Elizabeth Poret-Christ (2s):
What I’m trying to explain to them something maybe they could have done differently. I say, as the patient or
family member, I heard you say this, so it’s not necessarily what you said. It’s the perception of what, you
know, I heard you say when this doctor to take the bad example, when he was saying that my husband was
circling the drain, he wasn’t trying to be callous. That might just be a medical term that he would use with a
colleague, but explaining to him how it felt to hear him say that might make him stop and pause in the future.
Elizabeth Poret-Christ (37s):
If he goes to say it to a non-medical person. So I’ve tried to really make my comments with the doctors and
the nurses that we train more neutral and more, you know, I’m explaining to them what the patient feels or
hears, as opposed to maybe what they’re trying to say. It doesn’t matter what you said, it’s it matters what
my perception was.
Announcer (1m 3s):
Welcome to difficult conversations lessons I learned as an ICU physician with Dr. Anthony Orsini. Dr. Orsini
is a practicing physician and president and CEO of the Orsini Way, as a frequent keynote speaker and
author. Dr. Orsini has been training healthcare professionals and business leaders. How to navigate through
the most difficult dialogues each week. You will hear inspiring interviews with experts in their field who tell
their story and provide practical advice on how to effectively communicate whether you are a doctor faced
with giving a patient bad news, a business leader who wants to get the most out of his or her team members
or someone who just wants to learn to communicate this is the podcast for you.
Dr. Anthony Orsini (1m 45s):
Well, welcome everyone to this episode of difficult conversations. This is dr. Anthony Orsini. I’m happy to be
with you again today. You know, one of the most exciting things of having my own podcast is that I get to
interview some amazing people from every field today. I’m especially excited because I get to interview
Elizabeth Poret-Christ. Liz is a dear friend of mine who I’ve known for, I think, eight years. She also works
with me at The Orsini Way, where she is director of operations.
Dr. Anthony Orsini (2m 17s):
Liz really runs the Orsini way. She’s involved in really every aspect of marketing, scheduling, and teaching.
And I know she already knows this, but I want everyone else to hear this without Liz, there is no, or see any
way it would not exist. So my would not do it without her. I asked Liz to be one of our first guests, because
she has an incredible story to tell actually several incredible stories to tell, and I’ll let her pick which one she
wants to choose to speak about. But Liz has been on the receiving end of several difficult conversations,
more than her fair share.
Dr. Anthony Orsini (2m 49s):
I might say what’s so amazing about Liz is what she’s been able to do with each and every life changing
situation. And what is most incredible about her. And thankfully, this is not a video podcast because I’m sure
I’m going to make her blush, but what’s most incredible about Liz is that she took every one of her
experiences good and bad and found a way to turn it into a positive and early on, she saw a contrast in
medicine between healthcare professionals who communicated with her beautifully and helped her in the
most difficult times and other healthcare professionals who just seem to make things worse with their actions
and in their words.
Dr. Anthony Orsini (3m 28s):
And so I was want to say, thank you, Liz, for being here. Thank you for all you do. And I think everybody is
going to be so excited to hear your story. So thanks for being on.
Elizabeth Poret-Christ (3m 39s):
Sure. thanks for having me, that’s quite an introduction.
Dr. Anthony Orsini (3m 42s):
I don’t give you too many compliments, but, but now that you’ve got a fat head, but you deserve every bit of
it. And I really look up to you and I think you’re an amazing person. And so I want everyone else to hear
about your story. So, as I mentioned in the introduction, you are the director of operations, which means you
do everything and you and I first met when you worked with me at the BBN foundation. And that’s kind of an
interesting story on how we met. You want to just go ahead and share that with everyone and just tell them
how you became involved in the parent advisory committee and how we were sure.
Elizabeth Poret-Christ (4m 17s):
So it’s my pleasure to tell this story. I was a very successful fashion industry person had a really great job
that I loved. They traveled internationally. And then in 2001, I gave birth to boy, girl twins. And as any parent
knows traveling, when you have little ones is super complicated. So I decided to stay home. And then in
2003 Annabelle was diagnosed with cystic fibrosis. So I was already a stay at home mom.
Elizabeth Poret-Christ (4m 47s):
And now I was the stay at home mom to a child with a medical condition and a pretty serious one at that. So
I felt the need to help and to become involved in my community so that I would have, I went, could go from
having no medical knowledge to at least being part of a community where I could get some. So I became
part of the family advisory council at our local children’s hospital. And as part of that, we were sent to a
conference in Washington to talk about the new patient and family care initiative that was being promoted
within our hospital building.
