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Simple words that save lives: lessons from “expert talkers” (bbc.com)
270 points by bookofjoe 20 days ago | hide | past | web | favorite | 165 comments

When asked why she is incoherent, he replied: “How the hell do I know?” When chastised for cursing he said: “Well I don't care, ya stupid-ass questions you're asking.”

It's my understanding that some people are particularly sensitive to cursing and aggressive language, while others don't really care much. When we read something like the above, both our worlds collide. The language sensitive people will relate with the dispatcher, while others will think what the hell, because it seems that she was not listening to what was being said, but rather focusing on how it was said.

In society it's each person's responsibility to be civil and courteous, but emergency dispatchers should not expect this from callers. Not everybody is polite, but everyone deserves to expect help when they call for it, regardless of the way they talk. Emergency response is not customer service, where you can just tell a client that you'll have to drop them because they berated one of the phone clerks and that's against company policy.

I'm not playing devil's advocate for bullies, nor saying that people who hate swearing shouldn't do certain jobs. But I believe that if the work is to be a public respondent to emergency situations, maybe learning to not take things so personally should be part of the training.

Somewhat O/T, but a dispatcher here in Sonoma County, California was recently named "best in the country" for her disposition and quick thinking during the 2017 Tubbs Fire in which several of my neighbors perished.

Some of her ad hoc instructions included telling people to jump in a pool or pond. This saved numerous lives [1].

She is now literally rewriting the script for how dispatchers respond to wildfire emergencies [2]:

"Her boss, Aaron Abbott, said that on several occasions “KT gave life-saving instructions to citizens in situations that were so unique that no emergency fire dispatch protocols existed for them.”

1 - https://www.pressdemocrat.com/specialsections/rebuildnorthba...

2 - https://www.pressdemocrat.com/specialsections/rebuildnorthba...

That is just awesome. I really wish as a software engineer that there were more jobs in my field that could make this kind of a difference to people's lives.

Both links are the same. Were they supposed to be different?

My dad, a commercial fisherman in Alaska, was on the radio to the marine dispatcher trying to get a rescue because his boat was sinking and there was water lapping his ankles. The dispatcher scolded him for cursing and from what he related later that only turned up the firehose. A helicopter did show up in time, so all was fine.

Baffling to me that people who are meant to be dealing with human beings going through stressful moments, perhaps the most stressful of their lives, believe policing civility should be part of the package.

It still seems strange for "how the hell should I know" to ellicit such a reaction. Even if/when it's considered a curse, it's not aimed at anyone. It's strange to me to see someone take the defensive when they're not being attacked.

I've known some people who considered religious curses inherently "aggressive", on the principle that blasphemy is an offense against god instead of the other people around you. But even the people who would chastise someone for swering in a crisis had the sense to wait for the end of that crisis.

I'd imagine that as much as anything, this is about 911 dispatching being a thoroughly unnatural role. On one end of the phone, it's a life-and-death crisis, but on the other it's the twelfth call of an eight-hour shift. Miscommunication across that kind of gap seems inevitable.

I think people like that are absolute babies. It's okay if you don't curse or even if you want to privately judge those who do but who rebukes another adult for a bit of salty language? Does anyone have a view that might change my mind?

I agree. Fair or not, I associate that with being rather sheltered. They’re just words, and a “bad” word uttered into the void, not directed at anyone in particular, has no power over you. To see people recoil over a simple “fuck!” when I stub my toe suggests a naïveté that I don’t have time for.

If nobody speaks up for being civil, there's no incentive to be civil. Certainly we need folk speaking up for civility so we can keep using our expletives with appropriate conviction. After all, the whole f'ing reason for cursing is to offend.

If you're not offended, I have to try harder to convey my indignity, you naughtyhead.

I think there may be two schools of thought here, though.

Some people interpret the very act of cursing as incivility, regardless of the purpose, and some people only view it as uncivil if it is meant to be uncivil.

Personally, I don’t agree that the only reason to curse is to offend. In my mind, curse words have a very specific meaning and sometimes they are by far the most appropriate word for a situation.

I would liken it to using words that describe parts of the human anatomy. There are some people who would never say the word penis in polite company, but sometimes it’s just the only word for the job.

Also, I’m not suggesting that my interpretation is the only reasonable one, just that I think there are widely varying positions.

I'm Australian and I think a large portion of us use swear words almost like punctuation.

Of course it depends on the social context. I'm not going to be swearing much at all at work and still feel a little startled (not offended, just surprised and maybe vaguely uncomfortable) when my manager drops an F-bomb or two. Yet around friends and family, F-bombs (and C-bombs [1] around close friends!) are almost used like exclamation points, purely to draw emphasis and attention to a statement.

I can only conclude it's one of those cultural things. So while I respect that some people find swearing deeply offensive and particularly only useful to offend, that's a really alien concept to me.

[1] F-bomb and C-bomb are slang terms referring to f..k and c..t respectively.

I think it's very contextual. I'd expect such a rebuff from my grandmother - at any age. From a public service, I'd expect them to be overly familiar with the stresses involved.

Yes, but if your grandmother rebuffs me, I’ll think, “what the hell?”

My grandmother was a school teacher. If you said it around her, you might well get the rebuke, whether or not you were her grandchild.

Many have triggers around tone of voice or curse words. So in some cases triggered ptsd ( trauma related pattern) and not really a choice available to take it personally or not. Trauma may be caused by repeated scenarios of control, humiliation, abuse, especially toward children.

I recommend nonviolent communication, the book and the practice. Teaches the ability to “translate” highly charged conversations into basic human needs and feelings.

I don't think the dispatcher reacted appropriately, but "how the hell should I know" comes across a lot like "you're stupid to think I could answer that question".

The full analysis of the call is fascinating.

For the dispatcher, the question was sensible because "I don't know" is one fork in triage that helps separate from answers like "she's diabetic so maybe her blood sugar dropped". For the caller, it feels like he's expected to have an answer and isn't getting helped by the dispatcher, particularly if he already knows that he doesn't have any useful information.

