May 21, 2024
By Natalia Romano Spica, Drexel University College of Medicine
I came to medicine from the world of ballroom dancing. While I knew that my stethoscope would be joining me far more often than my dance shoes, what I did not expect was how many lessons from the ballroom world would shape my learning and working in the clinical space. So many of the cardinal rules of ballroom dancing, also known as partner dancing, apply to medicine. Below are a few of the key ones that I realize have guided me as I look back on my medical school journey.
“Yes, and”: the greatest leaders know how to follow.
“Listen to the patient; they are telling you the diagnosis!” We’ve heard this quote in a doctoring class or from a mentor emphasizing the art of history-taking. As a dancer, listening to my patients often feels like trusting your dance partner, even when you don’t know what steps will come next.
Remember walking into a patient room with a perfectly crafted agenda, only to realize seconds into the encounter that you needed to immediately change your plan? We lean in and let our patients lead us through their concerns. Both ballroom dancing and medicine heavily rely on one of the core tenets of improvisation: “yes, and”: accepting the new reality presented to us and working with what we are presented. Even when we have a full choreography prepared, sometimes we simply end up taking it step by step. Patients are our partners and our best teachers, and so we follow their lead.
Flexibility and the ability to expect the unexpected are essential ingredients for success in medicine. While it is important to plan in advance, flexibility allows us to be ready for a completely new chief concern or schedule changes. “Going with the flow,” they call it these days. Ballroom calls it “floor craft”: the skill of crafting your way around a dance floor, no matter the curveballs or obstacles. “Yes, and” opens so many more doors and leads to so many more clues for our differentials than “no, but.” It allows our patients to feel heard, trust us more in return, and be treated with dignity. “Yes, and” improves patients’ experiences, as it does ours. The greatest leaders know how to follow and listen closely, so that they can then show the way.
Consent, always: “May I have this dance?”
I vividly remember a patient I took care of in my third year of medical school. She was always surprised whenever I’d ask for permission to uncover the blankets and examine her legs. “You know, most people just come in, take my socks off and never put them back. It’s peculiar to me that you care so much about even asking, and it means the world!”
The first lesson ballroom newcomers learn is that every waltz starts with a partner asking, “May I have this dance?” and waiting for a response. It’s not just part of the choreography; it’s a way to invite one another and meaningfully communicate that the other’s input matters. Just like it takes two to tango, it’s important that patients are informed of their options and on board with upcoming plans — especially in an environment, like that of health care, where the power differential is strong. And remember to put those socks back on!
Practice makes progress, but perfect practice makes perfect.
Imagine training hard for an upcoming dance competition, only for your partner or coach to tell you that your step “is not good” and then walk away. While it may be helpful to know that there is work to do, it doesn’t provide direction for how to improve. You’re left wondering: Should my arm be lower? Higher? Softer? More rigid? Or am I completely off time? Now imagine, instead, receiving detailed instructions on what to improve and implementing that to the best of your ability while you receive real-time feedback on how your changes are looking.
Giving quality feedback is a vital skill in medicine, just as it is vital to be able to receive feedback and implement it. While the spontaneous “good job” and “strong work” can be great reinforcers, meaningful change is most catalyzed by specific and constructive feedback. Similarly, it’s easy to point out what we don’t like about a surgeon or a schedule, but it’s sometimes more difficult to articulate what exactly is the issue and what needs to be improved. We need to be as specific as possible when giving feedback and be able to explain the expected impact of our proposed changes. And while it’s important to improve what needs to change, it’s equally key that we recognize what is going well and do more of the same.
Last, but not least: It’s so important to find mentors and coaches who can act as a resource, point us in the right direction and provide feedback that is part of a big picture. Feedback is a gift and an act of care, and modeling and giving good feedback are important ingredients for growing, nurturing and improving ourselves, our colleagues and our larger teams.