Elizabeth Poret-Christ (5m 25s):
So during that conference, I saw a presentation by a very large local children’s hospital that talked about the
use of experiential roleplay in teaching healthcare providers, what it felt like from the patient perspective.
And I thought that was so insightful to have doctors and nurses act like patients or family members so that
they could see what it was really like. And I thought it was such a great idea. I went back to our director of
our children’s hospital and said, I have a great idea have to do this.
Elizabeth Poret-Christ (5m 58s):
And he said, actually, there’s somebody already doing that. I want to introduce you to Dr. Anthony Orsini. So
I think I called you and never stopped bothering you until you let me come and help you. The rest is history.
Dr. Anthony Orsini (6m 11s):
So what’s really interesting is the funny part of that story. And what I remember is that after I met you on that
day, that you came to our first breaking bad news session, you were not very happy with the chairman of
pediatrics, because you had said that you had heard that dr. Orsini was using professional actors to train the
residents on breaking bad news. And you felt that that was just terrible and that it should be parents that are
playing this. I had already tried with parents and just realized that they just didn’t have the depth of acting
Dr. Anthony Orsini (6m 41s):
So, but you said something really funny after the whole day was over. And I guess that comes out, your
Brooklyn comes out and you said, I really, really p****d that. I said, why? And you said, now I have to
apologize to the chairman. And I hate, I hate to apologize
Elizabeth Poret-Christ (7m 2s):
So true all the time with my head hung down and was like, I was so wrong. How could I be so wrong?
Dr. Anthony Orsini (7m 11s):
Yes. And I know from personal experience that my wife doesn’t like the vet she’s wrong either. So, but that
was the beginning of our relationship. And we did BB and foundation for awhile. And you were a volunteer
teacher and then became a volunteer instructor, I should say, to teach these doctors how to communicate
better. And then you just stayed along with me as we went through the Orsini way and started teaching
patient experience. But you were such an important part in the teaching of these young residents on how to
discuss bad news.
Dr. Anthony Orsini (7m 43s):
And what’s really great about what we do is in your senior way, as we, we get non-medical people, who’ve
had some great stories, validate that what we’re teaching is correct. And so the topic of this podcast is
difficult conversations. And as I mentioned in the introduction, you’ve had some difficult conversations in
your life and tell whatever story you want to tell, because I think there’s so much that the audience can learn
from your experience and, and how you were able to get through these tragic times and now be someone
who’s teaching physicians, how to communicate.
Dr. Anthony Orsini (8m 20s):
And so I think everybody should just hear one of the great stories that you have.
Elizabeth Poret-Christ (8m 25s):
I don’t think I would be able to be of any help to you if I didn’t have these stories. And I think that a lot of
times when I share them with the people that we train, there’s kind of an aha moment that happens when
they say, wow, people really do communicate this way. So, I mean, I can give you a good one or a bad one,
which one do you want? First?
Dr. Anthony Orsini (8m 46s):
I think the, we had talked about the contrast between the, when your husband was sick and you, your
husband, and you had a of difficult conversations and what you learned at that experience that you had
already been working with me. But I think it’s a great story to tell everybody about what happened to Ken and
what you learned from that, and the difference between the two positions.
Elizabeth Poret-Christ (9m 10s):
So I thought that having a child with a medical condition really made me an expert in how to be an advocate
and how to be a mom and how to be a communicator, and then working for you for so long, I gained so
many incredible skills in communication, and then my family was just thrown for a loop. So as you know, Ken
was on a business trip to Orlando and turned out, had a raging sepsis infection that was ravaging his body
as he traveled.
Elizabeth Poret-Christ (9m 43s):
And when he got to Florida from New Jersey, he was very, very, very ill. And within 48 hours of landing in
Florida, he was in the hospital. And by the time I got there, he was dying and he had a full sepsis infection
caused by diverticulitis and a blockage in his colon and had an eight hour surgery. And when he came out of
the surgery, he was in the ICU and they let me in to see him.
