The Carmen Effect - And The Tyranny Of Jargon

Peter C. Johnson, MD, Principal, MedSurgPI, LLC

Over the course of several years while I was performing scientific research, I met with colleagues at a Gordon Research Conference in New Hampshire. Gordon conferences (as they are known) occur in the most genial of settings, characterized by warm summer days, plenty of food and drink and wide open blocks of free time that foster informal conversations and collegiality. They are usually held on the grounds of private prep schools, making participants in Gordon Conferences feel as thought they have stepped into John Knowles’ book “A Separate Peace.” An imaginative one can almost see Phinney reading beneath a nearby tree. There is something magical about Gordon Conferences that breaks down political and disciplinary barriers to allow people to converge in thought. They have provided continuously successful forums for scientists since the 1920s.

What accounts for their success? Much of it is the result of the attendees’ communion in common daily events. For example, in our generous free time, we would hike together in the White Mountains, play golf, fly fish or simply sit on the lawn and chat. I made one of my best friends at a Gordon Conference. Someone introduced us, knowing we were each planning to fish the next morning. We woke at 4 am and tattooed rainbow trout in the Mad River until our 9 am meeting began. The friendship has endured. The schedule of daily activities, including these joint leisure interests and meals, creates in everyone the sense that while their work is important, it is actually part of a larger whole – and it spurs on the desire to learn and to understand. It is quite the human dynamic to observe.

Not all Gordon Conferences are alike. Some, for example have razor sharp foci, for example: “Thin Film and Crystal Growth Mechanisms. In conferences such as those, all participants are likely to be able to communicate freely about their work, assured of mutual understanding. Not so, ours. Our conference was one of the mostly highly interdisciplinary Gordon Conferences. Though all attendees were pursuing the same goal (better clinical care through the development of medical devices and engineered tissues), our fields of interest were starkly different. Collected around the common dining tables were materials scientists, biophysicists, chemists, surgeons and pharmacologists, among others.

 All of those who make presentations at these conferences face a peculiar form of stress. Since the conferences are by invitation only, they tend to attract the best experts in their fields. As a result, each presenter is faced with having to educate a fairly astute audience. When also facing a multidisciplinary audience the presenter must balance the tendency to use the precise jargon of his/her own field with the need to ensure that all can understand their message. In our conference, we took great pains to make sure the presenters used common language and reiterated concepts, so they could be fully understood. Sometimes, however, the system broke down.

 Many of the schools where Gordon Conferences are held have no air conditioning – in fact, a black market for portable room fans often develops when the sweltering August evenings arrive. One particularly hot morning, I was sitting next to a woman who is an engineer for a large company. Let’s call her “Carmen.” She and I sat in adjacent seats throughout the conference, so we had time for a periodic chat and became acquainted. It was her first Gordon Conference and she didn’t quite know what to make of the experience. However, she was a learner, listening intently to each talk. Most topics being presented were distant from her intellectual comfort zone and she would periodically ask me clarifying questions when she knew that the topic was in my area of work.

 She and I found that we were taking pride in the fact that we had achieved a general understanding of all of the presentations to that point. It was refreshing to think that our unidisciplinary minds were able to expand and assimilate so much more than we thought they could hold. We were unwittingly entering a zone of cognitive hubris and were each about to be taught a lesson.

 One of the final presenters focused his talk on the structure of a specific molecule. He started out well. His images of bond angles and the like were clear and the format of his talk was well conceived. Carmen and I were once again on a roll of understanding. About midway through, however, his speech began to accelerate. It was unclear if he felt time pressure or if he was just getting excited about his topic. As he erupted forth, the commitment to de-jargonize his talk melted away and we were soon entertaining terms that would require more than just hearing them to understand them. Carmen and I looked at one another, disappointed and amazed. We sat through the rest of his talk only semi-engaged. We were beaten.

 As we walked from the classroom across the quad to have lunch, Carmen described her experience to me in this way: “I knew this would be a difficult subject to absorb but I was handling it really well. I was actually shocked at how much of what he said I could completely understand. But then he started to talk really fast and I was having trouble keeping up. And then he used a single term that I didn’t understand – just a single term - and he lost me from then on. It was as if I were a spacecraft orbiting the earth just fine, then I suddenly lost gravitational attachment and flew off into space on a tangent, never to return. Even though I tried, I simply couldn’t hook back into his talk after that. An essential building block was gone. So I just sat there. It was such a waste of time.”

 I enjoyed her description of the sudden loss of understanding we all experience when we are faced with foreign and complex jargon. What is important is that the effect of that loss affects not only that part of a presentation where it is used but also reduces the capacity to understand the rest of the presentation, as well. I dubbed it “The Carmen Effect” as we walked, which appealed to her as a way to make the lesson endure. I wonder if she remembers the event.

 Our experience illustrates the sensitivity of interdisciplinary communication in technology development. As we all know, the language of international diplomacy is nuanced to achieve important understanding between nations. Interdisciplinary communication demands and deserves the same care, particularly when the stakes are high, as in the development of biomedical technologies. It is wise when making presentations to assume that even a single word, if unknown to the audience, can dramatically reduce the value of the message you are offering.

 How can this be prevented? A good first step was offered to me once by Dr. Jay Vacanti, one of the leaders in the field of tissue engineering, which is highly multidisciplinary. He and his teams in Boston (which included representatives of many different skill areas) had difficulty understanding one another’s descriptions of problems, largely due to field-specific vocabularies. This resolved when they agreed to simply speak to one another at a 5th grade language comprehension level. Almost all scientific jargon immediately vanished from their conversations. They were highly successful using this approach. Using this technique to prefilter your own presentations can also be useful.

 When presenting, several active steps prove to be useful. It is best to observe your audience carefully at all times. Asking them for their questions is helpful. Sometimes, to break the tyranny of audience shyness, it helps to ask yourself a simple question, to give the audience a sense of the scale of “acceptable” questions. In all cases, developing a sixth sense to know when you have your audience at full understanding and when you do not is invaluable.

 Biomedical technology development requires effective communication between multiple disciplines at several key interfaces in the development pathway. Interdisciplinary communication, if done well, can speed product development cycles. When done poorly, the Carmen Effect results, costing time and money and frustrating participants.   Getting that spaceship back into orbit is significantly more difficult than taking the care to keep it there in the first place.