The Cure for the Common Conversation
“Most people do not listen with the intent to understand; they listen with the intent to reply.” — Stephen R. Covey
In medicine, we’re trained to diagnose, treat, and move on. Efficiency often becomes the currency of competence. But Covey’s fifth habit—“Seek First to Understand, Then to Be Understood”—invites a different kind of wisdom, one that begins not with answers but with deep listening. It’s about showing up with presence and humility, remembering that understanding is itself a form of healing.
Years ago, during a particularly stressful period on our inpatient service, I was working with a resident who continually clashed with nursing staff. Frustration mounted on all sides, and the tension began to impact patient care. One afternoon, after yet another difficult interaction, I invited the resident to walk with me. “Why do you think they’re acting the way they are?” I asked. The question caught him off guard. He was ready to defend, to rationalize, to make excuses. But as we talked more, he realized he had never really considered their perspective—only been frustrated by their perceived resistance. That conversation opened a door. He became more curious, began asking more questions, and listened more intently. And as the nursing staff began to feel heard and respected, it didn’t take long before the dynamics on the unit shifted significantly.
Covey emphasizes that genuine listening requires more than silence—it demands presence, curiosity, and suspension of judgment. This isn’t just interpersonal advice; it’s deeply grounded in neuroscience and psychology. Studies show that active listening not only improves trust and satisfaction in patient care but also strengthens team cohesion and lowers emotional exhaustion. When people feel heard, they are more likely to collaborate, adapt, and grow. The opposite is also true: being unheard fosters defensiveness, disengagement, and even burnout.
In our work, we often find ourselves in roles of expertise and authority. But the most powerful leaders and healers I’ve known are those who make space for others’ voices first. They lead with, “Help me understand what matters to you,” before asserting what they think matters most. That habit—of pausing to truly listen—has changed the way I show up with patients, colleagues, even family. It’s not always easy; the urge to fix or persuade runs deep. But I’ve learned that understanding isn’t about agreement—it’s about respect. And respect can build bridges over even the most turbulent waters.
This week, try an experiment: while in a conversation that has an emotional charge for you, resist the impulse to formulate your response while the other person is still talking. Just listen. Reflect back what you heard. Ask a curious question instead of offering an immediate opinion. Then share your experience with your PeerRx partner. You may discover, as I have, that listening first doesn’t diminish your voice—it amplifies your impact. Because in the end, the path to being truly understood always begins with giving the gift of understanding.