Some years ago I went to a concert by legendary Grammy award-winning jazz vocalist Bobby McFerrin. I had an aisle seat near the stage. Two-thirds through the show Bobby came down into the hall with his wireless mic, approached an audience member, and engaged in an improvisational duet, leading his mate in vocalizing whatever riff Bobby had begun singing. I watched rapt. Bobby turned and saw me. He changed riffs, approached, lowered, placed the mic between us, and we began our duet.
I listened to several repetitions of the riff before vocalizing it with him. Despite my musical background, (I played fusion drumkit into my mid-thirties) I had difficulty articulating the phrase. For Bobby, the master who articulates in rich and varied ways, had an effortless airstream. As I continued my effort to manage breath and increase articulation (i.e., mimmic Bobby) while trying to maintain up tempo phrasing, he sensitively began dumbing down his own articulation to meet me at (actually slightly above) my own level. With eyes closed and foreheads touching, we grooved, a musical master and a musical citizen in an extraordinary series of moments.
Bobby and I used a common language. After all, the syllables comprising his riff were basic. But his nuance, inflection, and enunciation equated to a very sophisticated conversation. Merely listening to Bobby appreciatively did not convey to me how sophisticated his musical conversation is; not until we locked in conversation did his exquisite command of musical language explode in my experience. I was surprised; after all, the silly syllables we uttered were basic vocal building blocks, i.e., words. Reflecting on it these years later, he made much more sophisticated meaning of the syllables than I was able to. He was the professional; I, the lay person.
Mapping this experience to my world now, I liken it to circumstances we find ourselves immersed in when a loved one is hospitalized. After much shock and bewilderment it gradually dawns on us that although we, the patient-family, and providers are speaking the same language, the meaning we make of common words and phrases must be different — what else could explain the disconnects, our breathless confusion and angst? We use the same simple words (care, advocate (noun) and advocate (verb), we suppose we have common meanings, yet our experience intrinsically tells us that patient-family meaning and provider meaning must be very different.
And it is.
I have long assessed that in order to advocate effectively when hospitalized we must first understand the root causes underlying ineffective behavior. I could, if I chose, start by offering you a list of things to do (and not to do). That’s both valuable and necessary. The real key however, is to go deep into the language we all use but don’t necessarily share. We do we expect care? If so, why? Are we naive? What is care, really?…do patient-families and providers consider care to be composed of the same elements? Do we all share a common understanding of advocate (noun) and advocate (verb)?
Mull this over and let me know your reflections. Let’s put our heads together. This time I’ll take McFerrin’s role.