From a completely dispassionate view, the dispatcher still got his answer: no known cause, continue to step 2. But as far as training dispatchers, it raises all kinds of questions: Can you reorder the questions to get the caller's observations and then their knowledge? Can you rephrase 'why?' so that "I don't know" feels like part of the process and not a breakdown of it? Can you prepare the dispatcher better to deescalate or ignore the hostility instead of worsening it?

"do you know why" or "have an idea why" might be a good jumping off point, though a lot slower to say. "Are you aware of any existing conditions (that might be relevant to this emergency)" is probably too long.

"Do you know why" sounds pretty good. It's not only less demanding, it's less likely to attract a guess from someone who feels obliged to answer.

Emergency Medical Dispatch is a fascinating case study of technical communication in general. Lots of jobs train people to communicate urgent information clearly, but EMD has exceptionally specific limitations. Only one side of the call is trained, so you can't rely on rehearsed protocols like EMTs or police officers would. And the priority of information is completely unintuitive to most of us because it's not just importance, but sequencing: info needed to dispatch an ambulance comes first, then info to help the caller do first aid, and only after that the seemingly crucial stuff like "what's actually making them sick".

> It's my understanding that some people are particularly sensitive to cursing and aggressive language

It depends on the country and culture too. Here in Scotland, swearing is basically part of the vernacular, especially if you're in informal terms with each other. For example, if I help out a friend, he might say "ta, you're a good cunt!", and it's a way of saying "thanks".

Wow, that was surprising to read as an American. Here, "cunt" is universally a negative + derogatory term, without exception.

It is not uncommon in languages for crudeness to serve as an indicator familiarity. In America one might jovially refer to a close friend as a "bastard", "motherfucker", or in certain subcultures use a word no white person except Eminem is allowed to use. I've heard many a young woman address her young female friends as 'cunt' or 'bitch'. Similarly, formality is often used to put distance between yourself and people you don't like, i.e. by calling them "sir".

Formality is used to put a respectful distance between people you don't like, but also people you don't know.

Too much familiarity with someone you don't known is a highly aggressive challenge. "What's up motherfucker" to some guy at the bar won't make any friends and might end in a fight.

As with many things there is quite a bit of nuance to the usage of registers, often differing by region. Opening conversation with strangers using an informal (but not crude) register is common in the US, and consequently the injection of formality can be done with hostile intention. If the hostility is not recognized by the other party the intention can be made clear by the juxtaposition of formality and crudeness. Consider a phrase like "Would you kindly fuck off?".

Eminem never says the N word tho. Quentin Tarantino comes to my mind as the famous white person with a pass.

"universally a negative + derogatory"

No it isn't. It's often hilarious, as in the above example. And in that one episode of Curb Your Enthusiasm. You wouldn't use it in mixed company, but if you know your audience you can say any number of horribly offensive things.

Indeed, thanks to the way culture is spreading through Youtube and other modern media, many here in America would prefer to adopt the lighthearted version of cunt from the aussies. Definitely not suggesting it's a majority though

Yep, I chose that example precisely because of the strong aversion to the word "cunt" in the US :)

Another example would be if I told a friend something incredulous, they might respond with "get tae fuck!" (meaning, "fuck off!"), or "awa' an shite!", (meaning "what a load of shit!").

How do you know when people are seriously cursing at you?

> How do you know when people are seriously cursing at you

Because there would be violence involved.

Seriously though, the tone, context and body language would be completely different.

It's hard to put it in words as our perception of aggression is a basic social instinct. But, broadly, you know from posturing (bucking up, moving in closer) eye contact, tone (more volume, or possibly less) and the cursing would get personal, demeaning, etc.

Context helps. A good friend is probably not cursing at you when you walk into the pub and he yells “how ya been, you old asshole?”

More interesting is how in the British Isles and Oceania, how cunt and mate have switched meaning.

I'd rather my friends call me a cunt (as the closest ones do) than mate, because the thin veneer of politeness in mate implies distance if not contempt (from strangers / acquaintances).

The Scots and the Australians use it in a much more conversational way than everybody else I've encountered.

It still has negative connotations, but in a much lesser way so it becomes part of friendly banter.

I’m sensitive to bad language used out of context. I’ll admit it.

Bad language in my brain wiring triggers fight or flight responses in me because in the wrong context, it sounds f’ing aggressive and violates all kinds of gentlemen’s codes.

It’s not the words themselves though. I can watch standup comedy with lots of bad language for hours. Another example is Jon Favreau’s character in Chef who curses liberally but his personality is so teddy bear like it doesn’t do anything to me. Joe Rogan? No problem.

But if I meet someone in a corporate setting who looks stern (especially a young insecure guy) and starts to let fly with bad language, I’m likely to cut the person down — because my brain interprets it as aggressive posturing and puts me in a mood to attack this person.

I need to work on my responses (I’m not justifying them), but I also want to share so that folks know how bad language can come across in the wrong context.

> But if I meet someone in a corporate setting who looks stern (especially a young insecure guy) and starts to let fly with bad language, I’m likely to cut the person down

That's obviously far less about the profanity, and more about the power dynamic and tone. My guess is the same response could be triggered with no actual profanity in that setting.

Even more bizarre than worrying about swearing, I once had a 911 dispatcher understand the street I was saying, but stop to correct my pronunciation. I had just moved to a new house and my roommate had injured himself. I called 911 and when I told them my address was "123 foobar" the dispatcher responded, "actually it's pronounced 123 foobaz". A long awkward silence followed which I eventually broke with a simple "ok". I really didn't know what else to say.

Correcting my pronunciation of a street name is fine in most contexts, but it seems like an awfully trivial thing to spend time on while my friend is bleeding profusely.

AKA Postel's Law: https://en.wikipedia.org/wiki/Robustness_principle

I've never been a dispatcher, but I have worked in on-site assembly plant tech support, and I've seen the problem with escalating interactions quite a bit. The way I approach it, people who call in are upset and excited about their problems, not mad at me. Other people heard the raised tone of voice and took it personally.

Also many have triggers around tone of voice or curse words. So in some cases triggered ptsd( trauma related pattern) and not really a choice available to take it personally or not.

