-it’s called dialogue. ‘

In the book, the authors provide a framework to work with, in every conversation, through pertinent anecdotes and encourage the reader to use it daily. After all, the best way to get better at something is to practice and with a combination of observation and introspection, we, as readers, delve into exactly what happens in a high stakes situation. Once we understand what goes wrong, we can step up and manage the situation.

What struck me while reading this book was that there are always two sides to an argument. You may choose to believe one side, but you cannot deny the existence of the other. And when we fail to acknowledge the thoughts of the person in front of us that the conversation deteriorates.

As George Bernard Shaw once said, ‘The single biggest problem in communication is the illusion that it has taken place.’

Why I Recommend this book

This book taught me that our unique past experiences are brought to bear in any situation we find ourselves in and they influence our actions. So it is critical to have that moment of self-realization to not fall into bad habits that we have developed and instead consciously respond.

The authors further elaborate on this idea. They urge the reader to resist what they call the ‘Fool’s Choice’- the idea that every crucial conversation is an either/or situation- and change our expectations of the encounter.

‘Under the influence of adrenaline, we start to see our options as unnecessarily limited.

We assume we have to choose between getting results and keeping a relationship. In our dumbed-down condition, we don’t even consider the option of achieving both.

That’s why those who are skilled at crucial conversations present their brain with a more complex question. They routinely ask: “What do I want for myself, the other person, and the relationship?” ‘

Solving this multifaceted problem instead of just focusing on being ‘right’ has helped me take a step back and objectively assess the situation. And this in turn has helped me share my concerns, listen sincerely and build better relationships.

Key Takeaway!

As I end my review, a word of caution to the reader: This book cannot magically turn someone into a genius conversationalist overnight. Or ensure that the crucial conversations we have never go wrong. Having said that, reading it has given me a whole new perspective and set me on a path of being present and proactive every time I speak. A path in which every successful conversation makes my day a little brighter.

So pick up this book, and give it a read, and you may find yourself conversing for the better!