The power of story and other essential physician speaking tips [PODCAST]

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“People remember stories in your speech. The rest fades away.

I learned that pearl of wisdom from studying great literature and telling personal stories, and now teach it to students of speech. Who can forget the stories of The Iliad and The Odyssey having once read the books or heard of these tales of Homer? And when I want to tell a story of a hero, I think of the story detailed in another chapter of the life of my heroic policeman father who rescued hostages and gave wise advice about medical school that has served me well throughout life, that is, Homework; Courage; Never Give Up!

Again, people remember stories. They forget statistics, graphs, and most information on slides. Stories that generate emotion have the equivalent of Velcro stickiness to your long-term memory storage.”

Donald J. Palmisano is a surgeon, an attorney and past president, American Medical Association. He is the author of A Leader’s Guide to Giving a Memorable Speech: How to Deliver a Message and Captivate an Audience.

He shares his story and discusses his KevinMD article, “People remember stories in your speech. The rest fades away.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Donald Palmisano. He’s a surgeon and a lawyer, he’s a former president of the American Medical Association, and he’s the author of the book A Leader’s Guide to Giving a Memorable Speech: How to Deliver a Message and Captivate an Audience. Donald, welcome to the show.

Donald J. Palmisano: Thank you, Kevin, for having me. It’s a privilege to be with you.

Kevin Pho: So I was wondering if you could first start by sharing your story and your journey to where you are today.

Donald J. Palmisano: Well, I was born in New Orleans, in the Irish Channel, and lived on top of a restaurant bar. I was sent to a boarding school because of some gang activity in the nearby projects, and I learned to love nature and how to trap flying squirrels and things of that nature. But I would finish my homework early, and I did a lot of reading in the library there: Bomba the Jungle Boy, Tarzan, the Hardy Boys, and so on. So I developed a love of reading and the love of poetry.

Then I went on with my career and went to Tulane med school. After my residency at Tulane, at Charity Hospital, I went into the military, ’68 to ’70, on active duty as chief of surgery, 821st Med Group, SAC. And I came out and went into practice with a colleague of mine, three years ahead of me, and we stayed together all these years. Our practice was disbanded in 2005 after Hurricane Katrina. Some of the members, we had built up to six people, went to other states; some stayed here. And my partner, Jim Brown, he actually is still at Tulane, in the surgery department.

But I have enjoyed learning throughout my life, and I try to keep up with that, and I try to encourage the grandkids. I send them books. We’ll talk about it in a moment: Strunk and White, The Elements of Style. I bought so many copies of that book and gave them to them. I don’t know if they read it or not. They tell me, “Oh, yeah, we read it, Papa.” But every now and then, I’ll give them another copy and say, “Read it again.” So I try to share my knowledge.

The reason I went to law school: I got sued back in the ’70s, early ’70s, as soon as I came out of the military, by someone I never treated. I didn’t know the woman. She said I operated on the wrong breast. In reality, the surgeon she had operated on both breasts; he had consent. The whole thing was a giant mess for me, but it made me upset that I couldn’t get out of the case. And so I decided to learn more about the law, and I was very active in getting tort reform in Louisiana with the medical society in 1975. So I decided to go to law school at night, and I worked in the day. And I’ve just continued to practice medicine the whole time.

I got involved with the AMA and eventually became the president, which was an exciting adventure. I was on the road in my presidential year 302 days, so I was exhausted at the end of that tour of duty, but it was mainly tort reform, antitrust relief, things of that nature.

And along the way, I carry my camera and take pictures. I’ve been taking pictures since I was 16 years of age. So right now, while we’re locked in, I enjoy going in the backyard at the bird feeder, and I tell the cat not to eat. We have a feral cat that lives in the backyard, and he seems to understand that. So I feed the birds, and I get some really interesting pictures of these birds. So that’s where we are right now.

My wife is wonderful, editing my books before we send them to the publisher. She’s a retired lawyer from a large law firm. So I’m blessed in many ways. I’ll be 81 in July, and I don’t really feel more than about 50, actually. I’ve got some aches and pains and a problem with my neck from an auto accident, somebody hit us, but other than that, I’m in pretty good shape.