I recommend nonviolent communication, the book and the practice. Teaches the ability to “translate” highly charged conversations into basic human needs and feelings.

As far as people having instinctive reactions they can't control, this can certainly be true. But I don't really understand who you're recommending nonviolent communication to in this context?

The person swearing was a random 911 caller attempting to receive help; we can't expect every caller to know nonviolent communication, or to recall it in life-or-death situations. The person upset by the swearing was a 911 dispatcher; if they have involuntary triggers around language then a job that absolutely requires remaining composed while talking to frightened strangers is dangerously poor fit. And I don't think it would actually be good for the dispatcher to practice NVC - whatever its merits, it's not a process meant for rapidly transferring vital information.

Safety and emergency-response communication is an entire topic of its own, and emergency medical dispatchers already get specific training on how to achieve the goals of that work.

The call became the subject of a paper, "When Words Fail: A Single Case Analysis" (1988) [1], which contains the complete transcript.

The conversation is fascinating and frustrating to read. The paper breaks down the interactions to try to find out where exactly communication failed.

> Our investigation revealed that the participants had rather different understandings of what was happening and different expectations of what was supposed to happen in this conversation. Over the course of the interaction the talk of both caller and nurse-dispatcher (and her supervisor) operated to extend and deepen this misalignment. This misalignment contributed in a fundamental way to a dispute that contaminated and transformed the participants' activity: the eliciting and giving of information concerning the condition of the caller's stepmother was displaced by the activity of arguing. We were thus able to show when and how words can "fail," not in the sense of failing to be heard or comprehended but in the sense of failing to achieve the "meaning" they might be perceived as semantically conveying.

The paper is paywalled, but can be accessed with Sci-Hub [2].

[1] http://www.jstor.org/stable/800591

[2] https://sci-hub.tw/https%3A//www.jstor.org/stable/800591%3Fs...

Thanks for posting it! I was initially infuriated at the nurse's response -- thinking "these are emergency professionals, how can they not know how to deal with people in distress?" -- but after reading the paper, I see the interaction was more nuanced. Like the article argues, it was a non-standard interaction, with bits of information offered in places where they aren't usually expected (even in informal conversations!), and both the nurse and the caller had built different mental models of what was going on, leading to disaster.

Fascinating indeed.

Also, I'm grateful Sci-Hub exists!

FWIW the word 'hell' is not considered a curse in Ireland or, afaik, in the UK

This was also in 1984, a time when language was much stricter. Nowadays I wouldn't expect 'hell' to be considered a swear word in the U.S.

> Emergency response is not customer service, where you can just tell a client that you'll have to drop them because they berated one of the phone clerks and that's against company policy.

That's why it's good for customer service and their management to push back when people are rude and not accept excuses. Besides making life dramatically better for customer service, it helps train people to be courteous as a matter of course. They learn courtesy works and will tend to build an unconcious habit that's more likely to exhibit when they're in an emergency.

I swear like a navvy at times (which I have worked on decreasing over the years), but feel extremely uncomfortable with it in some environments and times.

One concern I have about it is that it is a useful "letting off steam" step before an increase in physical aggression or temper.

When that step is removed due to it becoming a form of punctuation, the escalation to physical becomes potentially easier or quicker.

While in the military I got the distinct pleasure of driving a soldier with a dislocated shoulder to the local hospital. The soldier in great pain was cursing the entire trip. After a short visit to the hospital, I drove the soldier back untreated. The hospital refused to treat him because he was so vulgar.

My point being. Yes there are limits to what emergency response should put up with.

> The soldier in great pain was cursing the entire trip. After a short visit to the hospital, I drove the soldier back untreated. The hospital refused to treat him because he was so vulgar.

This is hard to imagine, actually. An incredible dereliction of duty by the hospital.

> Yes there are limits to what emergency response should put up with.

And your conclusion, as applied to the context you provide, is clearly wrong. Of course there are limits to what emergency response should put up with, but that doesn't even come close.

First, so you are fine in letting somebody else(!!!) die? Because the person calling 911 is not the person that is dying. Even if it was the same person - the death penalty for words? Really now?

Second, your story does not support your point, it just adds words to it with no apparent relevance.

>The hospital refused to treat him because he was so vulgar.

Was this a delivery facility in the USA?

Because if so, I'm 99.999% sure they broke the law. Just by way of example, recently, in one of the hospitals my S.O. runs, a gentlemen was cursing and racially berating a black nurse for attempting to treat his wife. Extreme vulgarity. (They had come in because the wife was having a baby. So emergency situation.) The hospital simply asked that the husband leave, and made sure that no black, hispanic or asian caregivers treated the wife.


Because it's unethical not to treat the sick, it's illegal in most states, and it will get you into serious problems with medical review boards everywhere in the US. All that then starts impacting things like Joint Commission, etc etc etc.

Of course, if the facility is already full and operating at legal capacity, that's one thing. But it doesn't sound like that's what happened in your anecdote.

No it was not a USA hospital. Does it make a difference that it was in a foreign country?

With respect to the legal ramifications of refusing service to a soldier? Yeah. It's pretty safe to say there would be a difference in response from the authorities.

> emergency dispatchers should not expect this from callers

Why should emergency dispatchers not expect a civil working environment?

I do not condone the response of the emergency dispatcher here but I genuinely want to know why an emergency dispatcher must be required to withstand hostile behavior as part of their job?

"emergency" rather definitionally indicates that "not normal" or "out of the ordinary" situations are occurring. For most callers, this may be the worst day of their lives - emotion/stress/danger/death/etc.

They're not required to interpret a caller's phone voice as 'hostile' either. Unless the caller actually says something like "I'm going to come find you and kill you or your family" or something along those lines, I don't think there's any reason anything a caller says should be interpreted as 'hostile' to the dispatcher. If they're agitated/upset - well... they're having an emergency.

Should medical staff not expect "sick people" in their office/hospital?

Someone who can't handle someone yelling or swearing on the phone should't be in a dispatcher role, and... yeah, I think it's gotta be stressful for them too, and they probably shouldn't do it a whole lot, as they'll burn out quickly.

