It is cold out there this morning!  Mid-twenties!!  The air had a
slight chill that was akin to liquid nitrogen.  I thought for a time or
two that I was going to be quick frozen.  By the time I came in from my
walk my skin was the same color as my Carolina Blue grubbies.  I quickly
lunged for the warmth of a steaming cup of fresh brew.  It was to no
avail.  My ice-cold hands quickly turned it into ice coffee!  Now I know
how Midas felt.

        Talking about a deep chill is a good lead-in to two interesting
and interconnected pieces about the less than warm temperatures of
traditional medical bedside manners that I've just read.  The first was
Geoffrey Kurland's MY OWN MEDICINE:  A DOCTOR'S LIFE AS A PATIENT.  It's
interesting.  Kurland, an accomplished pediatric pulmonologist, stricken
with leukemia, talks of his revelation of how doctors are present at and
involved in emotionally charged moments throughout their careers.  Yet,
with unacceptable rarity they are not trained to listen, to be empathetic,
to be sensitive, to create rapport, to generate trust, to just plain talk,
to be human.  They may have great medical skills at opening up people, but
far too many have weak people skills that close people up.  Kurland
describes his own sense of diminishment, devaluation, disempowerment as a
patient at the hands of his medical colleagues.  He talks about how the
attending physicians ignored what's fundamentally important and meaningful
to him as a human being.  I wonder what wondering we academics would be
led into if one of us published MAKING THE GRADE:  A PROFESSOR'S LIFE AS A
STUDENT?

        The second piece I read was an old article discussing how the
national medical licensing exam will include on a trial basis examining
"patient encounters."  It seems that there is a push in some quarters of
the medical profession to transform a major complaint into a major
concern.  That is, there is an attempt afoot to establish a balance in a
science-heavy curriculum with a "best friends" training to forge vital
connecting and supportive relationships between two human beings known as
patient and physician.  The Licensing Board is devising what I call a
testy test in bedside manner.

        If I remember my history of science, it once was, before the time
of scientific and technological innovation, before the likes of Jenner and
Lister and Pasteur and Koch and penicillin and Pfizer, that all doctors
generally had to offer was compassionate listening.  Then, the empathetic
patient concern model of warm caring went by the wayside as it was
replaced by the chill of an unemotional disease treating model.  Doctors
substituted what I'll call "presence" with antibiotics and surgical
"procedures" rather than balancing the two into a healing wholeness.
Yet, recent studies show that good communication leads to good clinical
practice and better outcomes for patients.  Patients want to talk; they
want to be respected; they want to be noticed and heard; they want doctors
to care about them as individual human beings.  Other studies show that
doctors can learn a lot about a patient's malady, as well as about a
patient's needs, by listening to the patient.

        Now, take the words, "physician" and "patient," and replace it with
"teacher" and "student."  There you have it.  Not much difference too many
times in too many places.  Communication qualities such as listening
carefully, making eye contact, touching, noticing body language and
showing empathy, being understanding and sympathetic may sound like
emotional fluff to many intellectual-oriented academics. But, as my good
friend, Alex Fancy, would say, they're really the right stuff.  After all,
compassion, empathy, sympathy are attitudes or spirit made flesh and
bones.  That bears repeating:  in academics so many are so far into their
heads and subjects that they are so far removed from the essential and
integral human element in education.  They so often underestimate the
power of a touch, a smile, a kind word, a listening ear, an honest
compliment, or the smallest act of caring, all of which have the potential
to touch and turn a life around.  It bears repeating because it only takes
one person who truly and caringly sees and listens to turn a life around.

        Anyway, I had an impish, perhaps treasonous, thought.  What if
such a test in bedside manners was part of our examination for our
academic degrees.  Wouldn't it be interesting.  Let's be honest.  In a
people business such as is education, too many of us just don't have the
people skills.  Most of us have not been trained in such skills.  Many of
us see ourselves in the information discovery and/or delivery and
transmission business rather than in a people serving business.  For too
many, their future is not really at stake, their job is not really on the
line, and their prestige doesn't really depend on their relationship with
students.  So, such skills are superfluous.

