Talking to the wall

"Why do people turn round and read the screen?"

Someone from a hospital leadership team asked me that last week.

I started to give the easy answer.
It's how they were shown.
They don't know any better.

Then I stopped, because that isn't true.

A group of health professionals were recently asked what makes a good presentation. I read their answers. Almost every one said the same thing in a different way.

Don't read the slides.
Face the room.
The speaker matters more than the screen.

Everyone knows the rule.
Most of us will still break it the next time we stand up.

So this isn't a knowledge problem. It's an instinct.

💡 ONE IDEA WELL

When I give a talk about the child who has fainted, there's a slide I always reach.
It's an ECG.

Most children who faint are fine. The ECG is how we find the few who aren't.* So I want the room looking at the right things. The QT that runs too long. The delta wave slurring into the start of the QRS. The coved ST segment in V1. (If none of that means anything to you, good. You're now the audience.)

None of that can be pointed at from the front of the room. I am not a weather forecaster in front of a green screen. I can't wave a hand behind me and land on the end of a T wave.

So I walk to the screen and put my finger on it.
That part's fine. The room needs to know where to look.

The trouble is what happens next.

I find the T wave. I start counting small squares. And I keep talking, to the screen, because my finger is on the ECG and my face has followed it.

By the time I've finished explaining the QTc, I've been talking to the wall for a minute.

The room is behind me. I can't see who followed the T wave and who lost it three squares back.

I don't notice until I turn round.

* And don't forget to check the blood sugar too.

🧰 LESS MESS, MORE MESSAGE

Watch the wall at a soccer free kick.

A row of grown professionals, paid to stand in the way of the ball. They know it's coming. They know roughly when. Some of them have done it hundreds of times.

And as the striker kicks it, some of them turn their backs.

That isn't a decision. When something is coming at your face, your body turns away first and asks questions later.

But keep watching. The ball hits the wall and drops, and it's still in play. The good defenders have already spun back round to find it. The others are still facing their own goal.

Turning isn't the mistake. Staying turned is.

The screen makes staying easy. It's the one thing in the room that can't look back at you. Once you've turned to it, nothing pulls you round again. The room is full of eyes, and the screen is quiet.
So you stay.

When my daughter started playing soccer, she shut her eyes and turned away whenever the ball came near her face.

She still turns away. Her body hasn't forgotten how to protect her. But now she spins straight back to find the ball, ready to kick it upfield.

The flinch stayed.
The return is what she practised.

⌨️ TRY THIS

Next time you rehearse, watch for the turn.

You'll still go to the screen. Let yourself. Find the thing, put your finger on it, then come back to the room before you say what it means. The screen shows them where. Your face tells them why.

On my ECG slide it sounds like this. Finger on the delta wave. "This slur, here." Turn round. "That's an extra, accessory pathway, the bundle of Kent, and it's one of the reasons a heart can race."

If you build your own slides, you can make the screen do some of the pointing. A circle that appears on the click. An arrow to the end of the T wave. Laser pointers are for cats.

Then practise the return until it's boring. It'll feel clunky the first few times.
So did spinning back to the ball.

🧭 ASK YOURSELF THIS

How long do you stay turned?

Forward this to someone with an ECG in their next talk.

​
Speak soon,

Andy

PS. My daughter has learned to come back. I haven't. Every time a ball comes near her face, I still flinch on the sideline.