To this - surely this would be part of any psychological testing done to screen dispatchers for suitability, no?

I would draw parallels here (though it's nowhere near in scale) with:

* firemen often risking their lives approaching (and sometimes entering) buildings in fire. It's a hostile environment, but it's their duty, whether they are paid or not (volunteer firefighters).

* policemen answering a call in a dangerous/hostile neighbourhoods (or just roaming). It's hostile environment, but it's their duty to be of service there.

Compared to the above, expecting dispatchers to emotionally detach and not take anything said personally is a smaller ask, in my opinion.

> why an emergency dispatcher must be required to withstand hostile behavior as part of their job

Emergencies make people stressed. Stressed people often curse.

Why? Because impoliteness shouldn't be punishable by death.

That's what I was thinking ... "I don't care that (you/your wife/you child) is dying, call back when you can keep a civil tongue in your head."

Also the one dying is (usually) not the caller.

“But why should I object to that term sir,” she says. “See, in our century, we’ve learned not to fear words.”

I once encountered someone who was contemplating jumping from a bridge. My immediate response was to keep him talking, no matter what, because I just didn't know what else to do? Everything I said agitated him more, to the point where he actually ran across the road to the other side of the bridge to get away from me.

Fortunately, I managed to flag down a passing ambulance and a paramedic intervened. This seemed to calm things down for a while until the police arrived.

However, one of the officers had the same effect as I had and the situation became quite desperate. His female colleague intervened though and that's when the situation turned around.

I ended up sitting in the ambulance with the paramedics while the drama unfolded. Eventually, the policewoman came over and said the guy was willing to get into the ambulance so long as 'that man' is not there (meaning me). So I bid my farewell to my new paramedic friends and left the scene.

I doubt he was going to jump initially but I wonder, if it was left to just me, whether the outcome would have been more tragic?

As a pointless counter-story, I almost ran over a dude laying in the middle of a highway. Another driver and me pulled off, drugged him to the sidewalk (he was heavy and strong, but not violent per-ce), and we sat on him until police came as he was obviously trying to run back into the cars.

[this story has no lesson, sorry]

As another semi-pointless counter-story, I was in SF once at a red light and I noticed a guy jumping out at cars on the road, but not actually moving towards them, just lifting his arms up and flailing.

So, my teenage self decided to teach this guy a lesson. When I started driving towards him, before he could jump at me I turned my car at him and drove right in his direction. It scared him half to death and he jumped backwards.

Lesson is sometimes sitting on a dude works when talking doesn't?

per se

dragged him*

I guess


Maybe it was just the fact he wanted to talk to a female and not a male if he was a male himself? Perhaps it made it less threatening, like when two strange dogs meet, if they are the same sex they will usually bark at each other, but if they are of opposite sex the tolerate each other better?

inimino 19 days ago [flagged]

Or it could have been an example of the well-known effect that women are generally peacemakers and men and generally the ones who start wars.

I worry that if the "keep them talking" -heuristic becomes widespread enough, we'll experience a cultural evolution where people flat out refuse to talk.

If you know the main strategy of your opponent it to get you talking, your most obvious strategy is to not talk.

I'm not convinced. Plenty of suicidal situations are not already sure of what they want, and random passer-bys trying to help are not necessarily "opponents" in this situation. Sometimes (often?) it really is just a cry for help, and talking to a stranger is someone answering that cry

Wow must have been tough for you. Sometimes the chemistry just works the other way I guess. Good on you for trying though. Have you noticed what were the others doing differently?

Noticeably, the policewoman kept a fair distance away while talking to the guy and didn't move forward until he'd given her permission to do so. Her general demeanour was calm and respectful and you could see the positive effect this had almost immediately.

Unlike me and her colleague who did, more or less, the exact opposite.

This is very important. I have had the most success when the other person feels in control at all times. Think approaching a wild horse, not saving a baby from a burning building.

Unfortunately, it is also counter to intuition for many, who just want to help and tend to swarm around the problem.

Don't think about approaching. There's nothing you can do if you're next to them that you can't do at a distance. In particular, you should never try to physically stop someone jumping (who is already on an edge). Given that, you may as well keep your distance anyway. The most important thing is to listen.

Sometimes being able to talk in a normal conversational tone is preferable to screaming over a distance.

Maybe he disliked you so much that it made the female officer seem that much better. In the end, he didn't jump. Sounds like you got a win to me.

Can you describe your emotional state?

Do you think it differed at all to the paramedics and policewoman?

Yes, panic. As opposed to calmly dealing with an everyday situation.

The policewoman did have the advantage of being able to close the bridge to traffic though, which also helped calm things down.

There's a reason many country's police forces get trained for deescalation. It's not a natural or easy thing to do for most people

What is the right approach in that situation? My intuition would be humour, trying to dedramatise, make the person feel the absurdity of the act. But I have no idea of whether that would make things worse.

The Zero Suicide Alliance have some very short training that they think is useful: https://www.zerosuicidealliance.com/training/

My advice would be to say hello, ask what's going on for the person, do not approach until they give you permission, do not dismiss what they're saying but hold hope, tell them that while you don't know them that you care about them and don't want them to die.

Don't for fuck's sake try to make a joke about it. This is one of the worst days of that person's life. They're on that bridge, on that train platform, because they intend to end their life. At that point in time this is the only way out they can see. It's not absurd to them.

Thank you for posting that Zero Suicide Alliance link. I was not aware of their training but will be checking it out.

I had a friend phone me late at night a few weeks back and it took me a minute to realize what she was saying when she just said "I don't want to be here anymore". Fuck the thought of it is still haunting now.

Thankfully she didn't follow through. Still really really scary.

I'm not an authority, but in my personal experience that can definitely make things much worse. A person in that state might not be able to see the absurdity (to them, it's the least painful option -- which is very logical and not absurd at all). You run the risk of sounding like your having a laugh at their misery on their expense.

