Thursday, July 10, 2008

Like a Surgeon

This week's conference extravaganza has been an eye opener (11 workshops and breakout sessions for a 500+ person conference, with effectively 2 Facilitators). Trying to process, reflect and be appreciative about what has transpired (and blogging about it each night ) has been incredibly useful to capture learning. We came here to help create the subtle environment for generative dialogue. Instead we were working very low on Maslow's hierarcy of needs. That's ok, it was what was needed. Tonight I'm going to use an analogy to try to crystalise what it has felt like to be here trying to focus on process facilitation.

This week we are like surgeons to whom the patient has come a little too late.

You work very hard to diagnose the problem, try different experimental interventions; but it is late in the game and you don't see a significant change. When you finally have all the information, you can see clearly that many months ago, this condition would have been easily treated, but now the condition is too advanced to treat. However, you are compassionate and committed to remaining a caregiver. And you spend your time now focusing on making the patient comfortable, fluffing the pillow, administering local pain relievers, helping the patient maintain dignity - generally creating a nice environment for the final days - and making sure the strongest memories that visitors and loved ones have of your patient are good ones. No level of intervention at this point, no matter how invasive, will change the patient's outcome; so you put your energies into administering care and support, and do it in the nicest possible way. (e.g. My most significant contribution today was buying a bottle of rum for the drafting team.)

There is a real role here for preventive medicine. We need to get to the patients much earlier. We need to help establish good habits, good reflexes, good decision making, good planning, and thus good healthy, interactive workshops and peer learning sessions, and happy participants. Surgeons are trained to do amazing things, if its not too late.