A Conversation is a Process of Coming to an Understanding

Recently, a colleague from time passed forwarded me a quote from Hans-Georg Gadamer’s book Truth and Method. He noted, “I thought of you as I read it and that you might appreciate this enough to pass it on.” I was unfamiliar with Gadamer’s work.

Frankly, Gadamer was hard to follow and I had to read the quote several times. But, when he wrote about the role of conversation in coming to a shared understanding, it held my attention. Gadamer states, “We say that we conduct a conversation but the more genuine a conversation is the less its conduct lies within the will of either partner. It is generally more correct to say that we fall into conversation.”

He goes on to describe a process in which “one word follows another [with] the conversation taking its own twists and reaching its own conclusions… but the partners conversing are far less the leaders of it than led.” He notes, “No one knows in advance what will come out of a conversation. Understanding or its failure is like an event that happens to us. A conversation has a spirit of its own and the language it conducts bears its own truth.”

It seems to me that Gadamer is describing a process by which patients and healthcare providers can arrive at a shared understanding of an unwanted diagnosis or prognosis. Most of us understand that discussing serious illness can be complicated by the language differences between the science of medicine and the patient’s lived experience of illness. Over the years I have observed how communication barriers can be minimized when these language differences are acknowledged by healthcare providers and patients. In effect, there needs to be a partnership without a designated leader. Listening to one another, clarifying what might have been misunderstood and arriving at the “truth” can result in more personalized care for the patient as well as greater satisfaction for healthcare professionals. As Godamer points out, “a conversation has a spirit of its own.” Why shouldn’t patient and doctor share in the spirit of “we’re in this together.”

Yes, I’d say Gadamer’s words are worth passing on!