I'm not sure general advice is possible, but if I had to give some it would be the exact opposite: compassion; acklowledging their pain; understanding that they most likely don't want to die -- they just cannot bear living. Be a person they can talk to. Let them know you take their problems seriously, and that they have value to you, just for existing.

There's a men vs women trope of trying to solve the problem vs actually listening. I suspect it actually applies a lot to these situations.

Once someone's to that point, they either don't want you to help - or don't think they want you to help. If they believed it could be fixed they wouldn't be in this situation. But no-one wants to die alone, so you can offer them someone to listen.

I tried pointing out the absurdity and it didn't have the desired effect. At one point I said 'what can be so bad that you want to do this to yourself' and he said his son had just died. What do you say after that?

Well, you start by saying you hear him and see his pain, that that is an utterly awful thing to happen to anybody, and that while you can't imagine what he's going through, it is completely understandable that he would be feeling so desperate in such circumstances. Acknowledgement is important. After that... that's the tricky bit. _Maybe_, you might say that while it feels right now like there's no hope, that that won't last forever. _Maybe_ you might suggest that his son wouldn't have wanted him to do this. But anything that sniffs of manipulation is dangerous ground, I think. The first part though, the acknowledgement, that's step one in speaking with anyone in emotional distress.

From the Last Psychiatrist Blog[1]:


"TV taught you how to love, it showed you what love looks like, feels like. But when you're actually in love, it doesn't look like that, so you secretly suspect you don't have the capacity for love, that there's something wrong with you.

Same goes for sadness. And it's worse when you're in the presence of someone else's sadness, you have no idea what to do. All you really know about experiencing these emotions is the script you got from TV. "Oh your husband died!? Oh my God, that's terrible! I'm so sorry for you!!" But you don't feel any of that. Nothing.

So you think to yourself, what the hell is wrong with me? This woman's husband died-- sure, I can fake it, but am I such an empty monster that I feel nothing?

Of course you feel nothing. Why would you?-- it's not your loss. What's wrong isn't your lack of feeling, but that you think you have to feel something, that you have to tell this woman, remind this woman, how horrible is her loss. You think the only way to connect with people is to have their emotions. You think she wants to connect with _you_. You think she wants _your_ help.

The problem isn't your lack of feeling, it is that you think that unless you feel it's not real. You forget that she has a life that doesn't have you in it.

What you should say is, "I'm very sorry to hear that. Is there anything I can do?" and that's it. But that feels insufficient. You think this because you think that there is something you can do, that the sadness is not real for you so it must not be real for her and you thus have the power to change it.

She's not looking for you to be sad, she's not looking to you for anything, her loss is bigger than you. If she needs anything from you, it's sympathy, not empathy.

But no one taught you this. So you fall back on the character "man helping grieving widow." Action!


What's wrong isn't that you don't know what to say to save him, it's that you think there is something you can say which can save him.

I'm not suggesting you simply walk away and let him die, I'm suggesting that if your reason for not walking away is "society would judge /me/ if I walked away" then you're framing the situation in terms of you. And if your reason for staying is "maybe I can save him, I have to try", then you're framing the situation in terms of you. Only God can save him or bring his son back, you or I cannot, and he knows it - although we might not know it, and act as if we can.

Subconsciously framing it as if the most important part of this man's grief over his dead son is the part you play in it, and how it affects you, is screwy, and it's what we're all taught (by TV and media) to do.

What can you do instead? "I'm very sorry to hear that."; acknowledge to yourself that maybe his grief /is/ enough to justify suicide. Acknowledge to yourself that it /is/ a tragedy that cannot be fixed by the right words, if only you knew them. Release yourself from the bondage of having to save him, and from the responsibility of thinking you potentially can save him (and get the credit), and free yourself up to focus on him, listen to him, be there with him. Or to leave if you're only going to make it worse. Because if leaving helps him, but makes society think worse of you .. surely you can endure the hit to your ego to help a grieving man, right?

Maybe the best thing you can do is help him die with dignity and without pain, carry a message to someone for him. That's what people say they want from a true friend, isn't it? Someone to help bury the bodies, someone who can and will put a bullet in me to stop me suffering?

Or maybe the best thing you can do is let him know that you understand his suffering is bad and you would do those things for him.

By feeling like you are obliged to care, must interject, must save him against his wishes, must say the right thing, you dismiss his grief, disrespect his sadness, appear false, threaten to take away his control over his own life, and push him away. By accepting his grief, sympathising with it, supporting him, maybe you give him room to move.

And maybe he still dies. And maybe he has as good a reason as anyone for it.

And maybe he doesn't, because someone was there listening to how he hurt without trying to change it or fix it or trivialise it, or make it about them. Someone being there with him, while he suffered, without expecting anything more from him. Like a friend would.

[1] https://thelastpsychiatrist.com/2009/01/can_narcissism_be_cu...

(NB. just realised that I'm interested in sending you a link which will fix you, then checking that it doesn't go to -1 votes instantly, to get my own validation here as "helping", instead of sympathising with your stressful and difficult situation without trying to fix it.

isn't that what we narcissistic generations built the "social" parts of the internet for, after all?)

It's OK to expect validation that you did a good thing or didn't do a bad thing, we are social animals. It's only a problem when this need starts taking over your life, much like any addiction?

Thanks for the comment btw.

You could tell him that if he proceeds he'd inflict the same pain he's in now to his friends & relatives. Maybe that would work?


Watch the video on this page: https://www.kent.gov.uk/social-care-and-health/health/releas...

People already feel huge amounts of shame about the pain that they're inflicting upon other people. Calling them selfish just re-affirms what they're already feeling, makes them feel worse, and increases the risk that they'll die.

No! -- at least, that's not what's suggested in the (excellent) course which DanBC linked to. An eye opener for me! Don't divert the focus to others. And (this is my take) don't be talking about what the person mustn't do -- they already feel boxed in! The goal is to steer toward a positive outcome. The course deals with this (and other) points better than I can. Recommended!


holy god please don't ever talk to a suicidal person in a manner designed to guilt or shame them ever.

Why not?

Watch the video on this page. It has interviews of people who survived a suicide attempt. https://www.kent.gov.uk/social-care-and-health/health/releas...

