Better economics of today: detachment or empathy in clinical practice?

In the LED-lit corridors of modern hospitals, where the steady beep of monitors reflect a mechanical heartbeat to human existence, a fundamental economic paradox unfolds daily. Should that white-coated architect of healing called the clinician maintain the cool distance of an architect examining a building blueprint, or should the clinican invest their scarce emotional resource in the messy, unpredictable connection with humanity. I think this question strikes at the very root of healthcare’s efficiency computation: the tension between the measurable and the immeasurable, between the quantifiable outcomes that VCs & administrators worship and the intangible healing that patients desperately seek.

The Case for clinical detachment: the efficiency model

From a pure economic standpoint, emotional detachment appears to offer compelling advantages. Like a seasoned trader who never falls in love with a particular stock, the detached clinician can make decisions based purely on data, unburdened by the cognitive biases; that emotional investment inevitably creates. They can allocate their limited time and energy with ruthless efficiency, moving from patient to patient like a well-oiled production line. Consider my friend Dr. Raju, an ICU physician whom I have observed closely during busy, daily shifts. That night, he treated a poor old man’s deteriorating renal output with the same clinical precision he applied to a young banker’s heart arrythmias. No emotional energy wasted on the unfairness of their circumstances, no mental bandwidth diverted to listening, analyzing or wondering about their stories. Pure, efficient medicine. In economic terms, he maximized his output per unit of emotional labour invested. This detachment model offers protection against burnout—that expensive form of human capital depreciation that costs the healthcare system billions annually but also risks the perception the doctor is not caring or involved – such perceptions always lead to violent upheavals or malpractice litigation. But, on the other side, when clinicians become too invested in their patients, they risk emotional bankruptcy; leading to reduced performance, increased errors and ultimately, career changes that represent massive sunk costs in medical education and training. Also, detachment can paradoxically help to serve patients better in crisis situations. The surgeon’s steady hand cannot afford to shake with empathy when making a life-saving incision. The oncologist delivering a terminal diagnosis must remain clear-headed enough to discuss treatment options, not crumble under the weight of shared grief.

The hidden costs of emotional distance

Yet this efficiency model ignores significant hidden costs and missed opportunities for value creation. Patients are not merely biological machines requiring technical fixes; they are complex systems where emotional and psychological factors directly impact clinical outcomes. The detached approach treats symptoms while often missing the underlying market dynamics of human healing. I feel that empathetic care produces measurable returns on investment. Patients who feel heard and understood show better medication compliance, faster recovery times and reduced likelihood of malpractice litigation. In economic terms, empathy generates +ve externalities that ripple through the entire healthcare system.

Consider the case of my patient Mrs. Gupta, a diabetic patient whose blood sugar levels remained stubbornly high despite optimal medication. Several detached clinicians increased her dosages and switched medications, focusing solely on the biochemical equation. After adequate doctor shopping, she was recommended to me and she came reluctantly. I took time to understand her detailed food habits, emotional landscape and discovered that she was self adjusting her insulin doses because of how she felt or the quantity of food intake but too scared to adopt CGM or titrate her insulin in consultation with her clinician. This empathetic investment of listening to her by quizzing, perhaps 10 extra minutes of conversation increased her compliance, reduced her sugar levels and boosted her health status to prevent long term complications.

The empathy premium: when emotional investment pays dividends

Incidences like these taught me that empathy, properly deployed, functions like a sophisticated market intelligence system to provide crucial information about patient motivation, compliance likelihood and hidden barriers to treatment success. The empathetic clinician reads not just lab values but the subtle economics of their patient’s life - the hard-working daily wages mother who can’t afford to miss work for follow-up appointments, the elderly man whose medication confusion stems from grief over his deceased wife who used to manage his pills, etc. Such intelligence permits emotionally charged interventions, reducing compliance issues and improving outcomes especially in cases like fungal treatments or even TB. An empathetic clinician can craft treatment plans that account for the full spectrum of factors affecting patient outcomes just like a skilled investor who looks beyond a company’s financials to its corporate culture and market position. Furthermore, empathy creates patient loyalty - a valuable asset in today’s increasingly competitive doctor space. Patients who feel genuinely cared for become advocates, referring family and friends, and choosing to return even when other options exist. This relationship capital appreciates over time, creating sustainable competitive advantages for clinicians.