Elizabeth Poret-Christ (10m 16s):
And when I asked the resident how he was doing, the resident very casually over his shoulder, said, he’s
“circling the drain”. And as a wife, as you know, thinking about my two children at home who may never see
their father again, and as an instructor of communication skills for physicians, instead of just collapsing to the
ground, like I think anybody would have, and probably what I would have done had I not have the experience
that I’ve had with you.
Elizabeth Poret-Christ (10m 53s):
I was able to say to him that that was not inappropriate way to communicate, and I’d like to speak to you
outside. And that’s when the Brooklyn really came out because I was angry. That’s just a horrible thing to say
to somebody. We don’t know whether he’s going to live or die the next minute. And here’s this guy equating
my husband to the water in the toilet bowl. So channeling every instructor ounce of existence that I could, I
pulled him outside and said that I would like for him to speak to me the way he would speak to a colleague
and I would stop him if I didn’t understand him.
Elizabeth Poret-Christ (11m 33s):
And he couldn’t believe that I would even dare to tell him that he wasn’t communicating well. And it turns out
I had to have him removed from my husband’s case because he just couldn’t communicate with me in any
way that made sense. And I had to have a new resident come in, but throughout that time, Ken’s 23 days in
the hospital, 12 days in a coma, there was a lot of times where I was very grateful for the communication
skills that I had, but always thought to myself What about the family member that’s sitting by the bedside that
doesn’t have the ability to question the physician, question, the nurse, or just say, I think something’s wrong.
Elizabeth Poret-Christ (12m 16s):
I need your help. And what tragic events would occur if people didn’t felt like they could say something.
Dr. Anthony Orsini (12m 22s):
I think that’s a couple of things you said that are really profound. One is that the doctor had no idea what he
did wrong. And I think, you know, most people who are lay people wouldn’t don’t know this, but there’s very
little communication training for physicians. Some people are natural, good communicators, and some
people just aren’t, but there’s certainly no excuse not to show or try to show some compassion. If you’re
trying and you trip over your words or have a difficult time. That’s one thing that I can teach communication
to just about anybody as you know, but that was pretty profound.
Dr. Anthony Orsini (12m 58s):
The other thing that you said is that you felt empowered as an instructor because you’d knew what to expect.
You, you knew that this is not appropriate and that you were emboldened to say something, but it is sad that
many people would not be able to speak up or just think that it’s not their place. And certainly when you are
worried about your husband, literally dying, those are not really words of comfort are they?
Elizabeth Poret-Christ (13m 27s):
It really? And what was the interesting part was my inlaws had flown in the next day. And every time I went
to question a doctor or nurse, whoever they would get upset with me, they would say, it’s not your job. Don’t
say anything. Don’t ask them a question. Don’t and a couple times, you know, we caught some medical
errors. We caught some things that were making my husband uncomfortable. That didn’t have to happen
because I was not afraid to say “Hey, wait a second”.
Elizabeth Poret-Christ (13m 59s):
Can we just stop for a second and see if this is okay? But the older generations don’t feel like you can do
that. They feel like, well, what do you know? You didn’t go to medical school. And I didn’t know the medicine.
And I never said I did, but I do know my husband and I did know when something was wrong. So yeah,
every time, and I’ve been given quite a few aha moments and life lessons I say to myself, like, how do I help
the next person from not having to experience that kind of thing?
Elizabeth Poret-Christ (14m 32s):
So if that doctor never says, circling the drain again, I’ve done my job. Like I’ve accomplished my mission.
Dr. Anthony Orsini (14m 39s):
Yeah. Because the way you describe him, he was shocked that he even said anything wrong.
Elizabeth Poret-Christ (14m 44s):
He couldn’t imagine what he could have said to upset me and or how he needed to change the tone of the
conversation to be more accommodating, which I found horrifying because my husband was not sick when
he left or at least we didn’t think he was, this was all quite shocking. And now he’s in a coma and he could
potentially die. And this guy just needed to get to the next patient. And he wasn’t stopping to acknowledge
the moment that he was in.
Elizabeth Poret-Christ (15m 16s):
And I felt the need to have this teaching moment with him, which is your fault, by the way, to take him
outside and be like, no, no, we need to have a chat about how this is supposed to go and this isn’t it. So
yeah, it’s just it. And it’s happened more than once. And it’s hard to be level headed when you’re calling
somebody out like that. But your level had prevails because they’ll remember the conversation. They won’t
remember if you yelled at them, but they’ll remember, you know, the calm approach, I guess, I hope.
