If I Understood You, Would I Have This Look on My Face? My Adventures in the Art and Science of Relating and Communicating

Book Title: If I Understood You, Would I Have This Look on My Face? My Adventures in the Art and Science of Relating and Communicating

Book Author: Alan Alda

Publication Information: New York, Random House, 2017, 197 pp., $28, hardcover

Many of us know Alan Alda best from his comedic work on the TV show M*A*S*H. I was surprised and impressed, however, to learn about his long-standing passion for science and scientific communication. In addition to his work in TV and film, he previously hosted Scientific American Frontiers, a program dedicated to sharing scientific discoveries and new technologies with the public, and also founded the Stonybrook University Alan Alda Center for Communicating Science. In If I Understood You…, he uses his experiences as both an actor and an improvisation teacher to illustrate the challenges and rewards of effective communication—lessons that are particularly relevant to the medical community.

Alda introduces his book with a personal experience in which he is a patient. During multiple interactions, his dentist does all of the things he should not do: use medical jargon, place Alda in a literally vulnerable position with “the sharp end of the blade inches from [his] face” (p xiv), appear impatient, and act defensive and unapologetic when questioned about the undesired results of a procedure. Alda states, “I wasn’t looking for friendship that day, but at least I wanted the feeling that I was actually being seen by him.” Rather, he felt like he was “something on his checklist” (p xvi). My visceral negative reaction to Alda’s experience prompted me to consider how many times we as physicians have made patients feel uncomfortable, frustrated, or invalidated by not adequately communicating with them or hearing their concerns. This example was clearly egregious, but how many times do we miss subtler opportunities to connect with one another, and, more specifically, with our patients? Alda convincingly contends that these interactions could be significantly improved with the addition of empathy and authentic engagement.

The first section of the book, entitled “Relating is Everything,” begins with Alda’s first experience interviewing a scientist on Scientific American Frontiers, which went poorly. His reflections on this interaction led him to explore meaningful communication through improvisation. Through a series of improv exercises, he demonstrates the power of synchrony, the value of responsive and contagious listening, and the role of social connection in improving communication. In the second section, “Getting Better at Reading Others,” Alda examines the cultivation and expression of empathy. Using a combination of vignettes, training exercises, and scientific studies, he illustrates how observing others’ emotions and appreciating their stories fosters genuine connection and empathy.

Alda himself is a direct and skillful communicator, qualities that enhance his credibility on the subject. He employs an informal, conversational tone, and the content is rich, stemming from years of personal experience and collaboration with experts in scientific communication. He reminds us that “good communication is the responsibility of the person delivering the information, not the person receiving it” (p 73). I particularly enjoyed the medically relevant examples, including work by Helen Reiss, a psychiatrist, and Evonne Kaplan-Liss, a journalist turned pediatrician, as well as the exercise “Reading the Mind in the Eyes,” which assesses one’s ability to read others’ emotions by only looking at their eyes. Though thought-provoking, the book included an excess of examples to illustrate the primary purpose. While some of the examples build on each other, individual chapters can be read separately to take away the salient points.

In this book, the parallels between scientific communication and physician-patient interactions are readily apparent. Alda refers to multiple studies that show the benefits of effective communication skills, including better health outcomes as well as improved satisfaction for both patients and clinicians. Entering a patient room “only with curiosity and [one’s] own natural ignorance” and welcoming his/her story promotes relationship building that can be long-lasting (p 11). Alda provides concrete examples, including a variety of improv exercises, which clinicians may employ to practice effective communication and nurture empathy. This book reiterates the importance of teaching and evaluating communication skills as part of resident training and continuing to reassess them over time. It is a worthwhile read for all, especially family physicians who hope to build lasting, meaningful relationships with their patients.