The optimal portfolio: strategic emotional investment

The most economically rational approach lies not in choosing between detachment and empathy, but in developing a sophisticated portfolio strategy for emotional investment. It is easy to say this but very difficult to learn how and when to allocate emotional resources strategically, deploying deep empathy where it will generate the highest returns while maintaining professional distance where detachment serves patients better. This requires developing what can be called “contextual empathy” - the ability to read situational dynamics and adjust emotional investment accordingly, eg. The surgeon must maintain detachment during the surgery but shift to empathy when comforting the family afterward. The primary care family GP might invest heavily in building rapport with chronic disease patients while maintaining greater distance with routine check-ups.

Today's Innovation imperative

Healthcare institutions must recognize that empathy, like any valuable resource, requires systematic investment and management. This means training programs that teach emotional intelligence alongside technical skills, workload structures that allow time for meaningful patient interaction, and performance metrics that account for patient satisfaction and relationship quality, not just throughput and efficiency ratios.

The most successful healthcare organizations of the future will be those that master emotional economics successfully - creating systems that enable clinicians to deploy empathy strategically for the quality of human interaction during care delivery directly affects the product quality while protecting against the burnout that destroys human capital.

Conclusion: The compassion cconomy

The choice between detachment and empathy in clinical practice represents a false dichotomy stemming from current trends of economic thinking, viz. ROI or Return On Investment. In the past, ROI was an output measured from the input of empathy in patient care and today’s educated folks are no different in their analyses. The future belongs to healthcare providers who understand that empathy, properly managed, is not a luxury expense but a strategic investment for better outcomes, sustained relationships and competitive advantage. In this compassion economy, the most successful clinicians will be those who learn to read not just vital signs but the vital signs of human connection, always with the goal of maximizing not just clinical efficiency but human flourishing. In clinical practice, as in the best business relationships, trust and understanding are not impediments to professionalism but the very foundation upon which lasting success is built. Therefore, in the current context, the question is not whether clinicians should be detached or empathetic, but how they can master the sophisticated art of strategic compassion—an economic innovation that promises to transform not just individual patient outcomes, but the entire architecture of human healing.

The blouse today – evolution to cover or unravel

 

Foreword

Indian fashion is a vibrant tapestry woven from centuries of tradition, culture, and innovation. From ancient draped garments to contemporary high fashion, the journey of Indian attire reflects a rich historical evolution influenced by social, cultural, and global changes. Indian women not only love the long drape called the saree but also wear it with much pride and adoration. Since ancient times, the saree has travelled a long way and undergone many changes not only in the way it is draped but also in the way the blouses are designed. The blouse has traditionally served both practical and symbolic functions - providing modesty while completing the saree ensemble. The blouse evolved as a novel fashion trend in India during the Victorian era British Raj and still does. Such evolution in Indian fashion is a testament to its adaptability and resilience. As it continues to evolve, Indian fashion, while staying connected to its rich cultural heritage is embracing innovative trends, new technologies and designs.

 

The blouse today

However, as Indian women increasingly assert their autonomy in professional, social, and personal spheres, clothing becomes a medium through which they can subtly challenge traditional boundaries while remaining within acceptable cultural frameworks. Transformation reveals several deep psychological and social currents at work. The strategic nature of this evolution is particularly telling. Integral to every Bollywood movie is the characteristic song-and-dance routine. This often provides an arena for the depiction of panoramic emotions that engage audiences across linguistic barriers. Located in the realm of popular entertainment, these routines are characterised by focussing on the female body expressions of movement and at the same time, exploring other aspects of appearance and costume to stand out and push the limits of appeal. Such cinematic experience is heightened by mobilising costume as a signifier of dramatic enunciation often serving as visual shorthand of the character. Maybe, this trend represents a negotiation between cultural preservation and creative expression for the Indian garments which traditionally have normative modesty are re-designed subtly for conveying sensuality for cinematic purposes

