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It's a common stereotype that men don't talk about their health. That may be why some people believe men don't care about their health. But maybe the reason most men don't talk about their health is because they don't know how to listen to one another.

How would you rate yourself when it comes to your listening skills?

Scot is the son of western South Dakota rancher who grew up mostly an only child. He feels his upbringing and culture has led him to be very uncomfortable talking about difficult things with other people and opening up. He doesn't feel he's a very good listener and constantly tries to solve other people's problems rather than listening.

Troy on the other hand feels like he's a pretty good listener, but he didn't used to be. It took years of experience at his job as an ER physician to learn how to listen out of necessity.

On this episode we're learning how to be a better listener with Kevin Curtis, the Director of Crisis Services with the University of Utah Neuropsychiatric Institute. The 7 Steps to Becoming a Better Listener

Whether you're talking about sports, mental health, or anything in-between, there are a key set of skills that are useful in any conversation. No matter how light or how heavy the topic is, It's important to build a foundation of understanding how to listen. Here are the seven key components of being a better listener"

Step 1: Create a Comfortable Setting and Opportunity to Have a Conversation
The first step to having a meaningful discussion with another person is to create an opportunity to have that discussion in a place you can both be comfortable.

If you believe someone in your life is in need and trying to open up, offer them an opportunity to talk. Invite them out to get a drink. Offer to snag lunch. Go to a ballgame. By offering, you've allowed yourself to be available to listen if they want to talk and by choosing a relaxing setting there will be less pressure and stress on the conversation itself.

And most importantly: After you offer an opportunity to talk, actually go and do it.

Step 2: Talk Less, Listen More
One of the most important parts of listening is to be present in the conversation. Don't let your mind wander and be distracted. Focus on the now. Listen to what they're sharing and be willing to engage.

For many of us, staying present in a conversation is hard, but we may not realize it. One of the most common difficulties with being present is that people keep thinking of what to say next. You will listen to the first part of what the person is sharing, then the rest of your mind is busy thinking about what you should say when they're finished. Or they share a personal problem with you and you immediately begin trying to think of a solution. This is not being present. This is not listening.

It's easy to assume that what you say and contribute during a conversation is the most important, but that's not the case. Sometimes the most meaningful part of a conversation is letting the other person share and be heard.

Remember, it's not about you.

Step 3: Be Okay with Silences
Silences can feel awkward, but they don't have to be. We often try to fill the discomfort that comes from silence with talking, but ultimately halts the conversation from getting any deeper or more meaningful.

Silences allow people to think and gain incite about whatever is being discussed. It gives us a moment to digest new information and consider how it makes us feel. It also gives a chance for us to consider what to say next and questions to ask. It allows us to feel and be vulnerable.

Kevin Curtis explains that he will ask a question then sit in silence for minutes while he waits for a patient to respond. It leads to a deeper understanding between him and the people he talks with. He reminds listeners that some of the most meaningful conversations in life don't have a lot of talking.

Step 4: Ask Good Questions
When you're listening to someone share something difficult, make sure you're asking questions that are there to help you understand what the person is saying. One of the biggest parts of feeling validated is when a person knows that they've been heard and understood.

Show that you're listening and trying to understand by mirroring what they've said with a question. For example, "Here's what I heard, is that what you meant?" or "So you're saying this. Do I have that right?" This is a simple question that show that you've been listening to what they've said and - more importantly - taken steps to make sure you understand them.

If they're discussing a situation you have little to no experience with, you should ask questions about the parts you don't understand. For instance, "That sounds really hard, but I want to understand more. Can you tell me more about this aspect?"

These are both types of active listening. This skill shows the other person that you're hearing what's said, saying something that reflects to show understanding and validating the person who's decided to open up to you.

Step 5: Be Careful When Sharing Your Personal Experience
Sharing your own experience can sometimes be helpful in a tough conversation. It can help build a stronger relationship through sharing an experience. Being vulnerable about your struggles can help validate that the person is not alone with their troubles. In some cases your story can even provide alternative pathways and a potential examples for how to improve their own situation.

However, it's important not to offer solutions. Do not use your own vulnerability to prescribe how the other person should ‘fix' their problems. Do not say something like, "I've gone through something similar. Here's what I did. You should do that." Do not assume what works for you will work for them.

Every person and every situation is different. What works for you may not work for them. Your job is to listen, not fix their problem.

