Communication Skills
The Work Beneath the Conversation: Articulation Work
There's a word for the part of our job nobody can see. Sociologists have had it since the 1980s. We were never trained in the discipline that keeps it.
Communication Skills
They can be learned!
Palliative Care
The Work Beneath the Conversation: I Could Do That If I Had Time
Three trials tested whether the conversation is the intervention. Two came back null and one looked inside the machine. None of them supports the sentence — or our answer to it.
Communication Skills
Beyond Mandatory Autonomy: When to Stop Asking
The asking is the easy part. It's the move that lets you leave the room with clean hands, a documented preference, and a man who will get chest compressions he never wanted.
Communication Skills
The Question That Ends With a Period
There are two options that are good for you. Both are disagreeable. My job is not to invent a third or to make you pronounce the medical conclusion so I don't have to be the one who said it. My job is to tell you why the boundary exists, in language you can argue with.
Communication Skills
Shared Decision-Making Is Ours. Don't Let Them Break It.
The distinction between a recommendation and a coercion is the moral architecture of palliative care. When that distinction collapses in the broader culture, we lose the ground we stand on.
Communication Skills
The 2 a.m. Second Opinion
Here's what I think is happening—quietly, unevenly, and faster than our field is tracking: the foundational architecture of serious illness communication is being restructured by a force we didn't design, don't control, and in many cases don't even know is in the room.
Communication Skills
Beyond Mandatory Autonomy: Truth Without Abandonment
Honesty and hope aren’t opposing forces. They are a matched set: hope for the best and prepare for the worst—paired with an explicit promise of nonabandonment.
Communication Skills
Teams, Not Saviors: Protecting Each Other from Compassion’s Edge States
Every team thinks they’re compassionate. Fewer can name the cliffs embedded in compassion—and fewer still can stop one another from going over the edge in the middle of a messy consult.
Changing the World
Death, Creativity, and Compassion: What Are We Really Training For?
In specialist palliative care, we talk about “compassion training” as if it’s a discrete skill you can add to a checklist. Joan Halifax’s enactive model challenges that notion: compassion isn’t a module; it emerges when attentional clarity, affective balance, ethical intention, and embodied engagement cohere in context.
Communication Skills
What Kyle Learned Recently
From time-to-time, I will publish articles that have recently crossed my path with my analysis of what they tell us. This will be the first in that series.