 

My hypothesis on the blouse

But, by maintaining the front coverage that addresses traditional modesty concerns while experimenting with back designs, women are creating a space for self-expression that conforms to acceptance and does not directly confront conservative sensibilities. The back of the blouse becomes a canvas for creativity and sensuality that is evident primarily to those behind them - a kind of selective revelation that allows for both conformity and rebellion. As a reflection of modern day rebellion, the back of the blouse has now shrunk to bra-straps and even tie-strings. This pattern reflects the broader psychology of gradual social change in India percolating from the top echelons of society to the slums and from cities to rural villages. Rather than dramatic breaks with tradition, incremental modifications to push boundaries and test limits of tolerance both at home and outside without completely abandoning cultural identity is emerging as a silent staircase of resistance to challenge the power of tradition & assertion of individual choice.

 

My dissection of the trend

From a psychological perspective, this may be a sophisticated form of identity negotiation, where women are trying to carve visual narratives that speak to multiple audiences simultaneously - satisfying traditional expectations while expressing personal assertiveness and modern sensibilities.​​​​​​​​​​​​​​​​ The trend also speaks to changing notions of femininity and attractiveness in contemporary India. As women gain economic independence and social mobility, they’re redefining what it means to be both traditionally Indian and modern. The evolving blouse becomes a symbol of this duality - honouring the saree tradition while embracing contemporary aesthetics and body positivity. The ultimate symbol is a backless choli! What does it signify? I do not know if it is a hint of inviting temptation, but if it is; then surely, it is a gateway to disaster in the years ahead with mindless aping rapidly galloping across generations.

 

Permit yourself to be missed!

Sometimes, the hardest thing to do is to step back. We crave badly to be present in people’s lives, especially those whom we love very much and show them how much we care. But in trying to stick to them closely, we lose ourselves, giving too much without noticing when it’s not appreciated. There is something powerful in pulling away, not out of spite or manipulation, but from a place of self-respect and self-worth. Because you recognize that your presence is a privilege, not a given option. So, step back and let them miss you! I am not talking about trying to make someone chase you. Those games are futile. This is to reclaim your energy and protect your peace. Sometimes, the best thing you can do for a relationship is to give it a little breathing room. Step back and let them feel the difference when you are not constantly giving.

Absence creates space. 

Space for reflection, 

Space for appreciation, &

Space for longing.

When you constantly make yourself available, it becomes easy for others to take you for granted. Your presence and kindness begin to feel ordinary, expected even. But when you create a little distance, they can feel your absence. And in that absence, they begin to recognize your worth and realize how much light you bring into their world. I know it’s hard. We believe that if we stay close, they will finally see how much we are worth. But you cannot prove your value by how often you are around. Your value shines through by what’s missing when you are not. And sometimes, letting people feel that emptiness is the only way for them to realize how important you are. If your connection is real, your absence will speak louder than any words ever could. And if it isn’t? Then no amount of staying, pushing, or overextending will make it so. The more you are always there, the easier it becomes for people to forget what it feels like not to have you around.

Creating space does not mean you abandon anyone. It means you give them room to appreciate you. You send a quiet reminder that your presence is a choice, not a guarantee. By stepping back, you set a boundary, saying “I love you, but I don’t have to chase you. My value does not lessen just because I’m not always around.” Try it to discover a new you and a new world!

 

Does changing the Mind-Set affect our ageing?

The truth

One cannot stop the march of time, but there is no need to dread it. People who think positively about getting older often live longer, healthier lives. At a pre-departure briefing this summer, we discovered Ms. Joshi climbed as a co-traveller. The occasion? Celebration of her 90th birthday in Japan along with an unknown group whom she planned to cultivate and win as friends. “I’ve always looked forward to travel at this stage of life where there’s a lot more peace without the struggles of daily existence and survival that enveloped me when younger,” said Ms. Joshi, who lives in Thane, India, and is a retired school teacher. Her enthusiasm for making the most of what comes across her age could be part of the reason she has lived such a long, rich life. While everyone’s experience with aging is different, experts are increasingly finding that having a +ve mind-set is associated with aging well.

