Learning to Ask the Right Questions

I read an article from the paper by a family practice doctor about an 88 year old patient with congestive heart failure and renal failure. He had been to a large number of specialists; none were able to help him, and so he was referred back to the family practice. In this case, if you treat one condition and the patient gets better, the other condition worsens. This man refuses dialysis. This family physician doesn't know what he can do for his patient. 

He then remembered a visiting palliative care physician's words -- "We forget to ask patients what they want from their care. What are their goals?" He then asks the elderly patient,"What are the goals for your care? How can I help you?" The patient responded, "I would like to walk without falling." The goal for these elderly patients should be to maximize their function. He told the patient that they have services designed to keep him comfortable and that would allow him to stay at home.

The nature of the questions we ask either keeps the existing system in place, or brings an alternative approach and future into the picture. In his book, Community, by Peter Block, he makes a distinction between Questions with Little Power and Questions with Great Power.

● Questions with Little Power are questions that maintain dominance and are concerned with Being Right. They are questions that create a predictable future without uncertainty. The result is the Present projected forward. What distinguishes the future, is it's unpredictability and mystery.

● Questions with Great Power are questions that have the power to make a difference, that engage people in an intimate way, confront them with their freedom, and invite them to co-create a future possibility. They are questions that cause actions, that do not allow the luxury of being a spectator.

Block defines a great question with three qualities:

● IT IS AMBIGUOUS. There is no attempt to try to precisely define what is meant by the question. This requires each person to bring their own, personal meaning into the room.

● IT IS PERSONAL. All passion, commitment and connection grow out of what is most personal. We need to create more space for the personal.

● IT EVOKES ANXIETY. All that matters makes us anxious. It is our wish to escape from anxiety that steals our aliveness. If there is no edge to the question, there is no power.

Questions with Little Power are -- "How do we get people to show up and be committed? How do we get those people to buy into our vision?"

Questions with Great Power are -- "What is the commitment you hold that brought you into this room? What are the gifts you hold that have not been brought fully into the world? What is your contribution to the very thing you complain about?" These types of questions have the capacity to move something forward.

In coming articles we will investigate these ideas further as Jim Myers and I address two very important questions about the present and about our future -- "Why the TOV Center? Why Now?”

Be Blessed,

Rabbi Jeffrey Leynor

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