Also, when sharing, be sure to avoid making the conversation about you. Sharing your own story can be really helpful in some cases, but if you take over the conversation, you're not helping them.

Step 6: Do Not Stress About Saying the Right Thing
Far too often we assume that the one hard conversation will be the last. We assume that we only have one shot to make the conversation meaningful to the other person. If we can't say the right thing, at the right time, in the right way - something bad may happen.

That's just not true. In fact, stressing about what saying everything perfectly will take you out of the moment and make you a bad listener. Be present, listen, and honestly participate in the conversation.

You don't have to be the hero of the conversation. There's more benefit to the other person in being heard and validated than any type of advice you could give. Besides, you can always talk more later.

"You'll always have another opportunity," says Kevin. There are no tidy conclusions in life, same goes for conversations. Most of them are just the first step in a much richer ongoing dialogue and a deeper relationship.

Step 7: Validate Them for Being Vulnerable
Opening up to someone else is hard. It takes a lot to be vulnerable to another person. Sharing your feelings isn't weak, it's one of the bravest things a person can do. So let the other person know that.

Thank them for opening up. Show appreciation that the person trusts you.

This small act of acknowledging the other person's vulnerability can open the door to future conversations. An opportunity for you to ask them "How's it going?" and have another enriching discussion.

You'll never find a solution to someone's problems in a single discussion. Treat every difficult conversation as the first step of support. Asking the Hard Questions

If you see signs of depression or suicide in a friend or loved one, having a conversation about it can be especially difficult. When a person is in crisis, it's more important than ever to be brave and be a good listener.

Ask questions that seek to understand how they're feeling rather than deflect the emotional topic. These questions may be extremely uncomfortable to you, but it provides an opportunity for you to get involved and help them get the support they need.

For example, ask things like "Tell me more about how you are feeling. "Are you feeling suicidal?" "Have you had thoughts about ending your life?"

The may seem scary to ask, but they're important to ask if you're going to understand how the situation the other person is in and how fully assess how you can help.

Remember, you are not the solution to their depressive or suicidal thoughts, but you can validate and support them while they're in crisis. Merely asking about thoughts suicide does not drive a person to the act of suicide. Kevin says that there are plenty of studies that show that you are not introducing the idea of suicide just by asking about it. If an individual feels suicidal, they have already thought about it.

One of the most important things to say is, "I'm really worried about you. How can I help?" This opens the door to allow you from transitioning being the sole source of support, to being the supportive person helping them get the professional help they need.

If you or someone in your life is having thoughts about suicide, contact the Crisis Line at (801)-587-3000. The line is not only for people in crisis, but for people who are worried that someone they love may be having throught of suicide. Their professionals will help guide you through the steps you can take to help get your loved one the Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot supports Greta Thunberg and her environmental action. He reminds us that the environment can have an impact on your health, so it's something we should care about. And Troy went to see Toto live and he had a blast. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

Interviewer: A day in the life of an emergency room physician or in this case, a night in the life, that's next on The Scope.

Announcer: This is From the Frontlines with emergency room physician Dr. Troy Madsen on The Scope.

Interviewer: Dr. Troy Madsen is an emergency room physician at University of Utah Health Care and I thought it would be kind of fun to go through a typical shift, the things that you encounter in an emergency room as one of your typical days. Is there even such thing as a typical day for you?

Dr. Madsen: I think you would probably say that the typical day is atypical because it always changes.

Interviewer: But you have a list. You keep track of everything you see every single night for whatever reason.

Dr. Madsen: I do. I keep track of it mostly because I need to remember to finish the charts to make sure I get those done but I do keep track of things. I also use my list of follow up with people, give them phone calls to make sure they're doing okay if it's someone I'm concerned about.

Interviewer: Got you. So let's just go down this list and see some of the things that you encounter and if any questions come up, I'll ask them but I think this should be really interesting.

Dr. Madsen: For sure. So this is a typical night shift and I'm certainly not going to reveal any protected health information or anything specifically about these individuals but these are the kinds of things we see in an emergency department.

So I walk into ER and the first thing I see is someone who is there with a fever. They've come with a fever as the first patient I go in and see, it may have been for whatever reason but their chief complaint, as we call it, the thing that's on the chart, on the board is that they have a fever and I have to try and figure out why they have that fever.

And then there's someone with a headache. The next room I go to and typically what I'm doing, I'm coming into a shift and there may be four or five patients waiting to be seen. Maybe they've gotten some testing going. So I'm saying, "Okay, fever, next one's headache."