        If nothing else, it doesn't take a proverbial rocket scientist to
know that patients who feel rapport with a doctor are more likely to do
better medically.  We've all been there.  I know I have.  A few years ago,
as an out-patient I had what I call "open hand surgery."  It sounds more
dramatic than mundane carpel tunnel surgery.  Anyway, the prep nurse was
one of those Dorothy's house should have hit.  As she man-handled me, I
kept looking around for her broom.  Boy, did I want to throw water on her
so she'd melt.  I am sure she was technically competent, but she had the
bedside manner of a hungry tiger about to pounce on a delicious lamb.
She was abrupt, stone faced, cold, distant, unreassuring, and harsh.
Let's just say that I was, to say the least, not a relaxed happy camper as
I went under.  She might as well have been an unfeeling robot.  I
experienced an infantilization.  (how is that for a made-up word)  I felt
slighted, overwhelmed by a harrowing, alienating, and frustrating feeling
of aloneness, helplessness, and diminishment.

        Ever come out in an out-patient recovery room.  I had this
amnesic, almost panic, attack, "Where am I?"  The place had the look and
smell of a morgue.  Unnatural and noxious scents of antiseptic and
anesthesia heavily fragranted the air.  There were bodies all around me.
I knew I was dead.  Slowly, as the fog began to clear, I cursed that
wicked witch in white whose unruffled manner made my last minutes on earth
unpleasantly tense, uncertain, unsettling, and frightening.  Then, I felt
a soft, caring touch on my hand.  I heard a soothing, caressing, angelic
voice softly whispering in my ear.  "Dr. Schmier, everything went well.
Your wife is outside in the waiting room.  I told her you'll be out in a
short while.  You'll be with her very soon.  Just close eyes and rest.
Don't worry.  I'll be here and I'll take care of you. Everything will be
fine......"  My panic disappeared, my muscles relaxed, and I gratefully
closed my eyes.  I may have had a thin line of a slight smile on my face.

        Now this nurse I am sure was just as technically competent as the
first, but unlike the first, she wore a halo instead of a cone hat; she
understood she was as much, if not more, in the people business as in the
medical business.

        It's no different in academics.  Studies, and my professional
experience, show that students who feel a rapport with a professor, who
are a member of a supporting and encouraging classroom community, who are
respected and trusted and cared about are more likely to reach out for
their as yet hidden potential.  The most basic of all human needs is the
need to understand and be understood.  Why can't so many of us understand
that?

        There is a Native American saying:  speak only half as much as you
listen.  I'm not sure most academics even listen half as much as they
speak.  Yet, seeing eyes and listening ears mean a seeing and listening
heart;  they mean being aware; they mean taking an intense and sincere and
caring interest in what is being said; they mean hospitality, respect,
appreciation, nurturing, and wonder; they mean being open to something new
about a new person;  they mean not being preoccupied with what to say when
the other person stops; they mean an intense silent conversation; they
mean not acting like Alice's hare, even if you are in a hurry; they mean
knowing beneath the spoken words is their meaning;  they mean knowing that
words have no meaning, people who speak the words have all the meaning;
they mean paying close attention to whom a person is; they mean creating
deeper silences in yourself; they mean not talking to yourself while the
person is talking; they mean getting the ears, eyes, mind, and heart
operating at the same speed; they mean not judging, labeling, analyzing,
diagnosing, prognosing before the person is finished; they mean not having
prejudiced notions, preconceived opinions, cynical attitudes, suspicious
feelings;  they mean creating a safe place for whatever is said; they mean
surrendering yourself to the needs of others.  Seeing and listening are
acts of love, for you make yourself accessible, you give yourself, you
make yourself vulnerable, to someone else's words and feelings.  They mean
a continuing form of embrace.

