Usable Insight – Listening Into People’s Eyes

When you listen for the pain, hurt and fear in people, it is always there.
And when people sense you doing that with no other motive than to alleviate all of those,
they will lower their walls and reveal them to you.
- Dr. Edwin Shneidman (1918 – 2009) American Psychologist, Suicidologist and mentor

“You listen into people’s eyes,” Doc Barham told me.

I said: “What?”

“When you sit down with people what you first notice is people’s eyes and then you look and listen into them for their hurt, pain, fear, anger and terror and when you do, they share whatever it is with you.  And then they exhale, feel relieved and open themselves up to you.  That is your secret sauce,” he explained.

Doc Barham is CEO of Xtraordinary Outcomes (http://xtraordinaryoutcomes.com) a company which identifies what makes individuals, companies and organizations extraordinary and in doing so, helps them to come from that special “tipping point” place to become even better.  He had been interviewing me about how I work with patients and seem to be able to get through to some of the toughest ones.

Like many “talents” or skills that people have, it was spawned out of a terrible experience.  I hadn’t made the connection until Doc identified the way that I listen.

Nearly thirty years ago, I had one of the more awful experiences in my career as a psychiatrist.  I had been paged to go up to a patient’s room at UCLA Medical Center  to “okay” the soft restraints the surgeons had placed on him plus the major tranquilizer they had then put into his IV.  The patient, who I will call Mr. Jones, was a fifty something patient with AIDS (just after it was identified as an illness), with a terrible infection, who had been placed on a respirator.  He had been pulling out his IV’s and then pulling at his respirator and was in a state of what the surgeons called psychotic agitation.

When I entered Mr. Jones’ room, he was lying with his arms and legs restrained.  His eyes were as big as saucers and they seemed to be screaming out to me.  His eyes in fact grabbed hold of mine as I kept repeating, “What are you trying to tell me?”  Because of the respirator, he couldn’t speak.  All he could do was groan in agony.  I put a pen in his right hand close to the restraint on that wrist and put a piece of paper near it so he could write.  All he could do was scribble something that didn’t make any sense.  I again repeated, “What is it?”  And again he couldn’t communicate what it was.

I concluded that what the surgeons had said was true and that Mr. Jones was psychotic and needing the restraints and the tranquilizer.  I told him: “Mr. Jones, you have pulling your IV’s out and pulling at your respirator tubing and we needed to restrain you and have also given you a tranquilizer to help you calm down.  When you calm down we will take you off the restraints.  I will keep checking in to see how you are doing. Do you have any questions?”  All Mr. Jones could do was stare at me with his eyes wide open terror which were now beginning to show the early signs of being tranquilized.

I checked in with him and his surgeons over the next couple days, but he was mostly sleeping.

Two days later I received a page from his attending chief surgical resident who in a curt manner said to me: “Hey, Mr. Jones is up, alert, off the respirator and commanded us to call YOU.  So I think you should come and see him as soon as you are able.”

With trepidation, I went up to Mr. Jones’ room.  When I arrived he was seated up in his bed. In a non-psychotic and very determined he way grabbed onto my eyes with his, said: “Please sit down,” and with those eyes placed me in a chair.

His eyes never left mine and I could not move mine away.  Then in no uncertain terms and with an emphatic voice he said: “What I was trying to tell you was that a piece of the respirator tubing had broken off and was stuck in my throat.  You do need to know that I will kill myself before I ever get into that situation again.  Do you understand?”

My eye winced and teared up as he revealed the answer to the mystery from my original visit.  I wanted to look away, but couldn’t.  Instead I said, “I’m so sorry that I didn’t know that.  And, yes, I do understand that you will kill yourself before you have to go through something like that again.”

And that is when I began to “listen into people’s eyes.”  I just didn’t know what to call it.

Epilogue: I might not have the opportunity to have had this experience if I were at UCLA today, because it is has undergone a transformation in the past four years where they have become completely patient and patient family centric as documented in the NY Times best selling book, Prescription for Excellence: Leadership Lessons for Creating a World Class Customer Experience from UCLA Health System by Joseph Michelli.

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