265. Complexity to Connection: Humanizing High-Stakes Communication

[00:00:00] Matt Abrahams: Moments lead to movements, which lead to momentum. My name is Matt Abrahams and I teach strategic communication at Stanford Graduate School of Business. Welcome to Think Fast Talk Smart, the podcast. Today I am super excited to talk to my friends and mentors, Jonathan Berek and Phil Polakoff. Jonathan is a renowned gynecological oncologist. He is a professor at Stanford School of Medicine and a former chair of the Stanford Department of Obstetrics and Gynecology. In addition to his extensive medical career, he is an active documentary filmmaker, creating and directing films on medical topics with a focus on patient stories. He's also the faculty director of Health Communication for the Stanford Center for Health Education, where he promotes effective medical communication and health media.

[00:00:48] Phil is a distinguished health transformation advisor, a consulting professor at Stanford School of Medicine, and a widely published author. With a career spanning 45 years, he has held diverse roles from a nominee for US Surgeon General to CEO of his own nonprofit, A Healthier WE, which is dedicated to improving health. He's the author of 5 books and more than 200 articles, making him a leading voice in healthcare innovation, policy, and administration. Welcome, Phil and Jonathan, I am really excited to have you here. It's been a long time coming. Thanks for joining me. 

[00:01:20] Phil Polakoff: Thank you.

[00:01:21] Jonathan Berek: Thank you very much. 

[00:01:21] Matt Abrahams: Shall we get started?

[00:01:22] Jonathan Berek: Yeah, absolutely. 

[00:01:23] Matt Abrahams: Awesome. Beyond being medical professionals, you each have worked hard to draw attention to and solicit money for important healthcare issues. Jonathan, can you share a bit about your work to bring attention and funding to women's cancer issues? 

[00:01:37] Jonathan Berek: Yeah, so when I came to Stanford 20 years ago, I realized in putting together the Stanford Women's Cancer Center that we needed more than just governmental funding. I put together with the help of many women, in particular, in the Stanford area, a philanthropic project called Under One Umbrella, where we raised money for women's cancer research. Those monies have been used to recruit people to create endowed professorships and also support our clinical research trials group, as well as giving out innovation awards. And that's really helped to improve our research capabilities and all the activities at Stanford Cancer Center. 

[00:02:20] Matt Abrahams: People around the area and around the world have benefited from that work. So thank you on behalf of all of them. Phil, your turn. Can you share a little bit about what you've been doing to highlight healthcare inequity issues?

[00:02:31] Phil Polakoff: I go back in a different direction, not better or worse than my friend Jonathan's. Mine's a little bit more holistic on the word health. In 1948, the World Health Organization put forth, there's definition of health. Health is a state of complete physical, mental, social, and I inserted the word spiritual, wellbeing, not merely the absence of disease or infirm. So I'm looking at how people improve their health, and I've seen healthcare and sick care through all the different lenses.

[00:02:59] So the challenge has always been how do you effectively have change transformation, which is not easy. Early in my career, I was a clinical investigative officer for the CDC Centers for Disease Control. I traveled around this country with a new organization called the National Institute for Occupational Safety and Health. And I got to see both urban and rural issues, and that's where my passion's been, to see the three Ps. Practicalities, policies, and political will. For me, the real opportunity now is can we cross the chasm and bridge the gap so it becomes for all of our society. 

[00:03:34] Matt Abrahams: And that work has been really important in the past and even more important today.

[00:03:38] Phil Polakoff: It's mission critical now, crisis to opportunity. 

[00:03:42] Matt Abrahams: Absolutely. Not only are you both steeped in the medical business and world, but interestingly, you both use very effective communication tools to bring your message to the public. You both, for example, use film. I'm curious to learn your thoughts on the importance of storytelling to move and motivate people, and what goes into a good story. I know Jonathan, for example, you've directed many films. I'm curious to get your take on storytelling. 

[00:04:07] Jonathan Berek: When I was an undergraduate student, I was very involved in creative writing. I wrote plays, short stories, and I was very involved in the theater, did a lot of acting, directing, and actually for a while thought I was going to end up in the theater, but decided to go to medical school after all. But what I learned during that time is the value of storytelling and how powerful it is in terms of engaging people with a message. Sometimes much more valuable to do it that way rather than just write it out. I had the opportunity in the past couple of decades to get into filmmaking as more as a hobby originally, although now it's become a passion, and I do a considerable amount of filmmaking, mostly short documentaries.