Dr. Anthony Orsini (15m 46s):
And as you know, I really do believe that physicians, I believe in humans in general, are compassionate
people. And that physicians and nurses and healthcare professionals are especially compassionate. It’s
conveying that compassion. That sometimes is difficult and that’s what you and I teach. And there’s ways of
doing that. And I think perhaps that position has never been called out on that before perhaps he was caught
up in a busy day, perhaps he was being very task oriented.
Dr. Anthony Orsini (16m 17s):
But in the end, when you have a patient who’s sick or is dying the, the words and the manner in which you
convey that compassion makes all the difference in the world. As I tell my fellow physicians, and when I do
my workshops or in my book, it’s not about you. And I may be as a position, extremely busy, but I have to
remember, it’s not about me getting home or getting to the next patient that if I just took two more minutes
and sat with you and leaned over and used the proper body language, that interaction would have gone
much better for you.
Dr. Anthony Orsini (16m 53s):
I think you’d agree.
Elizabeth Poret-Christ (16m 54s):
Absolutely. And I could even tell you, so when we got home from Florida after 23 days, it was very important
that can have a surgeon at home that could follow his case. And we were referred to somebody who is very
prestigious in his field, and we were told you’re not going to like his bedside manner. You’re not, may not like
his attitude, but he’s really, really smart. And he’s a really great doctor. And I agree with you. I do believe that
physicians want to be compassionate and want to help their patients, but other things get in the way.
Elizabeth Poret-Christ (17m 27s):
So I kind of braced myself for what this visit might hold and walked in, you know, kind of on my guard. And
when we got there from the minute we walked into the office, so Ken was 200 pounds. When he left, came
home, he was 140 pounds with a Walker, really very, still very ill. And we, you know, came into the office and
the nurses literally came out from behind the desk and they were like, Ken, we’re so happy to meet you.
Elizabeth Poret-Christ (17m 59s):
Come with us. You don’t have to wait in the waiting room, come right inside. And they made him comfortable.
And the doctor came in the room and he rolled up his chair and he sat right down in front of Ken with this
hundred page file folder of everything that had occurred in the past 23 days. And he sat down and he looked
Ken right in the eye and said, I just want to tell you that you are incredible and you have done such a great
job, getting better and doing everything that you should.
Elizabeth Poret-Christ (18m 30s):
And the very worst part is behind you. And that every day from here on, in is going to get better. And we’re
going to get you back to where you need to be and get you back to your life. But you’re great. And from now
on, everything’s going to be okay. And I swear, he walked out of the office, standing a little straighter, his
head a little bit higher because he really felt like, Oh wow, I’m going to be okay. The doctor just said, I’m
going to be okay. And it really was astounding to me. And I’d already had all this experience and all this
knowledge, but there it was right there in front of me.
Elizabeth Poret-Christ (19m 2s):
I just witnessed it firsthand.
Dr. Anthony Orsini (19m 4s):
What a contrast between how someone who communicates well and someone who doesn’t. And I think now
with your work with me, and you’re seeing the way we’re trying to teach that. And not only when it comes to
difficult conversations with tragic news, but just how, how to speak to somebody, you know, in everyday life,
how’s a doctor speak to a patient when they say hello and make them seem special. We’ve done some,
some teaching of HR professionals. So those are difficult conversations, too.
Dr. Anthony Orsini (19m 34s):
Life changing moments don’t have to be about death and dying life changing moments can be about
separation of employment can be about divorce. As one social worker once told me many, many years ago,
there’s very similarities between death and divorce. It’s just defining yourself,
Elizabeth Poret-Christ (19m 51s):
Your job, losing, you know, all of that is so they’re also linked together your emotions and your grieving
process of any loss. It doesn’t matter what the loss is, the grieving process exists. So, yeah. And when we’re
training family advisors, it’s also really important to explain that it’s not just about your pain when you’re
telling your story, it’s important to express your pain, but it has to be done in a way that the doctor can take
something from it and grow and change.