        Let me offer a medical scenario.  You have severe stomach cramps.
Your family members rush you to the emergency room.  The physician
reluctantly leaves his other more glamorous treatments, has never seen you
before, doesn't make eye contact, doesn't display any empathy, doesn't
listen carefully, shows little sensitivity, doesn't notice body language,
doesn't have a record of your medical background, doesn't get one, doesn't
examine you, doesn't answer your questions about your symptoms, doesn't
create rapport and trust, doesn't honor your feelings, and doesn't
communicate clearly.  The doctor is rude, condescending, abrupt,
inattentive, and, like Alice's hare, has no time for unnecessary "small"
talk however necessary and "big" such talk may be to you.  Yet, in the
literal wink of an eye, like Flash of the comic books, he or she utters a
precise "I know exactly what's wrong" diagnosis, prescribes a specific
drug, offers an exact prognosis, and is off in a whirl and blur.

        What kind of doctor would you think this person was?  Ready to
chase after an anbulance chaser?  Isn't this exactly what too many of us
academics so often do when we enter a class, especially one of those
uneducational, depersonalizing large classes, and more especially those
unprestigious, non-professional, mere "bread-and-butter," huge first year
survey
classes where we more often than not give mere lip-service to a humanities
curriculum?  The students lose, have stripped from them, their
individuality, identity, and their humanity.  Let's admit it.  Most of us
academics in higher education were not trained as classroom teachers. Most
of us are groping amateurs, although many are educating themselves and
seeking on-the-job training.  But, even then, too many of those struggling
to up-grade themselves are concentrating mostly on technology and
technique concerned with transmitting the subject material.  Like medical
school students, most of us weren't trained in bedside manner,
communication skills, and student encountering.  Far too many of us
haven't learned about learning or haven't applied what we've learned about
learning.  Most of us are still far more consuming talkers rather than
see-ers and listeners.

        Now, is there hope for those who don't or won't recognize that
academic performance on both sides of the podium is behavior driven?
Sure there is.  We have to take the time to learn how to see and to
listen.  But, that isn't the same as learning new technologies or methods
or techniques.  It can work if we work long and hard at it. It may look
easy, but not talking or doing, just seeing and listening is not simple.
The greatest barrier in learning how to see and to listen is the illusion
that so many of us have created that convinces ourselves that we already
do it--and do it well.  And, we casually dismiss students with a "what do
they know," when they say we don't.  I know.  I did it.

        I am a recovering talkoholic.  I now know that it's harder to stay
awake than you think.  I now know that it's harder to stay alert than you
think.  I now know that it's easier to be in a daze than you think.  I now
know it's so easy to ignore the human details.  I didn't now that or want
to know that when I was hooked on orating.  When I was addicted to
talking, trust me, silence was my enemy and I didn't listen or see most
others.  I was too busy wanting to be seen and to be heard.  I was too
busy to notice that there were others in the classroom.  I was so shut up
in myself I couldn't shut up.  I was so untrusting of myself and others
than I didn't trust the silence of just seeing and listening.  And, I
wasn't really listening to what I was saying about myself and students.
I was saying that I didn't really want to participate in those around me
regardless of my pronouncements to the contrary.  Then, after my epiphany
in October, 1991, I started learning that the highest development of
seeing and listening is seeing and listening to myself.  I started to take
a long and honest look at myself. I started to think about why I saw and
listened at little as I did, how I saw and listened to what little and to
few that I did, and understood what it takes time to change old habits.
I started working hard and long to learn how to be still, to see and to
listen, to get into a routine where nothing is routine, to find that place
where everything and everyone has a special place, to become mindful--and
grateful--for the everyday things in everyday life, to cherish the
extraordinary value in each ordinary person.  It was a herculean effort of
will and perseverance.  It was slow.  Small steps. There were setbacks.
Many colleagues saw my need for changing as a sign of weakness.  Some
still do.  Some felt threatened by my transformation.  Some still are.
Nevertheless, I continued to hear the call of authentic selfhood and true
presence.  It was a journey inward, downward, and outward.  Slowly, I
began to understand that the less my mouth spoke, the more my heart spoke;
and the more my heart spoke, the more my life spoke.  I also began to
understand that as I learned to truly see and listen, I was opening myself
to my experiences and living in community with others.  I was becoming
attuned to what was not yet visible in me and others, to what was seeking
to emerge, and to what was weaving that emerging spirit into the flesh and
bone and behavior of myself and each student.