Next thing I know someone's coming in who has had some burns. They've had some burns they sustained from flash burns where something exploded in their face. So I'm going in to see that person next, and then moving on from there to someone who has a laceration on their face. They were injured. They have a laceration I need to repair.

Interviewer: It's a cut?

Dr. Madsen: A cut yes.

Interviewer: Okay.

Dr. Madsen: Yeah a cut on the face, and so these are all of the things that are on my mind as I walk into my shift. I'm thinking okay, what do I need to address first? I've got this facial burn. I need to make sure this person is breathing okay, that it didn't affect their airway. Thinking on the laceration, okay I could probably wait on that. I'm going to check and make sure there are no other injuries.

Interviewer: So you have to make these decisions who you're going to see first. Somebody else doesn't do that for you.

Dr. Madsen: Oh, absolutely, I do.

Interviewer: Okay, so you've got a list of the things that are there and then you got to go oh, this is going to be the first thing I want to check out.

Dr. Madsen: Exactly.

Interviewer: Okay.

Dr. Madsen: I'm looking. I've got these patients I need to see and if someone there has chest pain or I can look at their vital signs, if their vital signs are abnormal I'm getting into that room first and I'm prioritizing all the time in the ER, who do I need to go see right now of those I've been seeing, of those who are new? Where do I need to go first?

Interviewer: So obviously somebody who is having difficulty breathing is going to be seen before I'm going to be seen with my broken arm.

Dr. Madsen: That is exactly right. We're going to go in to see that person first.

Interviewer: And the ABCs, let's talk about that just briefly.

Dr. Madsen: Yes.

Interviewer: Those are the three important things that you're looking for, go ahead and explain that.

Dr. Madsen: Yeah ABCs, we're always thinking airway first, making sure their airway is intact. They can move air through it. Breathing, making sure they are breathing. And then circulation, making sure they have a heartbeat, a blood pressure. Those are the three priorities I'm always thinking through. So if I look at someone's vital signs and their blood pressure is 70/40, I'm in that room immediately and the person with the facial laceration can probably wait.

Interviewer: Okay got you. All right, keep going.

Dr. Madsen: Yeah, so that's kind of what I start out with on the night shift. The next thing I see is someone who is pregnant, someone who is coming in with some pregnancy issues, maybe in the first trimester, the first third of the pregnancy, possibly having some bleeding during pregnancy, someone I would go in to see how are things going with their pregnancy. Are there any issues there we need to address?

And then someone who is confused, and this is a common thing we see in the emergency department.

Interviewer: Really?

Dr. Madsen: Yeah, it is and it's usually older people, often times someone who maybe in a care facility, who someone in the facility says this person is not acting quite right and the challenge there is it could be any of a number of things going on. So I've got to kind of throw out a net, as we say in that situation, often times running lots of tests to try and figure out what could be causing the confusion.

Interviewer: Could confusion be life-threatening?

Dr. Madsen: It could be, yeah.

Interviewer: That could be a symptom of something life-threatening for somebody.

Dr. Madsen: Oh it could be. I've seen cases where, and you just see them again and again so you kind of get programmed to think, oh maybe it's a urinary tract infection, maybe it's their medications, but I've seen cases of people who have had bleeding in their brain. Basically they're just saying, "Well, they're confused or not, acting quite right." They may have had a fall at some point and had blood that accumulated and no one knew they fell. So you've got to really look for heart attacks. You've got to look for infections. You've got to look for signs of trauma, all those sorts of things.

Interviewer: Okay.

Dr. Madsen: And then from there I again see someone else that has a headache. Someone else came in that also had a headache.

Interviewer: All right, so how often are headache's actually a good reason to go to the ER?

Dr. Madsen: That's a great question. A lot of people have chronic headaches and they know when to go to the ER for those because they just cannot manage their migraines at home. Big headaches that we worry about are those that are worse than previous headaches you've had or sudden onset severe headaches. If you had a headache plus a fever, we think about meningitis.

So those would all be reasons to go to the ER and all of the things that I'm thinking about is I see okay, the next patient I'm going to see has a headache. From there I saw someone who is suicidal, someone who actually came in saying they had had thoughts of hurting themselves, may not have made an actual attempt, but that's certainly a reason also to go to the ER and yeah.

Interviewer: I didn't know that.