[00:04:51] People are more likely to listen to something that's in a film than they are in the written word. I think it's part of our culture now because we're the television film generation. People feel the emotion when they see a story. In my case, I do a lot of medical related types of films and I use patient stories, which tears at the heartstrings often, and I think that gets the message across more than if I were to just say, well, I'm doing this little science project. And there's this molecule, and we're trying to do that, and people, their eyes glaze over. But if they hear a patient's story, if they hear someone saying, I took this drug, or I was on this medication and it gave me a remission in my cancer, people get that. They understand and they think, wow, this is a very important medical advance.

[00:05:42] Matt Abrahams: So I hear a couple things in that response. One is storytelling that has emotion can really connect to people, and storytelling that is personal, that brings it down to an individual level, can really help with that connection. Phil, you have also used film and media to really move people. I recall watching one of your films talking about Appalachia, and things going on in healthcare, and was very moved and part of what impressed me so much was actually seeing the things. It's one thing to read it. It's another thing to see it. What's your take on the importance of storytelling and what makes for a good story? 

[00:06:16] Phil Polakoff: I find it intriguing, or the intersection between Jonathan and I, our evolution was almost along a similar path. In the process I started doing radio shows and back then I found they were more interactive than podcasts today 'cause I would get questions from the audience. And then I saw it being a little different than Jonathan, but I was heavily involved in politics. So at a very young age, while he was doing his surgical training and his academic and all that, I was running for Lieutenant Governor of California when I was 32.

[00:06:48] So you realize that you had to be empathetic, but you had to say things that were very precise and very short on words. So that's my pearl. I now have the trifecta of words. So it could be what are the three most important thing in one's life? It's relationships, it's service and purpose. Two, how do you deal with social issues? You listen more, speak less. Three, think bold, start small. Move with passion and purpose. Because people don't have longevity. 

[00:07:19] Matt Abrahams: So a lot of insight there. So being concise and clear, highlighting bright spots are ways to enhance a story so that it's memorable. You are embodying, Phil, a saying my mom has, which is to tell the time, don't build the clock. Be very concise. Be very clear. One of the things I have enjoyed in our, in getting to know you and having you as friends and mentors is you both have really nice communication styles that are really effective. You're just both affable, super bright, and very articulate. Do you have advice for people on how they can be better communicators? You're around a lot of people and you see a lot of people communicate. Phil, are there a few things that you would recommend, suggest, advise people to do to improve their communication beyond being concise and clear? 

[00:08:04] Phil Polakoff: Coming in front with Jonathan and you, I thought about what was important. Make sure you do your homework ahead of time and have the questions distilled. Find mentors in your life that can help you and look to have opportunities that are outside of your comfort zone. 

[00:08:20] Matt Abrahams: Lots of goodness in that statement. Jonathan, one of the things that's always impressed me about you is you are able to take very complex, often scientific information and make it very relatable. Can you share how you do that so we can all benefit? What are some of the things you think about to make the very academic, very scientific information something that we can all understand and access? 

[00:08:41] Jonathan Berek: I guess the first thing I think of is the process of what some people call leveling, which is be sure that first of all, you know your audience. And so, you communicate in a style and with words and phrases that you think will connect with that particular audience. When you're speaking to a lay audience about a complex medical issue, you don't speak down to them and you don't speak up to them. You try to get to their level, and that's the best way to connect. 

[00:09:08] Matt Abrahams: Absolutely. And one of the things that you do, and I'd love to get Phil's comment on this as well, you listen very well. Many people I know with the accolades and backgrounds, such as you both have, almost use listening as the starting gun for their talking. Jonathan, you and I, we met, uh, you were a student in one of my classes and I was so impressed right away with how you listened to our MBA students who, whose life experience is very different than your life experience was at that point. And yet, you would listen, you would acknowledge what they said, and then you would connect to it. How important is listening in all of this? 