Elizabeth Poret-Christ (20m 24s):
It. Can’t be, you know, I have this terrible story to tell, and I’m going to keep telling it because it makes me
feel better. There has to be the evolution of what happens next.
Dr. Anthony Orsini (20m 34s):
So that that’s actually leads me into my very next question. You know, as a nonmedical person who spends
most of their time, training physicians, nurses, and medical people on how to have those difficult
conversations, it’s difficult, right? Because some would say, well, you’re probably going to be, maybe people
won’t take you seriously because you’re not in medicine. What’s been your experience when you’re giving
that news from the patient point of view. And how do you get around that?
Elizabeth Poret-Christ (21m 2s):
So I definitely at first felt there was some resistance that I wasn’t a medical professional telling medical
professionals how to do their jobs. So the way I learned to rephrase my communications with them is when
I’m trying to explain to them something, maybe they could have done differently. I say, as the patient or
family member, I heard you say this, so it’s not necessarily what you said. It’s the perception of what, you
know, I heard you say.
Elizabeth Poret-Christ (21m 35s):
So like when this doctor to take the bad example, when he was saying that my husband was circling the
drain, he wasn’t trying to be callous. That might just be a medical term that he would use with a colleague,
but explaining to him how it felt to hear him say that might make him stop and pause in the future. If he goes
to say it to a nonmedical person. So I’ve tried to really make my comments with the doctors and the nurses
that we train more neutral and more, you know, I’m explaining to them what the patient feels or hears as
opposed to maybe what they’re trying to say so that they can’t dispute.
Elizabeth Poret-Christ (22m 15s):
Well, I didn’t mean to say that, or I didn’t say that it doesn’t matter what you meant or doesn’t matter what
you said, it matters what my perception was. And that’s something that I think we’ve all learned. And with
your help, I’ve learned to reword and rephrase things so that there’s not a battle. I’m not trying to give
medical advice. I’m not trying to act like the doctor or the nurse. I’m just trying to tell you what it feels like
from the patient perspective. And that’s a perspective that most medical professionals never get.
Elizabeth Poret-Christ (22m 46s):
They never hear in a safe environment, what it’s like from the patient perspective, they’re only either getting
yelled at about what they said after the fact, or, you know, being complimented, but they never get that safe
environment to learn how to say something. That’s really hard to say.
Dr. Anthony Orsini (23m 2s):
And I have to say that I do when you and I are teaching together. And we’re teaching some, even senior
physicians who maybe been at this for 20 years, that we train, I can see they pay even more attention and
hang on to even your words, even more than mine. And because you validate what we teach and you can
say, well, I’ve been there. And I can tell you that just the idea that you sat down made a huge difference, or
you just didn’t connect with a patient.
Dr. Anthony Orsini (23m 34s):
And so it’s been, I think I agree a thousand percent that any training of physicians when it comes to
communication has to be done with both people inside, outside the medical field. If you just do one or the
other, I think you’re, you’re losing something. And the fact that you’ve had to get through many of these
difficult conversations is, is a testament to your resiliency and really what you’ve been able to do that. And so
each physician that you train sees about 250,000 patients, that patient interaction.
Dr. Anthony Orsini (24m 7s):
So that’s a lot of physicians over the last eight or 10 years that you and I have trained in. And that’s a lot of
patients and that’s why we continue to do this with the patient experience. So, you know, the name of my
book is called it’s on the delivery. That’s the name of our program. You and I have come up with that for a
patient experience. And communication is all about it’s on a delivery. And so I’ve had people tell me, boy, this
works with my husband too. So I don’t know, has, as Ken said, that deal because Lauren says that to me,
Elizabeth Poret-Christ (24m 37s):
Definitely not, my two 19 year olds might say, you know, we think you might’ve been working when we were
having that conversation.
Dr. Anthony Orsini (24m 44s):
Yeah. If I want to get Lauren to let me buy a car or something like that, and she’s saying no, cause she’s,
she’ll always say, wait a second. I know what you’re doing here. This is all in the delivery and
Elizabeth Poret-Christ (24m 56s):
Don’t give out our secrets, you can’t do that.