Kevin Pho: All right, that’s such a wonderful and rich story that you have. So today we’re going to be talking about a topic that’s near and dear to my heart: speaking. Now, why are speaking skills important for physicians?

Donald J. Palmisano: Absolutely important. To be a leader, you have to be able to communicate, and to communicate, you have to learn some tips. Many people, the majority of people, have anxiety. That is healthy; that is normal. But they get frightened. Some people feel like they’re going to have to vomit, they’re going to have to go to the potty. Well, that’s your body getting ready with the fight-or-flight mechanism, and you can use that to your advantage if you realize that, hey, this is going to help you do better. You’re not going to fall asleep at the podium.

And so, once you realize that. I learned it the hard way. They sent me to that boarding school across the lake when I was eight or nine years old. Everybody else was a year ahead of me because they didn’t have my grade, so my dad told them, “Put me in whatever grade you have, the next grade.” So I was told to get on the stage for a holiday play and be the first kid, to build up my self-confidence. And when I got on the stage, I couldn’t remember the first line. I only had four lines to say, and they turned this big spotlight on me, and I froze.

And so my dad was a policeman, a very heroic policeman. Afterwards, I apologized for embarrassing them. They said, “We’re not embarrassed.” He said, “I’m going to bring you something in a few weeks, and it’ll never happen to you again.” I said, “OK, Dad.” So sure enough, several weeks later, he brought me an Ekotape, a reel-to-reel tape recorder, and he said, “Every day after school, I want you to practice in this for 15 minutes. If you do that, it’ll never happen to you again.” And I did that, and it never happened to me again. So the message is practice, practice, practice.

Now, with all these phones we have, you can set your phone up, give your short speech or your long speech, look at it, and you will learn more about yourself than other people critiquing you. You will learn, “Oh, my goodness, I’m blinking my eyes. Oh, look what I’m doing with this. So I have a tic. I’m rocking back and forth.” Some very famous speakers that I interviewed told me what they had to overcome. My book discusses not just my ideas; it’s other people that I’ve interviewed. Someone was rocking back and forth, and someone taught him how to put one foot in front of the other, and it made it impossible for him to rock the way he rocked in the past, so he just stopped rocking. So those are the things that I think are really important.

And the book, I’m really excited about this book, my third book. The first was on leadership. When Hurricane Katrina destroyed everything, including taking the roof off of our house, I bought a trailer and a truck. We lived for a year in that trailer. It makes you realize that you don’t need a lot of creature comforts if you just want to survive. So my wife and I lived in that, and I decided to write the first book on leadership. I had notes for many years, little notes I would scribble down, put in my little phone, whatever it would be, and it took a little while to get a publisher. I got one. And then the second book was The Little Red Book of Leadership Lessons, 108 photos and images and quotes. It’s a quote book on leadership. So I enjoy writing.

I enjoy poetry, and I tell people that if you read Shakespeare, if you read Browning, if you read all of these famous people from the past, you will be able to put together something memorable. I had an occasion one time, before I was president of the AMA, when the AMA Alliance called me and said, “Would you come speak to our group?” I said, “Sure, let me just make sure I don’t have some interference.” I was in Chicago, and they said, “Well, in an hour.” I said, “In an hour?” They said, “Yes, the speaker bailed out.”

So I got in a cab, went over to this other hotel, and I’m thinking, what am I going to tell these wonderful members? They were spouses; 90 percent of them were ladies, and the others were men, 10 percent. So I thought of Elizabeth Browning: “How do I love thee? Let me count the ways.” And so when I walked into the hotel, they had their exhibits, “Hands are not for hitting.” Each state had put in an exhibit, a wonderful exhibit. So what I did, I just got up to the podium after the introduction, and I said, “How do I love thee? I love thee because of all the good works you do. Hands are not for hitting, I love thee.” And I went down the line, and that was the theme of the speech, and they loved it because, number one, it was personalized to them; it was an appreciation for them.

