What I learnt this week: It’s not what you say it is how you say it #WILTW

This is the twelfth #WILTW

What could directly link a peer reviewed academic article in a medical journal and a comedy sketch on eyebrows?

The importance of being able to read facial expressions.

One of my favourite comedy sketches is performed by Jim Eion

Published in the Emergency Medical Journal last month was this article 



Essentially patients with serious heart diseases lacked facial expression variability and surprise in response to certain stimuli which should provoke grimacing/laughter etc. I am uncertain at the moment what implications this will have for medical practice in the future but I am sure it is an important finding.

I try to stress to the junior doctors in our department, especially as we have a completely new set with us for the August handover, that it is important not just to take a history but really listen to what is being said. Often parents of children who are unwell have concerns that they don’t always fully express with words. Furthermore a great deal of communication is delivered through body action and facial movements rather than actual language. For example the subtle withdrawn demeanour of the mother who has post-natal depression is only noticed if you are actively observing for it [Further examples of this can be found in my quick guide to managing the febrile child]

It is not just with patients that observation of facial expression is vital. In dealing with colleagues at meetings and handovers it is vital that you are constantly observing the way things are said as well as what is said. The inability to read others tone and facial expression is a common reason for the development of poor working relationships in my humble opinion.

The next time you talk a history from a patient or have a discussion with another speciality: Are you just listening to what is being said or watching as well?

What did you learn this week? #WILTW

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