Dr. Anthony Orsini (24m 58s):
I know I wrote the book and now every spouse can be, but we can use communication to really help form
relationships. And really that’s a medicine is about right. That’s what, you know, we’re going to talk to some
other leaders in business about, you know, leadership is all about communication, right? And we’ve done
that together. And we all have had bosses who were great communicators. And we loved them. One of my
first bosses, I I’d walked through fire for her because she created such loyalty, but it’s all about
Dr. Anthony Orsini (25m 31s):
And I don’t think there’s a person in this world that hasn’t had a difficult conversation. And so I’m really
excited to continue to work with you. And so what advice do you have any family member just in closing
here, if you could just say to somebody who’s listening out there, who’s either had a really difficult
conversation in healthcare. Let’s go back to the tragedy of either can or some of the other tragic news that
you’ve heard when you are on that end. Now you were felt emboldened because when that doctor said,
circling the drain, you were already an instructor and your personality is not quiet.
Dr. Anthony Orsini (26m 11s):
You’re not a quiet personality. And so you were taught up to speak up, but what advice do you have when
the person who is receiving the tragic news from the first responder, from the doctor, from the nurse, the
person sitting on the chair and being told that they have cancer, what, what advice would you give to them?
Elizabeth Poret-Christ (26m 32s):
So having sat in that cancer chair myself, I think there’s a couple things I think that resonate with me. One is
I think it’s important to remember, like we said, in the beginning that the physician or nurse really does want
to help you. They’re not trying to hurt you or communicate badly. They just might not know that they’re doing
it. So it is okay to ask a question, ask for something to be repeated or ask for something to be explained that
you don’t know, it’s okay to do that.
Elizabeth Poret-Christ (27m 12s):
It’s okay to stop and say, I’m not really sure I just understood what you said. Can you write that down for me?
All of these things help you process the information that’s being given to you because especially when it’s
tragic or even bad news, you’re really not going to remember much about the conversation. So asking for
clarification or for something to be written down is not disrespectful and it will help you going forward. And
just understanding that physicians really do want to do the right thing.
Elizabeth Poret-Christ (27m 44s):
They just might not have the skill. And I think it’s really important to understand. And I think it’s a very, little
known fact that doctors and nurses, they don’t get any training in how to do this. And that’s why I think the
way we train and the process that we put our students for lack of a better word through really leads to some
aha moments because they just don’t understand how they’re being. I keep going back to the word
perception, but it’s everything.
Elizabeth Poret-Christ (28m 14s):
So if, as a patient to feel even just a little bit more empowered to say, I need a little bit more help than this,
that will change the course and the trajectory of your outcome as well.
Dr. Anthony Orsini (28m 27s):
I think that’s great. One of the things that you’ve heard me, quote, rabbi Kushner, who is the author of when
bad things happen to good people. And I am a big fan of dr. Kushner, but rabbi kosher makes the distinction
between curing and healing and he’s carrying is making a problem, go away. Caring is caring cancer, but
healing is providing people with the resources and other people to help them get through a problem that they
may or may not have go away.
Dr. Anthony Orsini (28m 59s):
And I think if we can just remember those kind and wise words that the healing starts from the moment that
you’re told you have cancer. And when you’re in your second story, that the surgeon who told Ken that he did
wonderfully and how great he was. And Ken stood up a little bit taller in your words, with just his words, he
started the healing process, and this is why I love communication. It’s so powerful by changing one word, by
doing something different, you can make the difference in people’s lives.
Dr. Anthony Orsini (29m 35s):
You can make your patients start to heal immediately and or you could just make people better by being a
good communicator. So this has been a real pleasure. I shall speak to you again later on today because
we’re working together, but, but I want people to hear your story. And so I think this is really a good, I think
people are going to be inspired. I think people will be emboldened. I think people will understand how
important communication is in medicine and their private lives.
Dr. Anthony Orsini (30m 7s):
And, and I think you’ve been a great and inspiring guest. So thank you so much. Thank you again, Liz for
coming. If you want more information about the, your way, you can find this on social media, also the
website, or see any way.com. If you have any questions or if you have an interview that you think someone
would be a great person to interview, please do not hesitate to email either me or Liz, and you can contact
us through the website. So if you liked this podcast and you want to hear more inspiring stories and learn
how to be a better communicator, we are going to have some great experts in their field.
1 (30m 46s):
And I think you’ll leave feeling a little bit better about the world each and every time, please go ahead and hit
that subscribe button and I will be back again next Tuesday. So thank you and stay safe everyone.
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