Review by Liza Pine
“It is the province of knowledge to speak, and it is the privilege of wisdom to listen.” – Oliver Wendell Holmes, American physician, 1809-1894. So begins the epigraph to chapter 1 of Dennis Rosen’s new book, Vital Conversations: Improving Communication Between Doctors and Patients. This strikingly apt quote reflects Rosen’s message: the key to improving communication between physicians and patients is to truly listen to each other.
Rosen draws upon personal experience, literary texts, theories of anthropology and sociology, and research to explore various issues in doctor-patient communication. Readers will be able to see the real complexities of communication due to differences in culture, language, socioeconomic status, literacy, and health literacy. Rosen is a seasoned guide to these issues since he has been a patient, healthcare provider, and trainee in at least three different countries.
Many of the book’s best moments are when Rosen uses personal anecdotes to illustrate the feel of miscommunication. In one story, he describes a busy night at the neonatal intensive care unit during his pediatrics residency in Israel. After helping to deliver a set of premature twins, Rosen entered the waiting room and proudly relayed to the newborns’ extended family the technical details of how he had intubated and ventilated, run tests and ultrasounds, and performed many other actions to stabilize the infants and ensure their safety in new life. Rosen explains, “For at least ten seconds after I finished speaking, they all just stood there, staring at me silently with unreadable expressions on their faces…
‘Aval doktor, kama hem shoklim? [But doctor, how much do they weigh?]’”
Rosen is an important role model; he is willing to show vulnerability by detailing mistakes and miscommunications he has made in his own practice of medicine, illuminating his own reactions and explaining the ways he learned from them. In describing his sometimes painful learning process, Rosen also provides his readers with concrete skills to improve their own communication.
Overall, Vital Conversations is a successful synthesis of theory and practice. Throughout the text, Rosen offers both hypothetical long-range solutions and current strategies to empower all participants to improve their experience within the health care system. He concludes by speaking directly to patients and physicians. He provides a list of ways patients can “take charge of the visit.” He reminds physicians of the importance of nonverbal communication, recommends ways to involve patients in their own care and says that above all, they should be be compassionate and empathetic.
Vital Conversations is a thoughtful and accessible read for providers and patients alike – anyone who is willing to listen.
Liza is a 2014 graduate of Wesleyan University where she was a Neuroscience & Behavior and Spanish double major. Liza is an intern at the Arnold P. Gold Foundation Research Instititute and is interested in medicine as a way to form relationships and enact social change
