Transcriber: Jack Gillespie Reviewer: David DeRuwe
Hello, I’m Julie Byerly,
and I am grateful for the opportunity to speak with you today.
I’m proud to be the dean of the Geisinger Commonwealth School of Medicine,
and I’m also a pediatrician.
And what I would like to do today is tell you four short stories,
true stories that have happened to me in my career
and that have helped me to learn to listen.
Early in my career, I focused my work in pediatrics, in clinical medicine,
and I worked in many clinical places,
but especially the pediatric emergency department.
And one evening during rotavirus season, before the rotavirus vaccine,
I had had a very busy shift.
My shift was to be from 3 to 11, I had worked endlessly that whole time,
and in fact, it was about 1:20 in the morning
when I was seeing what seemed to be the 100th patient of my shift,
who was presenting with vomiting, diarrhea, and dehydration,
like rotavirus tended to do before the vaccine.
I had become quite accustomed to managing those patients,
assessing for dehydration,
and beginning their resuscitation therapy if necessary for that.
And clearly I was tired, and clearly things were busy,
and I saw at 1:20 in the morning, a toddler brought in by his mother,
who was definitely dehydrated and had lots of vomiting and not diarrhea yet,
but I had the impression that surely that would start,
and he was yet another rotavirus patient.
His mother was telling me the history, when I rudely interrupted her and said,
“Yes, yes, yes, we are full of patients with gastroenteritis,
and we will begin his rehydration.”
That brave mother, who was even shorter than I,
English was not her first language,
she had to feel somewhat uncomfortable in our busy setting,
and in response to my rude behavior,
that brave mother put her hands on my shoulders
and said “Doctor, listen to me,”
and she sat me down in the chair in the room,
and she said, “Something is wrong with my child.
My child does not just have a stomach bug. Please look more closely.”
I took a deep breath, I listened to her, I better assessed the child,
and with the help of a care team,
we diagnosed that child with something very rare
for a two-year-old to present with.
In fact, it was a congenital diaphragmatic hernia that had not yet presented.
That mother saved her child’s life.
I was so thankful she demanded I listen.
Later in my career, I began to focus my work on adolescents;
adolescents with depression and anxiety were common patients that I saw.
I actually thought that I was pretty good
at taking care of patients with anxiety and depression.
And one thing that you’ll definitely learn in medicine is when you think,
when you get a little too confident, you’re always taught a lesson.
So I was a little too confident, perhaps,
with this teenage girl that I had been working with on her anxiety,
and I really had thought that she would respond
to the typical therapeutic measures
that I put into place and that we would work on together.
Reasonably far into our therapeutic relationship,
she probably could sense that I was feeling a little frustrated
that she wasn’t getting better like I expected her to.
That brave teenager looked me in the eye and said,
“Doctor, listen. I am not anxious.
I am in the wrong body.”
That young person helped me to help him get the care that he needed.
And sure enough, those symptoms went away that I was attributing to anxiety.
I was really thankful that he taught me to listen, that he demanded I listen.
He made me a better doctor.
Later in my career, I really focused in education
and I worked a lot with students, and in my work with students,
sometimes concerns would be raised about mistreatment
or how members of the community talked to one another.
I wanted to respond to those complaints very appropriately
and maintain a high level of professionalism in our community.
In one such situation where concerns had been raised,
I thought that I was appropriately dealing with those concerns
by helping a person who was making others in the community uncomfortable.
Clearly that situation was challenging to the class,
and a very strong student leader bravely came to me and said,
“Dr. Byerly, you are not hearing us.
Listen, this situation is dangerous and of concern”
I responded differently after hearing her demand that I listen,
and I appreciated her leadership,
and her leadership led to a much better environment for our school community.
And I was grateful for her telling me to listen.
Later in my career, I had a boss who I respected very much,
and in a meeting with him that was actually my annual review,
I was listing off what I perceived
to be my administrative accomplishments of the year,
and I was describing one situation that I had worked on,
and the words came out of my mouth,
“And this was hard because so forth and so forth and so forth.”
And then I described a second situation that I had worked on, and I said,
“And this was hard because of this, that, and the other.”
And a third situation I described to him as,
“This was hard because of this, this, and this.”
He interrupted me to provide constructive feedback
and he said, “Julie, listen.
You are supposed to be working on hard things.
That’s what leaders do. Easy things should just happen.
You should make those happen without much leadership energy.
Your time and attention as a leader should go to the heart of things.
Don’t tell me things are hard.
They should be if you’re spending your energy on them.”
That constructive feedback when my boss said, “Listen to me”
changed my perspective on the work that I do
and inspired me for future encounters.
I am so grateful for those four individuals
with whom I have had memorable encounters who used the word “listen.”
I have learned from them, for my ears to perk up,
for my attention to focus when someone says, “Listen.”
That brave mother saved her child’s life.
That courageous teenager demanded that I tend to his needs.
That student
protected her classmates with her courage as she demanded that I listen
and recognize the situation that I had previously under-perceived.
And my boss really changed my outlook on administration when he said, “Listen.”
For those conversations and the use of that word, that powerful word,
“Listen,” I’m so grateful.
So of course, a message for you that I would like to share
is to listen when people demand that you do so,
but a more important lesson that I’m trying to learn,
and that I hope to share with you,
is to listen, even when not demanded to do so.
When I reflect upon these four stories,
I’m thankful again that my attention was demanded,
but I also have a little angst myself about what I missed along the way:
What should I have heard?
What could I have learned if someone would have asked me to listen?
What I’m trying to learn now is to listen without being asked to do so.
Thank you.