Anagrams for eHealth

O Draconian Devil!
Oh lame saint!

In his book, The da Vinci Code, Dan Brown introduced many to the word ‘anagram’. Tom Hanks, playing Robert Langdon in the movie version of the book, was unbelievably adept at transforming that phrase into ‘Leonardo da Vinci, the Mona Lisa’ (personally, I had to suspend my disbelief so far that I needed SCUBA gear!). I often look at the Jumble puzzle in the newspaper and realize that even six letters can be challenging to rearrange into an English word. However, Robert was clearly a savant and did it with all those letters in seconds.

I guess it is clear by now what an anagram is. The definition is: “a word, phrase, or name formed by rearranging the letters of another, such as ‘cinema’, formed from ‘iceman’.”

As this is not an article about movies and I don’t intend to award stars or thumbs up or down, I should explain the relevance.

Among the many challenges confronted by those who of us who work in the eHealth field is enlisting others to participate in projects
that require significant effort and a redirection of their own priorities. That’s a tall order, and those gifted with the skills to do this are among our most valuable confrères. A six-letter anagram might help the rest of us become more competent in engaging others in crucial work.

The objective of the exercise is to motivate others, most often who are themselves involved in consuming professional activities, to orient their efforts in another direction. We may need physician-participation in the definition of the content of a medical record or in the use of a newly implemented system, as examples. Perhaps another important effort is to secure an individual’s commitment to lead a project, despite his or her current duties. So let’s start with the word ‘enlist’.

‘Listen’ is an anagram of ‘enlist’. It’s a convenient one because, in order to engage anyone in anything, including our thinking, we first have to listen to them. Books on negotiation spend many pages explaining that we need to understand the principles and perspectives of those with whom we negotiate. How can we do that unless we first listen?

Listening is extremely difficult. We all want to talk, not listen! We know we have something we need to say, but we are not yet aware of the nature or importance of what the other will say. Listening is a discipline. A crucial skill of a therapist, for example, is the ability to listen. The therapist must listen to the client’s problems, must listen to learn what is important to the client and to hear what has disturbed the client. Physicians have a particular problem with listening, as research has shown. Patients start talking about their problems and are often almost immediately interrupted either with questions or with comments. One article pointed out that, when asked why they did this, physicians often reported that they thought the patient would just go on and on. However, left to their own, patients usually took less than three minutes to express themselves!

Listening is difficult in itself, but showing that I am listening is an even greater challenge. From my own personal experience, I can tell you that many have told me that I don’t seem to be listening. This is not my perception, but I realize that I sometimes do not look like I am listening. How many have been asked by a spouse: “Did you hear what I said?” Some of us have developed last-in-first-out emergency memory neurons that can be quickly dumped containing the last 5 or so words uttered. Unfortunately, we probably weren’t listening…after all, I was deeply into the Canadian Tire catalog… So it is important to learn what people have called “active listening”, where we give indications to the speaker that the input device (the ear) is open and the CPU (the brain) and the software (my attention and thought process) are all functioning. So, some attempt to game the system, simulating listening by repeating back what the person just said. I suppose, if this is in different words and is interpretive, it can be an adjunct to the body signals of the listener, but it can also be a frustrating gimmick.

Human beings seem to have a need to fill all of time with some sort of audible signal. We see this in our youth, who seem to need music delivered by earbuds to synchronize their motor centers to permit them to walk down the street. However, the hardest silence is that in a conversation. There is an almost uncontrollable urge to fill any gaps in a conversation with words – any words. Any therapist will tell you that being silent creates a space that magnetically, gravitationally or otherwise attracts words from the client and can create openings where clients express their issues. Police interrogators use silence, because it can cause the perpetrator to blurt out something incriminating or confirmatory of the interrogator’s hypothesis. Silence creates a vacuum that must be filled! Try it. No! Not when your partner asks if you know what today is!

The word ‘silent’, a third anagram of ‘enlist’, is a crucial concept in engaging others. We must be silent so the other person can speak and express him or herself. We must be silent at times so we learn what the other person really thinks and concerns the person may have, but might be shy to express. We must be silent in order to listen. When we are speaking we are listening to ourselves not to the person across from us.

Enlist, Listen, Silent
This is a simple message, but one that has been important to me in my own life and may potentially be important to you. Given the challenges we have in engaging others in the complexities of eHealth, these simple ideas transubstantiate into important ideas. Perhaps they will provide you with some additional tools.

Closing the loop
It’s worth noticing that there are other anagrams of ‘enlist’, including ‘tinsel’ and ‘inlets’. I thought it might be fun to play with these words also. That would work in the direction of perfection (or at least completeness), but, I think, would undermine the good. Also, there are many anagrams of enlist that have fewer letters, but, again, citing these seems to detract from the main message. I guess it
is also hard for writers to create the equivalent of silence, but today I shall now do so…