Making A Difference

What impact or fingerprint have you made on those you would like to reach? A big question, but that was on my mind when I left Tampa, Florida a month ago. In my bag, I had 10 days of exciting fieldwork where I had been exploring patient-centered care through more than 30 filmed appointments.

My point is that you, as an audiologist, certainly have an impact – it might be significant or less so, but there is no guaranty that you will be remembered for it! The same holds true with the work of the Ida Institute.

Did you know that my ancient countrymen, the Danish Vikings, were “first movers” when it came to exploring new horizons/lands and had quite an impact on the ways people interacted and started to live their lives in the new settlements e.g. on the British isles and the North American continent. And you probably did not know that our last Viking king, Harald Bluetooth, became legendary for his extraordinary skills in making the Viking settlements unite and communicate with each other – which some thousand years later gave name to the wireless technology uniting different communication protocols into one standard. The Bluetooth symbol on your computer screen is actually an H and a B in runic letters merged on a blue background. Centuries later, another lesser known adventurous Dane – Jonas Bronck, made his mark on today’s New York by developing a piece of land that later became known as the Bronx.

These curious and brave men had their urge for exploration, creativity and impact in common. They all made a difference by inspire and “touching” other people in different ways.

During my fieldwork I saw regular use of the Ida tools e.g. at a Veterans Affairs Hospital in Tampa. I noticed how the Motivation Tools were seamlessly integrated in the VA patient case history form. It made me happy to see that the Ida Institute had been able to inspire a change of practice at the hospital clinics. I am sure that not all audiologists at the VA clinics necessarily know where the “Lines” comes from. The important point here is that the “Lines” are being used with patients, providing the audiologist with a snap shot of the patient’s readiness for action-taking.

Even though you might not be remembered, you can still have an impact and “touch” audiologists on the other side of the globe.

Owning Your Hearing Loss

“They see me as a different person than I am”

A recent interview made me think about the prevailing view on hearing loss in the general population – and how we need to change it!

Hearing loss can make those around you lose interest

Anthropologists are trained to be professionally curious and explore even the smallest subtleties in the social fabric that might uncover significant differences between the prescribed cultural norm and actual behavior. One of my latest ethnographic interviews allowed me to meet a 50 year old photographer from Copenhagen. Not long ago he faced isolation and experienced a painful breakdown of his social network. It was not subtleties that were at play here, as he told me:

“To suddenly realize that everybody sees you as a different person than you are… a guy with a growing, unappealing character that even friends refrain from commenting upon and to realize that I have become an arrogant asshole that friends are starting to avoid was a total shock to me!” and he continued: “When I realized that it was a hearing loss at play I did something about it and when my family gathered around me and said how wonderful it was to have me back again… I … you get moved to tears, really…”

Social relations are determined in a split second

 It was quite surprising for me to learn that the consequences of not being able to respond within a split second in a normal conversation actually meant people tended to think you were  arrogant or becoming ’a bit slow’. I am talking about fragments of time here! 

Luckily the guy I interviewed realized that it was the hearing loss that was ruining his social relationships and did something about it. Now wearing hearing aids has brought him back on track socially and made him a better communicator with his clients at work.

The noblest mission

After the interview he asked me, when I thought his hearing handicap was more significant; before he got the aids or after?  It made me think about how people view hearing.

The paradox is, that many people perceive the person wearing the (almost invisible) hearing aids as being MORE handicapped than the person who hasn’t taken any action, still striving to hear and missing out on communication and social interaction...  I will refrain from the obvious comparison with people who should be wearing glasses …..

Lots of anecdotal evidence and hard evidence from neighboring disciplines clearly show that people who “own” their disability e.g. manage their hearing loss, basically live happier lives.  Owning something you really do not want to own is clearly a challenge, but for audiologists the noblest mission of all is exactly to make that ownership happen.

For All Seasons

Fall is in the air, and it smells of new and exiting documentaries!

Of all seasons I like the fall the best. It has not only to do with the change in the air and the crispness of the morning sky. It has also to do with the beginning of a new cycle at the Ida Institute. Our new topic for the up-coming seminar series is drafted, the seminar series faculty of subject matter experts is nearly formed, and for me the endeavor of making a new fresh series of ethnographic films starts.

It is just as exciting every time

This time is a bit different though, since I do not have my usual Ida co-anthropologist assisting me with the interviews. That is a challenge, but an exciting one because this time I will use “local” ethnographic interviewers.

So where am I right now?

Well, I am part of the team creating the framework of the new topic. Every new topic – I can only reveal that it has to do with patient-centered care - is being put together by creating an understanding of the dilemmas and challenges it poses.

Ethnographic documentary films are essential

We have found out that the ethnographic documentary films are essential in understanding the topics we explore. The reflective nature of the Ida Institute's seminar series helps us pose important questions and identify needs that might not yet been expressed. To be able to pose these questions it is imperative that the films mirror real clinical situations with real audiologists and patients.

Observations of the real world turned into tangible tools

Firsthand understanding and real world experiences provide us with informed insights that are able to transform experiences into a tangible tool format. The new seminar series will help us through that innovative co-creative process. And if the process goes as planned, we will be able to exchange your experiences to a new tool.

