The Cocktail Party Problem
Imagine trying to listen to a friend’s conversation in a crowded bar. There is a constant background noise: voices, laughter, movement, glasses clinging/banging. The volume fluctuates and can distract you from listening to the conversation. Yet, you have honed the skills to listen without needing every word to understand, instead you can gather from other cues - facial animation, body language, and tone to listen and react appropriately.
I think about the patient-clinician interaction the same way. Whether it is in a crowded emergency room, or the quiet of a private exam room, there will be noise that creates a barrier to understanding for both parties: How well do you know the patient? What else is on the clinician’s mind? Are there biases present? There is a growing use of ambient listening tools capturing conversational documentation to ease administrative burden (clinician side) and aid in understanding (patient side). While the utility is apparent, hours saved on the clinician side, ability to refer back to notes for patients/caregivers, will it create more noise as an unintended consequence? When we look back at the static notes as data, could it create more confusion when we lose the other contextual cues of that dialogue?
Similarly, there is no shortage of technology that helps us “listen” to ourselves. Our physiology can be continuously monitored: heart rate, temperature, brain waves, you name it. There is even a device that can listen to our bowel sounds continuously to understand our gut health. Technology that helps us to be more aware and therefore engage in our health actionably, preventatively, we can agree, is good for everyone. However, is our physiology meant to be continuously monitored? Does it create too much noise, rendering the data meaningless and unable to drive the right action overtime? Take the bowel sounds for example, our gut is noisy, and using those sounds in insolation may have no clinical significance.
This isn’t about being a technophobe. But I fear the decline of our listening skills as we develop new habits and behaviors driven by technology. Fast moving culture doesn’t reward slowing down, yet the studies on meditation are consistent, intuition builds in the slow, unhurried space. We tend to rank logic above intuition as a mode of processing and deciding. I'd argue the opposite, that logic, practiced and repeated over years, is what becomes intuition. The art of medicine. Reading a negotiation. A market "feel" that precedes the data confirming it. None of these have a shortcut. They're built the same slow way real listening is: one unhurried repetition at a time.
If we let others (technology) do the listening for us, do we forget or never learn (in the case of our children) how? And everything just becomes noise?