We Americans really suck at dialogue. Honestly, we are terrible at it. No judgements here, because me too. I have also been really terrible at dialogue. And I could be projecting right now, except I’m not. Because I’m watching our social media outlets on a daily basis and most of us sound exactly like our politicians. We either say a whole lot of nothing in an attempt to smooth things over, or we sound angry, or we are appalled, or we leave Facebook temporarily, or we cut off friends, or we throw up articles about how right we are.

It’s debatable whether our politicians lead us or if they are mere reflections of us. Most of us choose a politician because they resonate with what we already think and believe. Rarely am I challenged by a politician I elect to office. I elect because I have found an outlet for my voice.

Debate reminds me more of a presentation, a show case. The way you win is by your style, not by the facts you present. All sides have facts, or, in the case of the 2016 election cycle, now we can include our belief of facts without any due process for checking them.

When it comes to the practice, however, of making changes to improve our lives in any given day, I have never found debate to win. I have never persuaded someone to my side with debate. For a while I thought it was because I was not skilled enough. I was too passionate. I couldn’t think quickly enough to counter argue. My words escaped me. I thought back to that high school debate team I should have joined.

Over time, though, I paid more attention to the people who changed my mind and how they did it.  If it was a heated topic, we argued. If it was a simple topic, we disagreed. If it was something I knew nothing about, it was their own story or the stories of others that they shared. The conversations were personal and they were honest and vulnerable and difficult. My brain flagged these moments. Sometimes the changes I made were small, sometimes they were drastic and sometimes they could be delayed to 10 years later.

Don’t get me wrong. Facts and statistics are incredibly important still. When we use a scientific process to create them, they are meaningful. They can challenge us to re-think our realities. But I’ve sat through “history” lessons from a past boss who ran through an amazing number of facts starting with the founding of this country to prove to me I was on the wrong side. And while I listened respectfully, at first, I knew he didn’t care about me. He didn’t care to listen to me. In his ideas of what a better America would be I wasn’t included. Regardless of how accurate his facts were and how many there were, without me knowing a single fact to counter argue, I knew his main goal was simply to feel like he’d won. That wasn’t enough for me to change my mind or be impressed in any way.

Community health is a topic that is important to me. As I work with people on an individual basis to get better healthcare, I have found that the toughest part of my job is setting the standard for dialogue and helping healthcare use it. Patients only come to me when they are upset. I am a last resort and they are at a breaking point. The patient-healthcare relationship is a tricky one because it is built on the authority of the doctor as the expert. Patients put a lot of trust into their healthcare being the best and doing what’s right. And healthcare puts a lot into marketing to keep this reputation. When a patient gets into a situation where a part of healthcare fails to fulfill this role of being right and doing everything in their power to help the patient, the patient can feel angry, indignant, appalled, hurt, ignored, maligned, shamed, etc. The feelings run strong and deep when someone wrongs you while you are sick.

To resolve these issues, the default button for all parties involved is to respond more forcefully and debate why they are right. It doesn’t work. Minds seem to get further entrenched with debate. Dialogue is the strongest chance a patient has to make needed changes in their healthcare system before going to lawyers or policy makers. Dialogue is treating both sides as equals. Both have important things to say that are valid. Listening is essential and active. The goal is to come to an understanding. You must let go of ideologies, that black and white thinking, the either/or scenarios, and allow for the “and”, the gray, the middle ground. Dialogue is not a power struggle; it is a relationship builder.

I’m betting on our abilities to work together that drastic changes in healthcare can happen more simply and sooner.

Image courtesy of David DeSilva. AXIS Dance company with dancers Sonsheree Giles and Joel Brown.