Here's a transcript: https://www.kent.gov.uk/social-care-and-health/health/releas...

They already feel immense amounts of shame. Adding to that shame just re-affirms what they already think, it confirms their distorted thinking that everyone would be better off without them.

The distorted thinking runs something like: "Only an arsehole would kill themselves and leave their family to deal with it, and I'm thinking of killing myself, therefore I am an arsehole. And I'm so terrible that they would in fact be better off without me."

Does it have interviews of people who didn't make a suicide attempt because they were guilted out of it? The dangers of not making a suicide attempt are so low we usually don't even bother to call out "survivors".

Because it may backfire and increase the probability that they follow through.

It may also work and decrease the probability that they follow through. Every strategy has its successes and its failures. If that were a reason not to do something, you'd never do anything.

Fair enough. There is indeed a chance that, counterintuitively, "burdening" the at-risk person with the consequences of their acts may work.

However, whose "burden of proof" is it? Should "OP" provide evidence to their claim or you to yours? If no claims are provided, what should the "default action" be?

I argue that, in face of the extreme consequences of the proposed action ("burdening" instead of "no burdening"), "no burdening" should be the default action, unless there's evidence that "burdening" works (which none of us in the conversation have so far provided).

> I argue that, in face of the extreme consequences of the proposed action ("burdening" instead of "no burdening"), "no burdening" should be the default action

You're wholeheartedly endorsing the idea I was using to mock you:

>> Every strategy has its successes and its failures. If that were a reason not to do something, you'd never do anything.

The consequences of, in your terminology, "no burdening" are just as extreme as the consequences of "burdening". That's obvious, because they are exactly the same consequences.

And the evidence that people will avoid doing things they might otherwise do, even at significant cost to themselves, for the sake of their family and close friends, is abundant.

> And the evidence that people will avoid doing things they might otherwise do, even at significant cost to themselves, for the sake of their family and close friends, is abundant.

Rational people, maybe. People on the verge of suicide are not acting rationally.

Where's the citable evidence for the claim that "shaming/guilting/burdening suicidal people makes them less likely to commit suicide"?

Look at what happened when a person who was actually suicidal shared the viewpoint that worked for him, in public:


With that level of public openmindedness, the citable evidence (of which this is a part) is guaranteed to dramatically understate the actual effectiveness of the approach.

I don't think I'm following here. The viewer was suicidal, but wasn't anymore when he was berated.

My interpretation from your link is that "watching videos of someone playing games helped a viewer not commit suicide".

How's this evidence for advocating berating people while (not after) they are suicidal?

The viewer was suicidal.

The streamer was also suicidal, and responded to the viewer's note with his personal viewpoint on committing suicide. ("People who do it are selfish and weak" -- pretty much the same viewpoint we're discussing here.) Note that, since the streamer was alive, that viewpoint successfully prevented him, the streamer, from committing suicide.

For sharing his successful views, he was made a pariah.

Nowhere in the post says the streamer was suicidal. It says they were depressed.

Even if it did, the suicidal person themselves thinking suicide is selfish is a totally different thing than someone else saying it to them, especially in a moment of crisis.

Not likely IMO. Telling him that ending his suffering makes him a bad person is just adding weight. Suicide isn't a linear decision that can be logically eliminated; it's a vortex of feeling trapped, hopeless, guilty, etc. that needs to be disrupted somehow.

From the "beatings will continue until morale improves" school of things.

"If he feels like shit, maybe making him feel worse will help?"

It would make things worse. There's not much absurd about considering killing yourself.

That person is seeing suicide as the only way out of whatever they are going through. You should try to see it their way and not the other way around. Ask questions and try to be understanding.

I think you cant take that person's word for what was actually going on in that situation. Somebody that still gets so angry about other people never wanted to kill themselves in the first place, in my opinion. They happily jumped on the option that you are annoying and so that's the escape out of that situation.

> never wanted to kill themselves in the first place, in my opinion

This is a dangerous myth and it kills people. https://www.samaritans.org/how-we-can-help/support-and-infor...

The article tells us to prefer some phrases:

- I want to speak with you (instead of: talk to you).

- Is there something else you'd like to talk about? (instead of: anything else).

To ellicit a better response from your interlocutors. The story goes that "talk" and "anything" show only apparent openness to engage in dialogue due to cultural associations/cliches, not actual interest.

In particular they mention the second one in the context of meetings. I think I'll try that one as a very informal experiment as I tend to prefer "anything" when asking that in meetings and I don't get a great response usually.

There’s a third alternative to “Is there something/anything else?” recommended in some coaching books: “What else?”

> “What else?”

But that's not even a complete sentence! That's a terrible question! What on earth would you want as a response to that? If someone said to me 'what else?' I'd just think 'what else... what?' What else were you planning to do today? What else did I need to tell you? What else did you need to tell me? What else did I want to ask? What are you asking me 'else' about?

> But that's not even a complete sentence!

Why do you consider the sentence incomplete when the context of the sentence you quoted is quite clear.

FWIW, it was beaten over our heads in school that merely writing “Yes.” in response to a question is not a complete sentence, but that may have been a pedagogical rule rather than a grammatical rule, to force students to learn proper grammar.

A sentence will generally not make sense out of context[0] anyway.

0: https://en.wikipedia.org/wiki/Sentence_(linguistics)#Major_a...

> In particular they mention the second one in the context of meetings. I think I'll try that one as a very informal experiment as I tend to prefer "anything" when asking that in meetings and I don't get a great response usually.

I'm pretty surprised to hear this one. I've never taken that phrase as dismissive, and it didn't occur to me that anyone else would (and it's my experience that plenty of times, others will bring things up upon that question being asked).

I think this is what successful communication should do: try to link to information beyond the actual words used. So in the example of “is there something else you want to talk about”, you might be pointing to a specific thing inside the thoughts of the person opposite and even if they didn’t even think about it, you speaking these words can literally materialize it inside their head.