[00:09:42] Jonathan Berek: Well, I think the two most important skills in communication are empathy and listening. And they are related because you demonstrate empathy through listening and of course, other phrases that you use to connect with people with whom you're trying to communicate. You have to have an open mind and an open heart, as they say, when you communicate with people. I think a couple of things that Phil said are important to emphasize. Doing one's homework, being prepared is critically important, and to quote an actor who says the other important thing is show up on time. It really has to do with demonstrating your availability and your awareness of the circumstance and the situation, so people take you serious. That's very important when you're communicating to an audience. 

[00:10:31] Matt Abrahams: You're showing respect and you're showing that I'm here for you. Phil, talk to me a bit about your perspective on listening and empathy, and you're expert at both, I'm curious. 

[00:10:40] Phil Polakoff: As you get a little older, two words have more impact to me than they used to, and I've gotten to the point where I'm patient, but I like a yes or a no. I don't like ambivalence or ambiguity. If you don't want to do it, that's okay. And if you do, don't constantly ask for something without telling what you get as your deliverable. Doesn't matter if it's academia, philanthropy, but make sure there's some tangible, definable results that you believe in as you contribute to someone else's efforts. 

[00:11:13] Matt Abrahams: What I'm hearing in what you just said really is about this notion of clarity. Clarity of the connection you have with the person, and taking the time to find those connections, and then clarity in the actions and communication. Jonathan, I wanna come back to one thing that you and I have collaborated on, along with my friend and your friend, Adam Tobin. You invited Adam and me to, and Adam has been a guest on the show before, to help bring ideas from the world of improvisation into the medical profession. Rather than build that whole story up, I'm just curious for you to share why you believe tenants from improv can be so important in, in really high stakes communication situations, such as a medical professional with a patient. 

[00:11:54] Jonathan Berek: When we first promoted this idea, of course, my colleague said to me, improv, I don't wanna do standup comedy. And I said, well, just think about it this way. Every interaction you have with a patient, you improvise. You improvise what you say. You talk around it. You don't have a script, you may have an idea of what you're gonna talk about, but the advantage of practicing a situation where you're improvising within a group is that it allows you to get more in touch with your ability to improvise so that when you're in a difficult situation with patients or others, it helps you refine your skills. And people got the notion and the sessions that you and Adam ran were very popular, very well received, and they got the message. Yeah, this is helpful, and a lot of people afterwards said, this really improved my communication skills. 

[00:12:42] Matt Abrahams: The point that I wanna echo for everyone is that you can practice spontaneity, right? You can put yourself in situations, learn some rules, and that can really make a difference. Because if you think about it, most of our communication is spontaneous, it's not planned. And in high stakes situations, having that preparation can help. And I appreciate that you invited us to do that. You are both examples and role models of people who've pivoted or expanded their work later in their careers. As I'm getting older and hopefully, perhaps a little wiser, I'm curious about your thought process behind the choices you made and the moves that you made. Did you always know you wanted to become advocates or did you discover this on the way? And how has this felt and how have you communicated this change to other people? A lot of people change and pivot as they get older, but we have to explain it. Phil, how have you always thought that this is where you wanted to end up? 

[00:13:31] Phil Polakoff: I don't think that's exactly my thinking. My thinking was how do you, as I said earlier, have a role in making meaningful transformation change? I think what I learned is it's less about I and more about we. There's another line that people can use in these times, if I is replaced by we, even illness becomes wellness. Only working together, will we have a healthier society. I tried many different ways, working for large healthcare corporations, looking for large corporations, the government, not-for-profit, academia, and I think what I did is I did not have enough laser focus on fewer initiatives because if you want to get something done, you have to be laser focused. And you can't be a clinician and a politician and see patients at the same time you're trying to be an entrepreneur because you lose focus. The other thing is I think I would've benefited by some executive coaching.

[00:14:25] So right now I'm much more laser focused given the challenges we're facing on trying to have a petition sign to make health a basic human right and get this to be a bipartisan hearing in Washington so people can collectively think it's their process, not mine. Maybe we take it initiative, but you get from moment to momentum to movement. Three M'S are not easy to go from A to B to C. So you have to have the passion, but also as you get a little older, and I'm not speaking for Jonathan, moderation's a pretty important word. Don't think you can do the same thing you used to do. I was a competitive athlete. You cannot be on a rugby field all over the world again, playing rugby, it's a little bit too much. So pace yourself and have fun. I mean, I think that you're talking about empathy on, tears are great, and I don't have a problem tearing in public, but it's also nice to smile and be happy.