And that’s what I tell people. Remember, in the chapter that I submitted to you, that you kindly published, chapter 10 of my new book, about stories: Stories are absolutely critical in order to get the people interested in your speech. They will forget your slides. They will forget your graphs, probably in a day or two, but they will not forget your stories.

Kevin Pho: And I think that is such critical advice. Whenever I give keynotes, it’s always stories that really make that message memorable. I have 10, 20, 30, 40 short stories within my keynote, and that really makes that message resonate. So let’s go one step further. How do physicians come up with stories to include in a speech? Do you have a method? Do you have a structure in terms of telling stories? Give a little detail in terms of how you tell your stories within the framework of a speech.

Donald J. Palmisano: I try to draw upon personal experience: Either I witnessed it or it happened to me. I tell people, don’t do a story based on a newspaper report. And now with all of this social media, which I think is fine for communication, I’ve learned a lot, but there’s so much false information out there, and people will stand up in the audience and say, “That’s not true. So-and-so was there. It didn’t happen.” Tell your story. Nobody can contradict your story. When I tell you I lived on top of a restaurant bar, nobody’s going to contradict me. I was in the Irish Channel, Corona’s restaurant bar, my maternal grandparents’. So tell your personal story.

And then here’s one story I told at my AMA inaugural address. A man in New Orleans took hostages in a home. The police were called by neighbors, and the house was surrounded. And then a man came up in an unmarked police car, in plain clothes, got out, talked to the officer in charge, and then he started walking toward the house. He took his coat off, he put it on the ground, and he held up his standard-issue revolver of the time, a Smith & Wesson six-shot revolver, four-inch barrel, laid it on the ground, walked up to the front door, opened the front door, and went in. The gunman put the gun in the policeman’s face and said, “Now I’m going to kill you.” And the policeman slowly raised his right hand and put it on the gunman’s forehead, and the gunman was perplexed.

My dad, that was my dad, the policeman. I gave you the punchline. I get emotional when I tell that story. He said, “You’re sick. You have a fever. Let me take you to the hospital.” And he said, “I have a fever?” “Yes, you have a fever.” And with that, my dad took the gun away from him. Another policeman rushed in with his gun drawn, and he told me at my dad’s funeral, years later, he said, “You didn’t know how he took the gun away, but this is how he did it.” And he said, “I was convinced he was going to kill your dad, and so I had my gun. I was ready to kill the gunman before he killed the other hostages.” So that’s a personal story to me. It’s hard for me to tell it without having an emotional tinge in my body. So people like that story.

I tell a story about how I was a good student. I got a scholastic scholarship to Tulane undergrad. I was told by my advisor, which in retrospect is great advice, to take English and take all these other things so you’ll be literate and you will be able to enjoy things later in life. And it’s true. But when I got to med school, everybody else had taken anatomy in advance, and I failed the first test, and it was shocking to me that I had failed that test. And I talked to my dad. I said, “Dad, I’m going to quit med school.” He said, “Why would you do that?” I said, “Because I think these people at Tulane are smarter than me. In med school, they come from all over; they’re not just from Louisiana.” He said, “Son, listen, you’re smart enough to be a doctor, but you have to remember three things: Do your homework, have courage, and don’t give up. You do those three things, and very little in life is impossible.” So those are the kinds of stories that I tell.

I never talk about a patient or give a name unless the patient was in the news, and we went to the medical school and she would talk to reporters and so on. Such a patient: I made the discovery early in my career that copper was an essential nutrient for adult health, and published it in the New England Journal of Medicine, and this lady was on long-term hyperalimentation. She had lost essentially all of her small bowel, and she’d come down to the medical school, a very wonderful patient. That would be a story I could tell because she’s in it, her face, her name. I’m standing with her at the hospital when they would do these stories about that. But other than that, you don’t want to talk out of school, but you want to give a message.

And remember, you have to speak to the audience and understand where they are. That was taught to me by a famous doctor at the AMA, Dr. Ed Annis, now deceased, but I used to get advice from him. Whenever I would see him at the AMA, I had a tape recorder. I’d run up to him and say, “Dr. Annis, give me a tip for today.” “OK, Donald, here it is.” And one of the great tips that he gave me was to think of your audience. Always think of the audience, and make sure you speak to their interests. Everybody in the audience comes to see you because they want to get something out of it. So what can you tell them in your realm of knowledge that actually helps them?

