A recent short piece by Taylor Lorenz got me thinking. 

She describes being targeted online with hateful comments and overt threats as follows:

“After a particularly vicious media segment about me, which completely misrepresented me and the events of my life, I realized that these people: the online commentators, many mainstream media journalists, and internet harassers, don’t care about the truth. They don’t care about who I actually am. I realized that, to them, I am simply an avatar that they’ve manufactured, often based on complete fabrications and half-truths, that they use to push their political agenda, or media narrative, or to communicate something about themselves. ”

Her initial response was:

“When people spread lies about me on the internet, I used to think, If only they knew me. If only I could explain myself. If I just gave them a bit more information they would understand me.”

Over time she came to believe this was false, and that attempting to explain/reveal/personalize herself not only didn’t help - it often made things worse. The haters were so committed to attacking the avatar (straw man) they had created that they simply used pieces of her revelations to amplify their attacks.

I see this constantly, but not just online. I think it also happens frequently in real life. People respond to their personal interpretation of what they think someone else meant. When - as is usually the case - both parties do this, the result is a frustratingly fruitless exchange of statements often devolving into nastiness: “What we’ve got here is failure to communicate.” 

This is similar to something Mónica Guzmán  describes in her excellent book I Never Thought of It That Way  She describes how common it is to argue against what one assumes another person means without first learning what the other person has actually meant.  She talks persuasively about the fact that different individuals and groups often use particular words or phrases to mean very different things. As George Bernard Shaw observed that “The single biggest problem in communication is the illusion that it has taken place.”

This resonates with me because effective and accurate communication was of fundamental importance during my 4 decades as a primary care physician. I needed to be what Guzmán describes as ferociously curious. In practice, this required that I ask my patients to explain and enlarge upon what they meant and give them time to think and respond. I had to be careful not to assume they meant what I would have meant if I had said what they said. Ideally, I could reflect what they said back to them so well they wished they had phrased it that way.

Some of the phrases I used were:

    •    “You said you were dizzy. Dizzy can be different things for different people. Can you describe what dizziness felt like to you?”

    •    “Hmmm. You had spasms.”  (Lean forward and wnd wait patiently for them to enlarge on ’spasms’.)

    •    “You said you thought you had pneumonia. Can you tell me more about why you thought it was pneumonia?”

    •    “You treated your <symptom/diagnosis> with <what they had described>. Can you tell me how you learned about that approach?”

    •    “You decided not to have <some test or treatment procedure> done. Can you tell me how you came to that decision?”

Think of how much better the world would be if the primary goals of conversation were learning and understanding rather than promoting a position or winning an argument. Ask questions and listen to the answers.


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