Learning to navigate difficult conversations is one of the toughest parts of medical training. One of the encounters that taught me how to approach these discussions happened a couple of weeks ago, and it occurred on the way to San Francisco via a ride-sharing app.
During the trip, the driver and I struck up conversation about medical training. She was excited to ask me about my medical education and to learn about my experience.
As our conversation progressed, we talked about her encounters with the health care system and she told me that she recently became a mother. She then informed me that she is firmly opposed to vaccination, and that she had chosen not to vaccinate her children.
Having had little experience discussing this topic, her words triggered a flash of activity in my mind. I began building a mental argument with the intent of changing her opinion, and I worked to recount every fact I know about the effectiveness and safety of vaccines.
Just as I was prepared to present my case, she told me how grateful she was to be able to talk to someone who would listen to her. In this moment, I realized that confronting her with facts and arguments would only damage the bond we had developed. Accepting that confrontation would end our dialogue, I told her that I appreciated her openness, and I invited her to tell me more about her decision to not vaccinate her children.
Over the next couple of minutes, she told me stories about negative experiences she’d had as a patient and as a mother. In hearing this, I realized that her decision to forgo vaccinations for her children stemmed from a deeper distrust of modern medicine.
For the remainder of the ride, we talked about the value of trust in patient-provider relationships and the importance of primary care in supporting children’s development. Ultimately, I don’t think I convinced her about the safety of vaccinations. However, I think our conversation gave her a chance to look at medical providers in a new, more trusting, way.
This experience has stayed with me because it taught me how valuable it can be to develop a bond with a person, even over a short time. Moreover, it showed me that although it’s tempting to try to change person’s mind about a single decision, it can be far more fruitful to instead create a safe space for open dialogue.
John George Douglas Cannon is a second-year MD student at Stanford hailing from Toronto. His interests include health care delivery and clinical research.
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