        To keep my eyes and ears, as well as my heart, open and to see the
wonderful sacredness in the ordinary, each day I engage in at least one of
three exercises.  One exercise, in which I asked participants in a recent
workshop to engage, I call "water journaling."  It's simple.  From the
moment I get out of bed, I consciously look for and see, hear and listen
to water in any place, at any time, in any form:  saliva in my mouth,
tears in my eyes, the toilet, the shower, the steam, the sink, the
toothpaste, the shaving cream, the fishpond, the cup of coffee, the
dishwasher, the puddle in the street, the fountain on campus, the vapor in
the air, etc. etc. etc.  You get the point.  I then make a brief journal
entry of each time I hear water, see it, and feel it.  Try it.  I am
always amazed at how this simple exercise sharpens my senses and hones
both my awareness and mindfulness, and how it becomes almost impossible to
ignore the usually ignored.  The second exercise I often do is to slowly,
ever so slowly, play with a raisin (a blueberry or strawberry in season),
roll it in my fingers and feel every ridge in every detail, stare intently
at, wonder about its origin as a succulent grape, magnify its shriveled
patterns, take it to my nose and deeply inhale it's smell, let it sit on
my tongue, feel the rushing flow of saliva, play with it, and let my
tongue and palate and cheek and gums and teeth feel every line in every
wrinkle. The third exercise is simply to just sit down and draw a picture
with the intent awareness of something I'm looking at.  It forces me to
take notice of the horde of ordinarily unnoticed extraordinary and
tinniest but important of details.  All three exercises are a form a form
of meditation, for as I sensitize and focus myself to that single raisin
or to water or to the particulars of a scene, I prepare myself and renew
my habit to be aware of, to be mindful of, to appreciate, and to focus
intently on each immediate moment and person.  And so, over the years,
I've developed the habit that when I walk across campus, down the halls,
into a classroom, or into a workshop room, I see and listen to nothing but
"sacred ones."  And believe me when I say the more "sacred ones" you
delight in, the more people you consider to be a reason for comfort and
joy and blessing, the more blessed joy will comfort you.

        The medical examing board recognizes that poor communication leads
to poor clinical practice and poorer outcomes for patients.  If we
teachers do not understand ourselves as communicators, we won't accept
that our first responsibility is to be effective see-ers and listeners.
Let me put it this way.  If you don't sincerely care about the person as a
sacred individual, you won't truly want to take the time and make the
sincere effort to see and listen; and if you won't take the time and make
the sincere effort to see and listen, you won't get to know the student;
and if you really don't know a student beyond knowing a name, you won't
appreciate a student; and if you don't appreciate a student, you won't
truly understand a student; and, if you don't understand a student, you
will tend not to have high regard for and tend to disregard him or her no
matter what you say.  Then, your academic diagnosis, prescribing, and
prognosis will fall back on labeling, on too often existing impersonal,
disconnected, disrespectful, distorting, and denigrating stereotypes,
assumptions, and preconceptions.  And when the student doesn't do what you
demand or expect, you'll put all the blame on him or her while exonerating
yourself.

        To paraphrase Pearl Bailey, for a student to talk to a teacher
whose door is closed is enough to tie the devil up in knots.  No, the best
way to understand and deal with students is not to talk about them, it is
to see and listen and stay intently aware and mindful of each of them.
Now you may not see eye to eye with a student, but listening ear to ear
and seeing heart to heart will have a far better chance of unleashing
potent forces of change and transformation seldom dreamed of.

Make it a good day.

                                                       --Louis--

Louis Schmier                            www.therandomthoughts.com
Department of History                    www.halcyon.com/arborhts/louis.html
Valdosta State University
Valdosta, Georgia 31698                    /~\    /\ /\
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