 

The proof

A decades-long study of 660 people published in 2002 showed that those with +ve beliefs around getting older lived 7½ half years longer than those who felt -vely about it. Since then, research has found that a +ve mind-set towards aging is associated with lower BP, a generally longer and healthier life and a ↓ risk of developing dementia. Research also shows that people with a more +ve perception of aging are more likely to take preventive health measures — like exercising — which, in turn, may help them live longer. -ve stereotypes of aging are everywhere and breathing in such beliefs can affect our view of the process & our health, says Becca Levy, author of “Breaking the Age Code: How Your Age Beliefs Determine How Long and Well You Live.” A 2009 study, for example, found that people in their 30s who held -ve stereotypes of aging were significantly more likely to experience a cardiovascular event like a heart attack or stroke, later in life than those with positive ones.

 

The Course correction

·       People can strengthen their positive age beliefs at any age. In one 2014 study, 100 adults — with an average age of 81 — who were exposed to +ve images of aging showed both improved perceptions of aging and improved physical function.

·       To change -ve age beliefs, one needs to become more aware of them and this is where the old benefits of diary writing kick in. Try a week of “age belief journaling,” in which you write down every portrayal of an older person — whether in a movie, on social media or in a conversation. Then question if that portrayal was negative or positive, and whether the person could have been presented differently. Simply identifying the sources of your conceptions about aging can help you gain some distance from negative ideas.

·       Associating aging with only loss or limitation means that you’re not getting the full picture of what it means to age. Instead shift your attention - look around for role models, see who’s doing it well. It might just be someone who attends a yoga class every week or volunteers for a cause.

·       Search and discover 5 older people who have done something you deem impressive or have a quality that you admire, whether it’s falling in love later in life, showing devotion to helping others or maintaining a commitment to physical fitness.

·       Research suggests that optimistic women are more likely to live past 90 than less optimistic women, regardless of race or ethnicity. But thinking more positively about aging doesn’t mean cover real concerns with happy thoughts or using phrases like “You haven’t aged!” as a compliment. Such things are tone-deaf. Instead, try to look at the honest reality with optimism. If you’re feeling deflated that your table tennis game isn’t as strong in your 70s as it once was, remind yourself: “No, I can’t play tennis like I did when I was 50, and I can only play for 10 minutes. But I can still play.”

·       Challenge your own fears about getting older and examine what worries you have about the process and then reflect on how troubling those concerns actually are.

·       If you are having an issue with your left hip or knee, don’t feel that I’m old and that is why I feel stiff and creaky but revive yourself by feeling hey, my right hip isn’t stiff and creaky, and it’s the same age. The point is that while getting older may be contributing to the hip or knee pain, it’s not the only factor because associating age with disability scares people.

·       Research has shown that emotional well-being generally increases with age, and certain aspects of nonsense recognition, and conflict resolution, often improve in later life. Focus on aspects like these that you are gaining, too. With time, we are likely to develop more resilience – the ability to cheer up and bounce back.

 

The conclusion

Successful aging does not mean that we won’t get sick, encounter loss or require care at some point, or changing any mind-set is easy. But if we can, it will allow us to see ourselves more clearly “as a person with lived experience and profound wisdom” as we age.

My 6th sense

 All of us know that the human experience is largely defined by our 5 primary senses: sight, hearing, taste, touch, and smell. Although these senses allow us to interact with and understand the world around us, there is a long-standing belief in the existence of a "sixth sense"—an intuitive ability that goes beyond the physical senses. I think I get glimpses of the same in my life as I traverse the path of daily existence. Though not often, I do get this innate feeling once in a way. This 6th sense, often referred to as extrasensory perception (ESP), encompasses a range of phenomena that cannot be simply explained by my traditional five senses. My encounters with my 6th sense includes abilities such as telepathy (mind-to-mind communication), clairvoyance (seeing events or objects beyond normal perception) and precognition (predicting future events).