Kevin Pho: Well, that’s wonderful advice and insight, and thank you so much for sharing your own stories and wisdom. Now, whenever I tell other physician speakers to share stories, sometimes they push back. They say they’re too informal, they’re too casual. “I’m in a scientific meeting. I’m doing grand rounds.” Now, how can you incorporate stories into all types of speeches that physicians may be asked to give?

Donald J. Palmisano: Well, you just have to find a link. There’s always an alternative way to a destination, so that’s your task: to find an alternative way. It’s the de Bono lateral thought process. And so what it might be: I gave a talk on the further development of medicine’s ethical code after the atrocities that were done in the concentration camps in the Second World War and so on. And what you need to do is just point out that whatever horrors have happened, we need to identify those horrors and set up some rules and guidelines. And when people break those rules and harm other people intentionally, then they have to be accountable for that.

But I think this is an example where you wouldn’t have to, maybe. Albert Einstein, let’s take Albert Einstein. If he walked into a scientific meeting and they put up a big board, and he wrote on this board and he said, “E equals mc squared. That’s my presentation,” now, you don’t have to tell a story there, because somebody was, “Oh, well, I don’t believe that. I don’t think that’s true,” or not. So sometimes you have something so profound, you just tell them and you walk off the stage. You want to keep it short.

But you can weave a story in. You can talk about how you felt when a patient told you, “Doctor, I know you’ve done everything you can do for me. I’m at peace with my God. I’m at peace with my family, and I’m ready. I don’t want any additional treatment. That’s my decision. I don’t want you to hasten my death. On the other hand, I don’t want any new experimental drugs. I’ve made peace. Everybody dies, and I’m ready.” You can share a story like that. There are times when that story is important to someone else who has an illness.

So I’m fascinated by stories. I love stories. One story that I told to a group, at a recent talk that I gave to international business people at a convention: I said slides put people to sleep. Now, sometimes you have to put slides up. If you’re a plastic surgeon and you want to show all the different things you’ve done, with the patient’s permission and so on, that’s one thing. On the other hand, you don’t need it. You put all these graphs up, people fall asleep.

Now, there is a woodpecker called the ivory-billed woodpecker, the largest woodpecker in the history of the world, and it was extinct around 1932, so they say. Well, right after that, a Louisiana person in the legislature, he had a permit to go hunting in the Atchafalaya Basin, between Baton Rouge and New Orleans, the largest swamp in the United States, and he said, “There’s an ivory-billed woodpecker.” He shot it, and he brought it to Wildlife and Fisheries. He says, “It’s not extinct. Here it is.” Now, what a horrible thing to do. It might have been the last one, perhaps, or maybe one sitting on a nest somewhere. And so you can weave that in. But unless it’s a story like that, and you’re a birder, say, and you were coming from Baton Rouge to New Orleans for this convention, and you happen to be a great photographer, and you had your cameras, and you got a picture of it, you could show that slide. He’s very distinctive; he’s got a big white band when his wings are outstretched. But other than that, I don’t show slides anymore.

I also talk in my book about when I was a young man, my first national speech. And I wasn’t a keynote, Kevin; I was a follow-on, one of the worst positions, right after the keynote, because everybody’s excited and they all go out and get coffee or whatever, and I was next. So there I am in an audience of 500 people, and they bring up a big device, and I didn’t know what it was because it looked larger than a projector. And the guy came out on the stage. He looked like he came from the cover of GQ magazine. He had an Italian suit on, perhaps, and no notes, and he pointed to that device in the center, five people away from me, and suddenly something came out of the top. It looked like a puff, and I said, “My goodness, this is a hologram.” In my naive state, I said, “This is a hologram.”