But, before we get there, a lot of planning has to be done. This is for sure a collaborative endeavor and I am already very much indebted to extremely helpful colleagues in Tampa, Florida, and the United Kingdom.

Stay tuned for new films

As you might sense, I am looking very much forward to go on this year’s fieldwork with my camera. During the next months I will frequently give you insights to how my work is progressing. And of course I will bring you snippets’ of film footage as well.

John and Gill: Communication Partners

What can you learn from watching the ethnographic videos?

After more than 4 years and 35 films, I am still amazed how Ida Institute documentaries are able to provide insights that help audiologists understand their patient’s communication needs. I find the videos especially helpful when it comes to understanding and exploring the patient’s communication relationship to their spouse, children and other communication partners.

Let me show you how:

In 2009 I visited John and Gill from Colchester in UK. Gill has a profound hearing loss. While John supports Gill, the hearing loss is clearly putting a strain on their relationship. Unintentional irritation, lack of patience, loss of spontaneity and even social pain are well-known and common consequences resulting from hearing loss. The hearing loss is “owned” by Gill, but it is clear that John is also to a great extent affected by it, because hearing loss essentially is a matter of social communication – thus not reducible to kilohertz and decibel.

One of the ethnographic insights I got from the visit was the role shifting in their relationship. John tells us that he is “acting as an earpiece” for Gill at social gatherings. This means he has taken over some of Gill’s former communication competences in terms of small talk, social networking and even friendly gossiping.

People with hearing loss often experience the loss of social competences as a loss of their own identity. : “I am not the person I used to be”, I often hear. Gill was very much aware of this and during the visit she even joked about the fight they would have of being the family’s best gossiper if she suddenly she got her hearing back…..

So what can you learn from this:

By letting the patient talk freely about their hearing loss, the ethnographic video uncovers some of the real problems Gill and John are dealing with. These “real problems” would probably have gone unnoticed if she had been given a traditional questionnaire to gauge her hearing ability.

Therefore my advice to you is:

Be curious and take the time to listen to your patient’s stories and challenges! Chances are you will get a more precise and more realistic picture of your patient’s concerns, especially their relationship and communication challenges with their spouses and friends.

I hope this will inspire you to try out the ethnographic method of being curious, posing open-ended questions and listening! If you are interested and would like to know more I can clearly recommend that you take a closer look at the Ida Institute's GPS and Communications Rings tools.

A Beginning

Welcome to my virtual office and my first blogpost.

This first post is rather long so that I can explain what I am actually trying to achieve through my presence in the blogosphere.

I am a social anthropologist with a PhD in “Rumor and Gossip – as Social Resistance” and a trained cameraman and director from the National French Documentary Filmschool. I’ve made more than 30 short documentaries since I joined the Ida Institute in 2008. Many of my documentaries are available on our website and more are coming.

Our main goal in producing the ethnographic documentaries is to inspire audiologists worldwide to reflect upon their own practice and promote a more patient-centered approach. We strongly believe that a cornerstone in changing deep-rooted behavior is awareness of your own practice – even though it can be a burdensome task during a busy day at work.

And that gets to my goal for this blogspace.  I want to know what you see when you view the documentary videos – the “ethnographic mirrors” -- on the Ida website

Perhaps I should step back and start by explaining how these ethnographic mirrors are created.

It is a simple process. When I visit a hearing care professional in his or her clinic, I use a small handheld camera.  As part of my method, I take a participatory approach. I very deliberately avoid becoming the detached fly on the wall…instead I insist on being the friendly fly in the soup.

  

You might say that I am almost an irritating presence with my camera. If I am not being accepted and given “permission” to enter the comfort zone of people I film, these documentaries will never succeed. You, the audience, will immediately sense that there are signs of resistance in the body language of my subjects, indicating that my camera is intrusive and unwelcome. Luckily, it very seldom happens!

Because I am getting up close and personal with the camera, it often feels a bit like dancing a tango.  It can be quite intimate and, of course, requires at least two participants!

The camera itself always plays a role in setting the scene. The challenging part is to create a safe space where the interactions becomes real, honest and trustful – where the patient’s worries of losing more than “just” hearing are expressed and where the audiologist does not have all the answers.  

The goal of an ethnographer/anthropologist is to reveal the yet unarticulated differences between what people say they do and what they actually do.

But, we do more than this.  We make the documentaries common points of reference for reflection and discussion as part of the co-creative learning principles that you can find on our website and at Ida seminars and workshops. It is my experience that these ethnographic documentaries work as excellent “mirrors”, reflecting common challenges for all audiologists.   

Through the conversations on this blog, I aim to help you observe other practices -- and your own -- through my “ethnographic eyes.”  I hope to provide you with a new and thought-provoking way of looking at the clinical encounter between hearing care professional and client. And I hope to inspire you to rediscover your own clinical practice.

By doing this, I provide you with a unique possibility to overcome your professional and personal barriers by enabling you to share your everyday dilemmas, challenges and successful experiences.

I look forward to sharing with you!