In ancient Greece, the Oracle of Delphi was believed to possess the ability to foresee the future. In many indigenous cultures especially in south India, shamans and spiritual leaders are thought to have heightened intuitive abilities that allow them to communicate with the spirit world. My scientifically inclined friends will be sceptical of my 6th sense due my inability to provide any empirical evidence and the scientific consensus echoes that rigorous and reproducible evidence is needed to validate these phenomena. However, there have been numerous studies and experiments aimed at investigating ESP with some experiments having yielded intriguing results.

Like me, there are many people who report experiencing moments of intuition or "gut feelings" that seem to transcend logical explanation. This everyday intuition can manifest as a sudden feeling of danger, a sense of knowing what someone is about to say, or an inexplicable urge to take a particular action. Before rubbishing it, think of people capitalizing on this concept of the sixth sense and converting that into a popular theme in literature, films & television. Movies like "The Sixth Sense" and TV shows like "Stranger Things" have explored the idea of individuals with extraordinary perceptual abilities. These portrayals often blend various elements with the possibilities of the unknown to captivate audiences and introduce the concept of PO as possible after yes and no. No doubt that the existence of the sixth sense remains a topic of debate, but it continues to intrigue and inspire. 

Whether viewed through the lens of science, spirituality, or popular culture, the idea of a hidden, intuitive ability challenges our understanding of human perception and the mysteries of the mind. My 6th sense is uncanny and unjustifiable. It is here to stay all during my stay on this planet!

The Politics of Smile

 I am tired of the “Can I get a smile?” and “Smile, it’s not that bad!” comments that are a too common part of thoroughbred city life. I am tired of things like the “Smile! You look tired” demand from the rickshaw driver, who recently dropped me at the airport. Delivering a grin and a chirpy “I’m fine, how are you?” seems like an unnecessary cheerful bluff, even slightly deranged. Although smiling may be a universal sign of positivity, there are cultural differences. It is well known that women are often expected to smile to make others feel more comfortable. 

This expectation also seems like a big part of American existence. The wide American smile is a relatively recent development. Americans smile far more than people do in other home countries. Does America’s emphasis on smiling say something about a desire for happy endings, for appeasement and artifice? Or do they smile more as a way to cope with troubles or as a source of comfort? Maybe it’s Americans’ access to orthodontics & cosmetic dentistry that a “Hollywood smile” of bleached and blinding-white teeth has become a defacto standard. This makes the American smiles more assertive, reflecting Americans’ rating of themselves as more dominant. 

The more corrupt a society is, the more its citizens see smiling as suspicious. A 2015 study concluded that people in countries having a long history of immigration do smile more than those in other countries as smiling is a form of nonverbal communication between those who don’t share a language.

Smiling when you don’t feel like it has been proven to make you feel good by producing actual feelings of happiness. I have tried it and it does work, but I don’t want to be ordered to smile because if a smile is the appearance of happiness, then to be commanded to smile takes away my right to my own feelings forcing me to appear happy, even if I am not. 

My smiling boycott did feel a little risky as there may be something about my neutral expression that comes across as seeming worried or displeased. People have asked if there was something wrong when I was feeling just fine. To compensate, I’ve found myself smiling forcefully when socializing with strangers, wanting to assure them that they don’t have to worry. That I’m O.K.

Perhaps my annoyance at being told to smile depends on who is doing the asking, and why. Which leads to my experiment: I stopped smiling at people for a day and gauged reactions, including my own.

For a few days, I didn’t smile at my patients as they came and went. I wanted to smile at them, but instead, I pressed my mouth into a straight line. I felt as if I was being incredibly rude, as if I’d betrayed a social contract. Forcing myself to not smile, it turned out, was even harder than forcing myself to smile that full day. 