I think PSAPs should release a list of the most common questions they ask 911 callers. My kids basically know how and when to call 911, but they definitely aren't trained on the best answer to the "is this a house or an apartment" question cited in this BBC story. (In our case, the relevant answer is "house" even though our mailing address includes an apartment number.) Maybe I'd create a poster so they remember what to do under stress, e.g.,

DO tell the 911 operator that we live in a house, not an apartment

DO tell the 911 operator that we have five people in our family (omit the detail that our foster child isn't biologically related)

DO NOT tell the 911 operator that, technically, our fish are "pets"

DO NOT attempt to negotiate a Creative Commons license for the recording of the 911 call

As part of a first aid course, we had a lesson on what to tell the local equivalent of 911, including the place, number of people affected, type of accident and so on (I've mostly forgotten since it was a decade ago). Also the course included practical exercises (I remember having one with simulated epilepsy), with simulated phone calls.

I was taught in school (elementary or secondary school, I forget) how to make an emergency call.

We were taught a recommended recipe: Who, where, what. You tell them who you are, where you're located, then what the problem is. The responder can then start asking questions to get the details they need to classify the category and urgency of the emergency.

It's really something that should be widely taught.

I’ve always thought answering the “where” part is more important. Especially with cell phones where they probably don't have a clue where you are. At least that way if the call got dropped or something they’d know where to direct some kind of help.

I could be wrong.

In the several times I’ve called 911 in an urban area the dispatcher I get is most interested in where to route the call. If medical or fire, they transfer to fire and for everything else they transfer to police. It is almost like they serve as a quick triage and then route to the appropriate place.

Once the actual dispatcher answers they ask a bunch of questions. They waste very little time and can almost seem rude or impolite as they don’t really let you deviate from the “script” but I assume it is because they need to gather the most info in the shortest amount of time.

Thankfully I’ve never had to call with something that requires both medial and police (eg shooting, etc)....

The only time I've ever called 911 emergency services, the operator opened with "9-1-1, where's your emergency?" They apparently do this first so that, if the call gets cut off, they can send somebody to the scene to render aid and find out what the situation is.

I was curious about the 911 call the article mentioned, if anyone else is, here's a transcript.


Admonishing someone for cursing in that situation is just nuts.

I once called 911 for a traffic accident and I also got flustered when they kept asking for my address (I wasn’t involved) instead of telling me that someone is on the way. Ali l wanted to hear is “we have sent somebody”. Then it would have been much easier to answer other questions.

I've sort of had the opposite experience. I made a 999 (UK) call for a traffic accident - head on collision, one person dead at the scene, another died later, devastating scene on a winter's night with just what car lights were left, a horn stuck blaring and quite a bit of smoke in the air.

I was at my home and heard it. Ran to a few hundred metres away and as I got there a nurse arrived too who by chance was driving that way. I made the call because I was pretty certain she'd handle the carnage better than I could.

They answered and I explained there had been a head on car crash, the next question was Police, Fire or Ambulance? Which threw me a bit, I don't care who you send that can deal with this! I think I said Ambulance and then they sent all three anyway.

They then asked what road I was on, it was a minor road and I couldn't remember the road name so I was trying to describe where it went from and to and how far along it was. The person answering the call seemed not to know the place names I was giving, my brain was working overtime trying to find references.

It wasn't until the next day that I realised I should've just given my home address and they'd have found us easily.

I had a similar experience when making a much less serious 999 call for a drunk dude we found passed out in the middle of a car park, it was only after I hung up that I noticed Google have some sort of feature which knew I was making a 999 call and was offering me information about my current location on screen - had no idea they did that though so didn't think to look at my phone screen...

Wow, kudos to Google, a great feature! They really should publicise that more though, I would have had no idea either.

> the next question was Police, Fire or Ambulance?

In the Netherlands I hade the same experience with my only call. I still get angry I had to make that decision. In fact I am pretty sure I got it wrong. In the end no one came and 4 hours later I got a call asking whether I still needed help.

Thank god things had calmed down at that point, but that was pretty much luck. Had I made the right choice between police, ambulance or firefighters, a lot less luck would have been needed.

In many cases when they’ve asked me that the next step was a quick transfer to the local police precinct dispatch or the local fire/medical dispatch. Dunnno what they do when they need to dispatch all of the above though...

Indeeed. It seems that here, the emergency number is just for dispatch.

> I also got flustered when they kept asking for my address (I wasn’t involved)

This is entirely reasonable.

1) Its a stressful situation

2) Your home address is irrelevant to the situation. But because they're asking, you assume they think its relevant[1]. So you're subconsciously worried that they are going to show up at your house because of the miscommunication.

3) You can't quite consciously put your finger on why you want them to stop thinking about your home address because its a stressful situation.

[1] See Grice's 3rd maxim https://www.sas.upenn.edu/~haroldfs/dravling/grice.html

I made a 911 call once about someone yelling "GET AWAY FROM ME SOMEBODY CALL THE POLICE" in an altercation across the street from my window. My address wasn't showing up properly in their database[1], so I started trying to say "they're homeless so the exact unit isn't necessary, let me give you cross streets" and she cut me off immediately with the most holier-than-thou delivery of "homeless people need help too".

....dude, _I_ called _you_. Obviously I'm on board with the idea that homeless people need help during emergencies just like anyone else. I get that dispatchers are people and people aren't perfect, and this lady's unprofessionalism didn't end up making much of a difference in this particular case, but I wonder how much gaps in training and competence bigger than these minor examples cost in terms of response time and lives.

[1] Which is pretty concerning if I ever have an emergency...

The one and only time I made an emergency call, I was right around the corner from my home but I couldn't describe where I was. I wasn't in any way injured (I was helping an old woman who had fallen and cracked her head on the pavement), but the call and situation completely flustered me. Quite eye-opening.

The emergency services operators in the UK make it very clear -- should the situation warrant immediate attention -- that someone _is_ on the way before they go on to ask more questions or suggest action to take as appropriate. I'm quite glad to have only had to experience that once, even thinking about it has raised my heart rate.

Non-emergency calls to the police will usually involve working out who you are at some point in the conversation; non-emergency calls to NHS24/NHS Direct will start off by taking contact details and triaging that you really are not an emergency case. If you drop off the line and they can't get back in touch with you, they've got enough information to make sure you're OK.

