In Praise of Simple Questions

Sitting in a hospital room with a family member this past Sunday morning, I was fascinated by the questions posed by the nurse practitioner doing the intake interview.

The NP was friendly and engaging and did many things right in the course of putting his patient at ease. But his interviewing skills? Oh boy, those could use some work.

Some of his questions were quite direct and specific, which was good. But his patient had barely responded before he was jumping in with “Gotcha, gotcha” and moving on to a new question.

In fact, despite his good questions, he hadn’t learned anywhere nearly as much as he might have, if only he had let his patient finish their sentences.

The experience got me thinking about the role of questions (and listening) in discerning what’s true, in nailing stuff down.

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And it got me thinking about three questions I asked that prompted unexpected, news-making answers. But it also prompted me to ask a few friends and colleagues about their views of simple questions.

Let’s start with my friends, and I’ll follow up in a subsequent post with my experience.

Most of what follows is drawn from the world of journalism, but I want to begin with a couple of physician friends.

Rich Mier, a retired pediatrician, recalled speaking with an elderly patient who had volunteered to be interviewed as part of the training Rich received as a second-year medical student.

He described the unexpected response he got to one of his assigned questions, which was simple enough: “How are your joints?”

“Well,” the man responded, “I don’t get it up like I used to, but for someone my age, I’m doing OK. Thanks for asking.”

What do you think is going on?

This question comes from Bevin Kenney, a primary care physician at a community health center in Boston. She teaches first year students at Harvard Medical School how to nail down what’s going on with patients.

Bevin says a patient’s response to the what’s going on question is often, “I have no idea!”

She adds: “But many people say all sorts of things that make sense from their perspective and it really helps me understand how they are thinking about things. And (the response) provides an opportunity to do some education and make different connections for them.”

Bevin says she challenges students to “ask a lot of open ended questions before we interrupt a patient, before trying to get to detailed closed-ended questions.”

In the process, the patient and the doc build an investigative partnership aimed at finding the best possible answers to that going-in question.

After this post was published, I heard back from Dr. Jim O’Connell, who helped found Boston Health Care for the Homeless Program four decades ago and now serves as its president. (He’s also the subject of Tracy Kidder’s bestseller, Rough Sleepers: Dr. Jim O’Connell’s Urgent Mission to Bring Healing to Homeless People.)

Jim suggests that med schools could do more to help future docs grasp “the subtleties of inquiry.” And what about his own training?

I always insist that my years of bartending and waiting on tables were the best training ground for getting to listen to and know our patients.

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How do we know that?

This comes from Lisa McGinley, a member of the editorial board at The Day newspaper in New London, Ct. She also spent ten years running the city desk, the heart of a local news operation.

She recalled her response to reporters pitching her with juicy tips they were eager to turn into stories: How do we know that?

“When (the reporter wasn’t) quick to answer I knew we were about to have a longer conversation,” Lisa told me by email. “Gosh, I loved that job and that part of that job!”

I suspect one reason she loved both is the satisfaction she took from helping colleagues nail stuff down — and making sure their readers were getting information as close to the truth as possible.

Like many of the questions shared by my friends, this question from the city desk can be useful in so many dimensions of day to day life.

As in: How do we know that our contractor understands what the city building code requires before construction begins? Perhaps you have some examples of your own?

Congressman Simmons, we disagree with you on every issue. How do you expect us to support you?

Governor O’Neill, you don’t appear to have any ideas of your own. Can you point to one?

These questions come from Greg Stone, who also served on the editorial board at The Day, the paper where I got my start and wrote about here.

Greg and his team addressed these questions to Robert Simmons, who represented New London in the U.S. House of Representatives from 2001 to 2007, and William O’Neill, who served as governor of Connecticut from 1980 to 1991.

Not the friendliest of questions, but then journalists aren’t supposed to be friends with the government officials they cover, especially when they’re interviewing them as part of the process to decide the newspaper’s endorsements.

There are times — and I suspect these were a couple of such times — when a direct, challenging question can yield far more of the truth of the matter than a tamer inquiry might.

What do you love about it?

Jill Geisler, a clinical professor of journalism, leadership and ethics at Loyola University in Chicago and previously one of the nation’s first female news directors, says she began asking reporters that question about their stories “when I stopped being a story fixer and started being a writing coach for my newsroom team.”

Jill, with whom I overlapped at the Poynter Institute for a decade, said the question “encouraged (the staff) to tell me what they were proud of and wanted to protect.” She added: “It gave me a road map for understanding their thinking and helping support or gently refute it.”

Asking about what someone loves is such an interesting way of getting to the heart of the matter. In a piece published in The Week ten years ago, author Laura Munson explained why, upon meeting someone, she doesn’t ask, “What do you do?”

Instead, she asks: “What do you love to do?” Only a couple words longer but apt to reveal a great deal more.

And what did your mother think of what you did?

Melissa Ludtke, author of Locker Room Talk: A Woman’s Struggle to Get Inside, and veteran reporter for Sports Illustrated and TIME Magazine, explains: “I just believe that each of us has a strong connection with our moms. Might be a good one, or not so good, but asking about what she’d think of what we do is likely to reveal aspects of the person we are interviewing that we wouldn’t otherwise see.”

This is the kind of question I never thought to ask and wish I had.

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Why do you think that?

Ellen Hume, a former Detroit Free Press colleague who went on to big reporting jobs at the Los Angeles Times and The Wall Street Journal, describes this question as “aspirational.”

She explains: “It’s more the question I wish I had used more often in my career.”

These days, she’s especially interested in having good conversations with people whose politics are different than hers. And she’s hoping that question will help open doors and yield some insight.

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What should I have asked you but I haven’t so far?

This question from David Beard, a former foreign correspondent for the Associated Press who edits the Starting Point newsletter for the Boston Globe, is one I’ve posed from time to time.

But mostly in journalistic settings. Like Ellen, I’m thinking more these days about how to ask questions like that in everyday life. So much so that this post has me looking forward to my next encounter with a Trump supporter.

Hopefully I’ll ask some good, simple questions. Followed by: What should I have asked that I haven’t so far?

I hope you’ll add whatever questions you’ve found helpful in the comments below.

By the way, in case you’re wondering, the family member whose hospitalization prompted this post has been released and is doing fine. Thanks for wondering!