One of those days, after I reached home, I held the elevator door open in my building for a woman in a wheelchair as we squeezed into the narrow space together. We nodded hello and for a moment I forgot about the experiment and my lips shaped out without thinking: I smiled. Not an obligatory smile, not a coerced one, but a moment of sincere connection. She smiled back. And I felt good

My attempts at improving conversations

I love to butt into conversations, observe and listen to discussions on assorted topics, where friends sit around and talk about whatever is on their minds, may be with a drink. What am I looking for in these small talks? When people get drunk, there is the thrill of getting a glimpse into their personal life and beliefs, hoping to learn something different. But I think what I am really listening for is connection. I do not feel like I am ever eavesdropping on real people as I participate, too, getting closer, closer to each other or closer to a conversational destination that they did not know they were headed for when they set out. Whether we are participating in them or listening to them, the goal is to forget about the outcome and just connect. 

My adult behaviour must have been shaped from my upbringing when younger; where there was love in our home but no expression. Whether it was nature or nurture, I grew into a person who was a bit of an introvert but I have learned something profound along the way. A lot of the time, I used to just stand on the side and observe people mostly making an idiot of themselves with shallow knowledge yet, I used to stay silent for fear of hurting their emotional availability to me or their joys. If you had met me 5 years out of medical college, I think you would have found me a pleasant enough guy, cheerful, but surely inhibited — somebody who was not easy to connect to. In truth, I was a practiced escape artist. If you revealed some vulnerable intimacy to me like any talk on sex, I was good at moving always discretely to make meaningful eye contact with your shoes and then excusing myself to go home as relatives were expected.

Life has a way of tenderizing you, though. Becoming a husband and then a father was an emotional revolution, of course. Later, I absorbed my share of the normal blows that any adult suffers - broken promises, personal failures, financial vulnerability and everything that comes with getting older. The ensuing sense of my own frailty as well as the shock of cancer detection was good for me, introducing me to deeper, repressed parts of myself. I learned that living in a detached way is a withdrawal from life, an estrangement not just from other people but also from yourself. I am no exceptional person, but I am an observant grower. I do have the ability to look at my shortcomings and then try to better myself by learning from the better ones to prod myself into becoming a more fully developed person.

Being openhearted is a prerequisite for being a full, kind and wise human being. But it is not enough. People need social skills. The real process of, say, building a friendship or creating a community involves performing a series of small, concrete actions well: being curious about other people; disagreeing without poisoning relationships; revealing vulnerability at an appropriate pace; being a good listener; knowing how to ask for and offer forgiveness; knowing how to host a gathering where everyone feels embraced; knowing how to see things from another’s point of view.

In any conversation, most people shoot the breeze for a while, before they descend and get immersed on to any one topic which is dissected threadbare and sometimes, as a postmortem. The tone of such discussions is always buoyant, full of comedic bits, at times good-natured teasing and at others reflecting hollowness. It is a fizzy soft drink feeling, fun and weird and straightforward enough to make lifelong friends or even enemies. It has made me listen to other people differently. But those who sprinkle warmth, humour and weird thinking with their repartee leave a significant impact. I did not care how long I had to go silent as I just wanted to keep listening and laughing along. And before I knew, with my years of voracious reading and hilarious experiences, I was drawn into conversations as an active participant. What makes a conversation interesting to take part is the same as what makes one interesting to listen to! My favourite conversations with friends, the ones in which I feel most connected, are sprawling, agenda free, even repetitive. They go on for hours and often fail to reach a coherent conclusion. But they have a key ingredient in common that I love: connection to suggest close presence, even after the conversation is long over. 

People want to connect but I see the results in the social clumsiness that I encounter too frequently. I estimate that only 30% of the people in the world are good question askers. The rest are nice people, but they just do not ask. I think it is because they have not been taught to and so do not display basic curiosity about others. Above almost any other need, human beings as social animals long to have another person look into their faces with love and acceptance. The issue is that we lack practical knowledge about how to give one another the attention we crave. Some days it seems like we have intentionally built a society that gives people little guidance on how to perform the most important activities of life.