[00:15:21] Matt Abrahams: I like that idea of seeing interactions as the beginning of the next conversation. The ability to be focused, to moderate what you do, to have fun. That's all great advice and I hope everybody is listening to how Phil uses words. I love I to we, illness, to wellness, from moment to movement, to momentum. These are all ways to help us not just remember, but to feel a sense of ah-ha or motivation. Jonathan, tell me about your decision and arc and how you've communicated that focus. 

[00:15:52] Jonathan Berek: I think as I progressed in my medical career and matured, hopefully, during that process, I was trying to look more at the big picture. You know, when you're laser focused on taking care of patients and doing research, in my case, cancer research, you have to be very dedicated to the process, but as you mature in the field, you learn the importance of mentoring others. Obviously, when I was younger, I desperately needed mentors, and I learned from that experience. I learned from you and others in the communication field. So in a way, you served as a very important mentor at the time when I needed it. 

[00:16:32] Matt Abrahams: One thing I heard both you say differently, you talked about mentors and finding mentors, and you talked about coaches and finding coaches. It's not a single act. You have to have others to help you, and you both have served as mentors for many people, including myself, and I am greatly appreciative of that. Before we end, I always ask three questions. One I create just for you, and two, I've been asking everybody on the show. Are you up for that?

[00:16:54] Phil Polakoff: Always. 

[00:16:55] Jonathan Berek: Go for it. 

[00:16:56] Matt Abrahams: Excellent. Phil, looking back at your career and success and you've had many successes, and in your case, many careers, what is one thing you wish you would've known when you were younger that would've helped you along the way?

[00:17:08] Phil Polakoff: Social interaction. The best thing that ever happened to me is when I married my wife, who's my hero, and that changed my path of direction. 

[00:17:17] Matt Abrahams: So making those social connections and being open to them. Same question to you, Jonathan. What is one thing you wish you would've known that would've helped you along the way?

[00:17:26] Jonathan Berek: How to be smarter. I think when you're young and you're invincible and you think that whatever you do is okay, you have to learn to be much more circumspect and it takes a while. That's part of the process of growing up, becoming a mature human being. 

[00:17:42] Matt Abrahams: So learning to question and learning to be empathetic earlier. Jonathan, who's a communicator that you admire and why? 

[00:17:48] Jonathan Berek: Phil Pizzo, he's probably one of the best communicators I've ever encountered. His ability to speak extemporaneously is quite extraordinary. Virtually every time he gets up in front of an audience, afterwards, people, oh my goodness. That's incredible.

[00:18:05] Matt Abrahams: Phil, what are the first three ingredients that go into a successful communication recipe? 

[00:18:11] Phil Polakoff: Being invited to participate, reflecting and stepping back, and pause for a moment. And three, to make it a communication process. The three I's. Interactive, interconnected, and interdependent, and that it's the start, not the finish, of a dynamic, meaningful interaction.

[00:18:32] Matt Abrahams: All three of those ingredients, although you slipped in five there, really, are really important. The one I wanna highlight for everyone is the reflective piece. Taking a pause, taking a beat. A lot of us in our communication rush through it. I'm glad we did not have to rush through today. And to your point, this is just the start of hopefully a deeper conversation among the three of us, but also everybody listening to take away the advice from you. Find mentors and guides. Think about how you tell stories and connect. Make them concise. Make them empathetic. Gentlemen, thank you. This was a true pleasure. I'm glad we finally made it happen. Thank you.

[00:19:06] Phil Polakoff: Thank you.

[00:19:09] Matt Abrahams: Thank you for joining us for another episode of Think Fast Talk Smart, the podcast. This episode was produced by Katherine Reed, Ryan Campos, and me, Matt Abrahams. Our music is from Floyd Wonder. With special thanks to Podium Podcast Company. Please find us on YouTube and wherever you get your podcasts. Be sure to subscribe and rate us. Also, follow us on LinkedIn and Instagram. And check out fastersmarter.io for deep dive videos, English language learning content, and our newsletter. Please consider our premium offering for extended Deep Thinks episodes, AMAs, Ask Matt Anything, and much more at fastersmarter.io/premium.