And it wasn’t a hologram. I had just read about it; it was on my mind because I had just read National Geographic. It was a fire. And people started to scream, and they came and put the fire out, and then they took it away, and they said, “OK, don’t panic. We’re OK.” So the man is standing on the stage, and he just stands there. I call that a dramatic pause. Well, it went beyond a dramatic pause, and finally two people came and took him off the stage. The guy was in a state of shock. He relied on those slides. And they tapped me on the shoulder, and they said, “Dr. Palmisano, would you mind going to the stage and speaking now?”

Now, that taught me that if it could happen to this famous orator, it could happen to me. And if it could happen to me, what can I do to prevent that? Well, what I would do, I tell people, is I write some notes. I tell this to the medical students. Of course, I teach at Tulane, on how to give a memorable speech, an elective course. I said, “You write down the key points.” And one day, you will get a tilt. You will get the blue screen of death, in the early days of the computers. And how do you boot it up again? You turn it off, you turn it back on, right? So you just look at this, and it says, “Oh, today we’re going to talk about the four elements of a memorable speech,” and I’ll put it down here just so I could show you. And that way, boosh, and then you can go from there. The moment you have that flash where everything gets wiped out for a moment, panic sets in, and you have trouble, and 10 seconds seems like two minutes, and so you get more anxious. So what you need to do is just to have some notes with you.

So what I wanted to get across in this book: I wanted people to overcome their fear of public speaking, and I wanted to tell them that if you want to give a great speech, if you want to get a standing ovation, these are the things you need to do. Number one, you’ve got a knowledge of the topic; that’s a given. You’ve got to show passion. You can’t just be up there: “Hello, I want to talk today.” You can’t do that, OK? If you’re shy, just keep practicing at home. Your presence, presentation skill. I made up an acronym called CODAC: content, organization, delivery, action, and control.

And then in the content, I talk about Strunk and White. Kevin, I’ve got a whole bunch of copies of it, because what happens is I keep buying these. I give them to my grandkids. I’ve always got a supply, and I say, “This is the most important style book you can buy.” And then I tell them about rhetorical devices. If you go back, and I went back a couple of thousand years and looked at speeches, looked at the translations for languages I didn’t speak, and looked at all the English speeches here in America and so on in the English language, what did I find? I found rhetorical devices in all of these speeches: anaphora, rule of threes, rhetorical question.

Rhetorical question, back in the old days, 2,000 years ago: “How long, O Catiline, must we tolerate these abuses?” Anaphora, which is “These are the boys”: This is President Reagan on the 40th anniversary of D-Day. “These are the boys of Pointe du Hoc. These are the men who took the cliffs. These are the champions who helped free a continent. These are the heroes who helped end the war.” There’s anaphora. Martin Luther King Jr., that wonderful speech, “I have a dream,” and then he says the rest. Then he says, in the next paragraph, “I have a dream,” and so on. And then I have the rule of threes: “He came, he saw, he conquered.” And I have a bunch of those different devices listed. But if you look at a speech you like, some presidential address, a time of crisis, the Second World War, Pearl Harbor, whatever the event is, look at those speeches and you’ll find rhetorical devices.

Kevin Pho: So much wonderful advice you’ve given us in this interview. We’re talking to Donald Palmisano. He is a surgeon and a lawyer, a former president of the American Medical Association, and the author of A Leader’s Guide to Giving a Memorable Speech: How to Deliver a Message and Captivate an Audience. Donald, what is your take-home message for the KevinMD audience?

Donald J. Palmisano: Well, thanks. I wrote down three things here. First, do get a copy of Strunk and White. I don’t care how good you are at giving speeches or writing; you can always learn something. By the way, White, he was a columnist, but he also wrote Charlotte’s Web and Stuart Little, so quite an interesting man. So you want to get that. The second thing is: Follow my dad’s advice. Whatever your endeavor, do your homework, have courage, and don’t give up. Always find an alternative way to get to the destination if somebody puts up an obstacle to you. And third, I would encourage you to get my book, so that the tips are in there. Anyway, I appreciate the opportunity to be here, and I have my website at donaldpalmisano.com.

Kevin Pho: Fantastic. Thank you for your time, and thank you for joining us on the show.

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