People are not as clear as they think they are, and we’re not as good at listening as we think we are. Being a loud listener by continually responding to comments with encouraging affirmations, with “Oh, really,” “aha” and “yes” makes me better accepted. By asking: How did you come to believe that, I have learnt that it gets people talking about the folks and experiences that shaped their values. The quality of any conversation directly depends on the quality of the questions. Kids are phenomenal at asking big, direct questions. As adults, we get more inhibited with our questions, if we even ask them at all, we are generally too cautious. People are always much more revealing and personal when they are telling stories and people are dying to tell their stories but very often, no one has ever asked about them. Naturally, the conversation gets warmer and more fun.

People don’t go into enough detail when they tell a story and so, turn them into a narrator without trying to be a stopper. If somebody tells you he is having trouble with his teenager, don’t turn around and say: “I know exactly what you mean. I’m having incredible problems with my own child.” You may think you’re trying to build a shared connection, but what you are really doing is shifting attention back to yourself.

Asking people where they grew up when meeting for the first time inevitable gets people to be are at their best when talking about their childhoods. That gets them talking about their families and ethnic backgrounds. I once asked a group of doctors, “What’s one favourite unimportant thing about you?” I learned that a very impressive academic I know has a fixation on trashy reality TV. And there, after a hearty laughter, we established trust with each other. It is great to ask such crazy questions, ones that lift people out of their daily defence strategies and help them see themselves as one of us. One great ice breaker has been - If you died today, what would you regret not doing?

Intentionally or not, lots of people walk into conversations carrying a lot of elite baggage embedded in systems that disrespect them or keep them down. At times, it is political and there is often criticism, blame and disagreement in such conversations. The temptation to get defensive will be there but it’s best to resist this temptation. The first tip to any such conversation across difference or inequality is to stand in other people’s standpoint and fully understand how the world looks to them. 

In any conversation, respect is like air. When it’s present nobody notices it, and when it’s absent it’s all anybody can think about. My view of wisdom has changed over the years and I think tha the wise person’s essential gift is tender receptivity. Note that every conversation takes place on 2 levels. The official conversation is represented by the words we are saying on whatever topic we are talking about. The actual conversations occur amid the ebb and flow of emotions that get transmitted as we talk. With every comment, respect or disrespect will be exhibited, making one feel a little safer or a little more threatened. The essential moral skill in such situations is being considerate to others in the complex circumstances of everyday life rather than just be right. This art of fluid conversation, I wanted to learn initially for:

1. Utilitarian reasons - If I’m going to work as a clinician, I don’t just want to be a superficial diagnostician and therapy guy. I must understand my patients more deeply — to know whether he or his family is in any crisis, can he handle uncertainty with comfort or is he of a self-centered nature or generous to people around?

2. Moral reasons, too - If I can shine empowerment and positive attention on others, I can help them to blossom with least medication and fewer visits. If I see potential in their children, the family may come to see the hidden potential in them. True understanding is one of the most generous gifts any of us can give to another.

3. Reasons of congenial community survival - We have evolved over time to live with groups of people like ourselves. Now we live in wonderfully diverse societies, but our social skills are inadequate for the divisions that exist. 

If we let fear and a sense of threat grip our conversation, then very quickly our motivations will deteriorate. We won’t talk to understand but to pummel. Everything we say afterward will be injurious and hurtful and will make repairing the relationship in the future harder. If, on the other hand, I show persistent curiosity about your viewpoint, I show respect. And as the authors of “Crucial Conversations” observe, in the best conversations, whether they are between you and your mom on a marathon phone call or at a professional discussion, everyone is listening closely. They are curious about each other, asking is he reacting authentically or speaking just be heard. They are allowing the conversation to happen without muscling it toward any predetermined outcome but yes, they are all observing. What is important to learn and adopt is - If we are going to accompany someone well in the journey of a conversation, we need to abandon the perfection or efficiency mind-set. We need to take our time and simply delight in another person’s way of being. I hope conversations teach people not only how to understand others but also, how to make them feel respected, valued and understood.