The transcript makes the article ridiculous. This issue had nothing to do with the trivial choice of words that the article talks about. The nurse was 100% wrong.

She asked to speak to the person who couldn't breathe!

It has all to do with choice of words, but of a son. He never told nurse that she can't breathe. She told here "she's having difficulty breathing" and then "No, you can't (talk with her). She seems like she's incoherent."

incoherent - (of spoken or written language) expressed in an incomprehensible or confusing way; unclear.

Only person here that is incoherent is son. "having difficulty breathing" means breathing but with difficulties. "incoherent" means talking but words does not make sense.

Someone in that moment of panic is not carefully choosing the words they're using and considering their dictionary meaning.

I'm a paramedic, not a calltaker, but if someone is described as "having difficulty breathing" and "incoherent", that warrants an EMS response. Start the rig and ask any other questions you have after that.

I'm not pedantic about word use, but if somebody uses random words they can't expect other person to understand. When nurse asks what is the problem and they respond "i don't know, how the hell should i know?!" Should nurse know? How?

What about panic attack? It can be described as shortness of breath (difficulty breathing) and sense of terror, impending death, loss of control (being incoherent). It's not life-threatening and does not warrant EMS response.

It makes the BBC article ridiculous, but not the academic article. Check it out; it's fascinating: https://sci-hub.tw/10.2307/800591

>Myrick complained people drove by her home crying "Murderer, Murderer!"

Can we talk to these people? Give them a phone please. Why won’t they talk? If you continue your complaints, we have to hang up, ma’am. Bye bye.

Fucking hell, that made my blood boil.

The guy on the phone was totally right. What if it was that nurse's mother? Why the hell would they think standard protocol was to talk to someone who lay dying. It's nuts. The supervisor is nuts. The nurse was nuttier still.

That was from like 1984 or something?

Sometimes the worst things happening lead to positive outcomes later. That incident probably shook up the entire industry and an outcome is something like that won’t ever happen again.

Kind of like major engineering disasters teach us a ton of stuff and in the end, ironically, make the world a safer place from those lessons.

It's really messed up that for some people, politeness is more important that someone's life.

I liked this article but kinda want like 50 more examples.

I think the talk vs speak and the something vs anything seem so obviously true but I don’t think I would have realized it on my own, even given a lot of time.

How many other small changes in wording can have a profound impact on communication?

You might be interested in the book “Never Split The Difference” which has been recommended on HN frequently:


You might also be interested in looking into nonviolent communication.

Thank you. ^_^

He has several talks and interviews on YouTube: https://www.youtube.com/results?search_query=never+split+the...

Listen to Soma-FM: SF 10-33 sometime. The dialogue protocol between dispatch and police/fire is remarkably controlled and consistent under the most difficult of circumstances.

Exceptions are suspect gunfire, multi-story "working" fires, and foot chases.

Hearing an officer 10-97 (arrive on scene) at a multi-vehicle accident calmly request multiple 408's (ambulances) code 3 (emergency response) belies the chaos at the scene and the intensity of what s/he is actually experiencing.

For what it's worth, most systems are phasing out all that coded stuff and just using plain language.

In SF, with all the hills and low spots, it seems to me the coded dialogue might be more efficient or perhaps easier to communicate. Officers are often 10-1 (receiving/sending poorly) and requested to 10-9 (repeat last message) as in "One Edward Fifteen you are very 10-1. Please 10-9."

And it's weird how your brain picks up on the code and immediately understands the seriousness of the situation. When a 408 is upgraded to code 3, enroute, you sense the urgency. A simple "affirm, upgrading to code 3" tells the officers at the scene that the 408 "gets it" and "hang on, we're hurrying." Usually with the sound of sirens and air horns in the background.

It's not easier or more efficient (it's actually more error prone, since there's less context). The systems also tend to be very regional (a "10-50" can be very different things depending on where you are). Generally the reason its used is "that's how we've always done it". The other reason is that it sounds cooler...

(I work in a system that has (mostly) phased out codes in favor of plain words)

I've heard officers shroud context using codes. "Put me on it, I've dealt with him before. He's a known 800 (mentally ill person)." Or "show me 97 (on scene), subject appears extremely 811 (intoxicated). I'll advise."

99% plain language yet subtly informative.

Generally we use meaningful acronyms in those cases. Still a code, but one that is a lot less arbitrary. e.g. EDP="Emotionally disturbed person", or EtOH=Ethanol

In my opinion it's about keeping your priorities straight. That dispatcher had been given a script and told that they had to get people to answer a certain set of questions. The dispatcher had decided that people who called had to conform to this rule, becuase they had to. They forgot their job was to save lives, not get answers to questions. It's a symptom of attempts to codify interactions between people with simple rules. The rules become the focus, not the big picture.

Reminds me of this thread about a memorable 911 distress call:


Reminds me of non-violent communication - https://www.cnvc.org/

Do you folks have book recommendations that have tips along these lines? I find these useful while driving hard conversations too (Example: Letting someone go from the team).

Another recommendation for "Never Split the Difference: Negotiating as if your life depended on it" by Chris Voss. An insightful look at negotiation and how to be better at it.

I read it after seeing it recommended here a few months ago.

With the advent and spread of AI based call response systems, would negotiation be the final frontier that a General AI would have to break to prove its efficacy and the replaceability of humans.

I guess, negotiation happens at a very human level. Taking SOS calls, asking the right questions and making the right decisions is a subtle art.

Given the current state of "AI", the dispatcher would've sent Jehova's Witnesses and then badgered you for the next three years about "people with emergencies like yours also liked"

>I guess, negotiation happens at a very human level. Taking SOS calls, asking the right questions and making the right decisions is a subtle art.

ML excels at the subtle, as long as the outcome between subtleties is observable.

ML could be used to identify and craft better procedures for the humans.


If you think an article about communicating well in life-threatening emergencies is somehow advice for "the next big product pitch", maybe it's not HN that should step back and think for a second.

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