Dr. Madsen: Yeah, we see that quite commonly and partly I think because our emergency department, because we work closely with the University Neuropsychiatric Institute. So a lot of patients who are admitted there will come through us, but I would say over the course of a shift, I very commonly will see at least one, maybe several people come in who are there for either a suicide attempt or thoughts of suicide.

After that I go in to see someone who is there for what we call a "crisis evaluation." This is addressing psychiatric complaints, psychiatric issues and not necessarily suicide, maybe they've been more depressed. Some people have chronic psychiatric issues. They may have had issues where they're not taking medications and have become very manic or had a lot of issues associated with that.

And then from there I saw someone with atrial fibrillation. So this is an issue where the heart's beating very rapidly, where it's just sometimes so quickly that we have to actually give them a shock to get it back into a normal rhythm and that's something very commonly we'll do in the emergency department.

Interviewer: Like a shock like "boo" or how do you shock them?

Dr. Madsen: We shock them with electricity?

Interviewer: Really? To get their heart going to where it should be again.

Dr. Madsen: Yeah, exactly and you may have seen on movies where people pull the paddles down. They're holding the paddles on their chest and then everyone says "Clear" and then they shock. It's not quite that dramatic but it's pretty close.

Interviewer: Really? So that's what it looks like.

Dr. Madsen: Yeah, you're actually delivering electricity to the heart to take it from an abnormal rhythm and try and shock it back into an organized rhythm, and I'm not just walking in the room grabbing paddles and putting it on their chest. These are people who come in, they're talking to me, they know when it started. It may be the first time it happened or they may be familiar with this from before. Maybe they've been shocked in the past. I make sure they would meet qualification to be able to undergo this procedure safely, but then I give them medication to sedate them and give them a shock.

Interviewer: Okay.

Dr. Madsen: Yeah. From there I saw someone who is short of breath and who came in saying they just weren't breathing well. After that an allergic reaction, a severe allergic reaction. We had to give medication for it to treat it. And another fever patient, someone else with a fever and I finished up the night with another case of a rapid heart rate and atrial fibrillation.

Interviewer: That is quite a night. How long is your shift?

Dr. Madsen: The night shift's scheduled for eight hours. I usually plan I'm going to be there about ten hours, just wrapping things up and taking care of patients at the end of the shift. So that's a pretty typical day or night in the ER.

Interviewer: And from that typical day or night, I don't even know if I should ask this question, how many of those people actually made the right choice coming in?

Dr. Madsen: As I look back on these, I can't really say that any of these, I would say don't come in. These were all, as I'm looking back specifically at these, and again it's been a while ago. I'm not going to say when all this happened because I don't want to tie this into any potential health information on anyone but these all seem like fairly legitimate reasons to go to the ER.

The other issue at night is there are no urgent cares. So it's not like you can go to an urgent care or call your doctor and be seen in the middle of the night for your facial laceration and things like that.

Interviewer: Sure. Well that's very, very interesting. So I think the interesting thing for me was, my perception always was you'd see a lot of broken bones, a lot of cuts, a lot of that sort of thing, but there's quite a variety of reasons somebody might come to the ER.

Dr. Madsen: There is. You see a little of everything and that's what's fun about it. Like I said, you go from the room of someone who is pregnant to someone who is having a heart issue, to someone who is having trauma, to someone who is having a psychiatric issue, kind of the full spectrum.

Interviewer: That's really interesting insights on things that I wouldn't have expected in your list there. What are some things that weren't on the list that you do tend to see typically but maybe just not that night?

Dr. Madsen: One thing we didn't see a lot of that night was trauma. Lot of people coming in injured and the most common sort of trauma we see is motor vehicle accidents and injuries from that. We also see penetrating trauma like stab wounds or gunshot wounds. Occasionally we see that. We didn't see any of that that night either.

Another common thing we'll often see are infections, things like pneumonia or people just coming in with upper respiratory infections. I didn't see a lot of that that night either. So it's kind of funny in the ER, that's the fun thing about it that you never know what you're going to get. There are some nights where it seems like you just cannot get out of the trauma room. It's just one accident after another. Other nights, you may not even go in the room.

Interviewer: Yeah and other nights, it might just because lot of people that are confused.

Dr. Madsen: Exactly.

Interviewer: Like confused old people coming in for whatever reason.

Dr. Madsen: That's exactly right. We didn't have a lot of that that night either but there are some days where that seems like that's all you see are older people coming in confused and not sure what's going on and then you have to really kind of look for a lot of different possibilities in those scenarios.

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