On being present, not perfect

Just over a year ago, I was invited to give a TED Talk as part of Boston Children’s first-ever TEDxLongwood event. As exciting as the invitation was, it was also daunting. After all, TED Talks are supposed to be insightful, profound, personal, funny, and entertaining- and all of this in less than 18 minutes! Oh, and let’s not forget the requisite “story arc” and unexpected, memorable ending. On more than one occasion, I thought, just what had I gotten myself into? Is it too late to bail?

Truthfully, I had never even heard of a story arc. I had been a biology major! My stomach felt a bit queasy contemplating the foreign concept. That was, until our knowledgeable and resourceful librarian, Alison Clapp—seeing me wandering around the hospital library searching for inspiration and some shred of structure—cheerfully suggested, “I have just the book for you, Elaine: How to Deliver a TED Talk: Secrets of the World’s Most Inspiring Presentations.”

As read the blessedly short book, I wondered to myself, What was it about delivering a TED Talk that was unnerving me so? It dawned on me: How about summoning and sharing intimate details of my life, going to a deep place so publically, and a fear of disappointing myself and the potential audience of millions? That would set anyone back.

And then there were the bevy of practical considerations. Would I remember my talk without any slides? How would I tell the time without the distraction of putting my glasses on and off? What would I wear and what about my hair?

I watched a few TED Talks and slowly started to kindle my mojo. I offered myself all kinds of advice and reassurance, such as, “Stick with what you know best.” I conjured Oscar Wilde’s timeless counsel to, “Be yourself; everyone else is already taken.” Good advice.

And then, it became crystal clear and the title arose, On Being Present, Not Perfect. I knew what I needed do.

As a nurse and psychologist, I have devoted my career to holding challenging conversations in the pediatric intensive care unit and teaching others to feel capable and confident when talking with families and shepherding them through their darkest, most stressful times. In my talk I would take the listeners on a journey of how I came to understand the profound value and healing that can reside in genuine conversations with our patients and their families. I have learned that a year, five years, ten years down the road, it’s not the medicines, treatments or surgeries that people remember, but rather the words we utter, the look we share, and the relationships we dare to establish. And in this work, we are called upon to be present, not perfect. As Carl Rogers so poignantly teaches us, perfect wouldn’t be good enough.

When I quelled my fears and turned to what I knew deep down, the TED Talk effortlessly came together. I had a chance to share with the world what I had learned from patients and families.

And so, I began with a story of how, as a novice nurse, I was unprepared for a mother approached me seeking to talk and unburden her worries about her young son with cystic fibrosis. Of how I learned that I could listen carefully, offer my full presence, show genuine curiosity and care, curb my judgment, and be authentic. I went on to share some of my own personal healthcare experiences that further convinced me of the enduring value and healing of healthcare conversations, if done well.

Delivering the TED Talk, I distinctly remember hitting my stride when describing our approach to holding challenging healthcare conversations at the Institute for Professionalism and Ethical Practice. I was on terra firma and the story arc bowed gracefully. I enjoyed sharing the Wizard of Oz metaphor—courage, brains and heart—to highlight the core ingredients of honest, effective conversations. I had contributed something that I hoped would improve the emotional standard of care.

In the year since, I have been uplifted and gratified by my talk’s impact. It averages over 1,000 hits monthly on YouTube, and has been incorporated into nursing and medical school curricula across the country and abroad. I have received dozens of emails from professionals and patients who have validated the message and connected it to their own experience. Through their emails, these people have shared their stories with me—stories of good and not so good experiences of healthcare conversations that helped them heal, restored hope or reaffirmed their commitment to being the best nurse, doctor or healthcare provider possible.

Elaine Meyer Institute for Professionalism and Ethical Practice healthcare communication difficult conversationsIn the realm of conversations and engaging in relationships with our patients and families—as when giving a TED Talk—the best advice to be present, not perfect can be liberating indeed. And together, I truly believe we can change the world, one conversation at a time.

Elaine C. Meyer, PhD, RN, is the director of the Institute for Professionalism and Ethical Practice (IPEP) at Boston Children’s Hospital and an associate professor of psychology at Harvard Medical School.

4 thoughts on “On being present, not perfect

  1. Great story and TED talk. Wonderful to see the impact the talk is having. Such an important reminder of the power of presence in our healthcare conversations.

  2. Great talk! It is hard to believe you had that early “trepidation” but your passion for your subject certainly came through. Frankly, “the being present, not perfect” concept can be applied to all aspects of our lives and is a function of slowing down!

  3. This is a must watch for anyone caring for patients. “Being Present” cannot be stressed enough and should be the first step in any and all conversations. One of my most memorable moments was being with my dear friend who had metastatic cancer and her physician sat on the floor next to her, held her hand to discuss palliative care. I will be forever touched by his kindness (despite waiting about 2 hours for the appointment – that disappeared, because he cared enough to be present). Thank you Elaine for sharing your story.

  4. I love how you describe your dual journeys, both the journey of learning to be authentic and present with patients, and also your journey of creating the TED talk. Wonderful essay!

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