This weekend my son, Ayrie, had his 21st surgery for a rare disease, Juvenile-Onset Recurrent Respiratory Papillomatosis. JORRP causes benign tumors to grow aggressively and quickly on his vocal chords, often robbing him of his voice and threatening to block his airway. He’s 4 and it’s been 11 weeks since his last surgery. Not as good as we had hoped for but better than the 4 weeks that we used to have between surgeries. His voice is non-existent right but his body seems to be recovering well.
After a series of hospitals and surgeons we have chosen to see Dr. Hartnick at Mass Eye and Ear Infirmary in Boston, MA, a Harvard specialty hospital. So a few weeks ago when I started to hear some stridor (sort of a squeaky sound when Ayrie was breathing in) I emailed Dr. Hartnick and we picked a surgery date that I was comfortable with. It’s always a hard call to decide when to have surgery… I want as few as possible because who knows what the impact of all of the anesthesia and surgical procedures are having on Ayrie? But on the other hand, I can’t wait so long that he needs a tracheotomy.
So we picked the date and I bought the very expensive plane tickets ($1,250 for the two of us) and paid for them with the money raised by my friends and donated by caring people near and far. (Thank you Friends, Family, Richard, Christa & Running for Ayrie!)
I’ll you spare the details of the horrendous flight and get to the realization I had about listening… Perhaps if I read more I would see that this has been written about to the point of exhaustion, but for me it was a flash of insight.
I met with one doctor who asked a lot of questions. We sat across from each other with Ayrie’s bed between us in the hectic atmosphere of the pre-surgery galley. He asked me questions and looked me in the eye when listening to my responses. To any observer, he seemed to be taking his time and giving respect to my responses. But I realized that he wanted to be in full control of the conversation. He would cut me off (politely) if I strayed from the original question. The focus of our exchange was narrow and completely dictated by him. I felt that there was a power imblalance and that even though he was technically listening, he didn’t want to hear my version of the story. I left the encounter feeling like there was something missing. I felt… perhaps treated like a child?
After the surgery I met with Dr. Hartnick who people (families, nurses, other doctors, social workers, etc.) unanimously seem to feel is an excellent communicator. He gave me a quick recap of the surgery and then, in a very relaxed fashion, turned the conversation over to me. I asked my questions and he treated each on as important, and made sure that he answered them to my satisfaction. We looked at the surgery photos and had a back and forth about what we were looking at. He asked questions like, “Does that makes sense to you?” I felt like there was equal power and that we were partners in the conversation. Before leaving he asked me to follow up with him in a few days by email with my impressions of how Ayrie was healing. When he walked away I felt valued and empowered.
Once again I am struck by the relationships between education and health care. In education it seems to be believed that a constructive classroom is the most effective. The teacher frames the learning and acts as a facilitator, but the students are in control. The teacher knows some of the boundaries of the learning experience but never knows quite where the students are going to take their actual learning experience. In the end, the teacher (who may be quite an expert in the given subject) and the student usually end up learning a great deal, some of which might even be surprising! But even though constructivism can create a very powerful learning environment and exchange, it is rarely done well. Teacher are often afraid to give up the power (what will happen? what will the learn? w hat won’t they learn?) and students are often ill-prepared to take ownership of their own learning even when given the chance. Sound familiar?
