The Fascinating Evolution of Surgery & Asking Questions That Connect-SYSK Choice
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Listen and subscribe to the latest season of Undertow, The Harrowing, a Storyglass production presented by Realm, available wherever you get your podcasts. Today on Something You Should Know, why dogs love to hang their heads out of a moving car window. Then, the amazing history of modern medical surgery and how major advances were met with resistance, like anesthesia.

For about 20 years, surgeons, many of them, refused to use anesthesia because doctors felt the writhing of a surgical patient during an operation increased their energy levels and allowed them to survive the operation in a better condition. Also, how to take a nap so you really feel rested and the way to have more meaningful conversations that really connect.

So one of the tools that we actually teach people, if you're starting a conversation with a new person or somebody that you know well, is to pay attention to what they are wearing, caring, sharing, or presenting, and ask a question rooted in your natural curiosity. All this today on Something You Should Know.

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Something You Should Know. Fascinating intel, the world's top experts, and practical advice you can use in your life. Today, Something You Should Know with Mike Carruthers. Hi, and welcome to this episode of Something You Should Know. I don't know why, but I always enjoy when a car drives by and I see a dog with its head out the window, seemingly enjoying that wind on its face.

And although there is no real scientific explanation as to why dogs love it so much, it's probably their sense of smell. A dog's sense of smell and their nose are so much more sensitive than ours, they're likely experiencing something wonderful that we could never understand or experience ourselves. But the bad news is we probably shouldn't let them do it.

Aside from the obvious danger of falling out of the car, dogs who hang their head out the window are exposed to tiny and not-so-tiny particles of dirt and debris that can get in their ears and eyes and nose, resulting in injury or infection. And that is something you should know. Surgery

It's a scary word. When you're told you need surgery, it's usually not a good thing. And yet, surgery can be a lifesaver. It can fix a lot of things and make people well. What's so surprising to me, what I learned from my first guest today, is that what we know as modern surgery is really only about 100 years old. And yet, it has advanced so rapidly in that short amount of time.

The amazing history of surgery, modern surgery, is fascinating. And here to tell it is Dr. Ira Rutko. He's a general surgeon and historian of American medicine. He holds a doctorate of public health from Johns Hopkins University, and he is author of a book called Empire of the Scalpel, The History of Surgery.

Hey Ira, pleasure to have you here. Well, thank you for inviting me, Michael. I really appreciate it. So you point out that modern surgery as we know it really only started in the late 1800s, early 1900s.

But the idea of doctors and doctoring and medicine, I mean, that's been around for centuries, maybe thousands of years, where doctors treated to one degree or another, treated illness in people. So why did it take so long? Why did it take really until quite recently for surgery to become part of medicine and be a real thing?

There are four foundational elements that need to have been discovered or slash invented, whatever word you want to use in order to do a safe and effective operation. Now, what are those four things? Firstly, a surgeon has to understand human anatomy. They have to have a roadmap in front of them. They need to be able to tell where they're going.

Second is they need to be able to stop hemorrhaging because if the roadway is getting flooded in surgical operation by blood, you can't see where you're going anyhow. So anatomy and bleeding. Third, anesthesia. You can't have patients writhing on a table.

And the fourth thing is antisepsis. So anatomy, bleeding, anesthesia, antisepsis. Without those four foundational elements, a safe and effective operation cannot take place. And antiseptis means so that bacteria doesn't get in there and infect and...

Yeah, so let's, if you don't mind, let me just discuss a little bit and give you some idea of times. So the beginning of an understanding of human anatomy occurred in the 16th century, mid-16th century, by a gentleman. His name was Andreas Vesalius. He wrote the first, what you and I would call, the modern textbook of human anatomy. Prior to that time, there had been very few dissections of a human cadaver.

So mid 16th century, we're beginning to understand anatomy. At the same time, one of his peers learned how to stop bleeding. It was very simple. He invented a forceps that allowed him to grasp a blood vessel. He could put a tie around the blood vessel and he could stop the hemorrhage. So those were founded, invented in the 16th century. Now there's only one problem.

We have 300 years more before anesthesia and antisepsis come about. So anesthesia happens in the mid 19th century and antisepsis not until the end of the 19th century. So by the beginning of the 20th century, I guess we could say by World War I, we had the four elements were in place.

Well, those are some pretty big obstacles to solve. But I'll bet that even when those obstacles were solved, that there was probably resistance within the medical community because just human nature, people like to keep things the way they are. And you start talking about solving those kind of problems and leading to surgery, that there would be some resistance. Yeah.

They always wanted to go back to traditional thinking, meaning that you would think if somebody discovers anesthesia and the patient no longer has discomfort, that's a great idea. Well, it's not quite as simple as that. For about 20 years, surgeons, many of them, refused to use anesthesia.

I know that's hard to understand, hard to believe. Why would you subject your patient to pain? And the reason, amongst the reasons, was because surgeons and doctors felt that the writhing of a surgical patient during an operation increased their energy levels and allowed them to survive the operation in a better condition. So for 20 years, we're trying to understand why.

Not the discovery of anesthesia. We're trying to figure out whether it should even be used. All right. So that's anesthesia. Then antisepsis comes about. So let's talk about antisepsis because it's a great story. And around 1860, a French physiologist by the name of Louis Pasteur, we all know pasteurization. He discovers this thing or things. They're called bacteria.

First time ever. And he says to the world, listen, there is another form of life out there. You might not see it. You can't feel it. You can't touch it. But I'm telling you, it exists, i.e. bacteria. That concept was then taken over by an English surgeon. His name was Joseph Lister, like Listerine. And Lister says, you know, that's a great idea, those bacteria.

I have a feeling that those bacteria are what's causing infections, surgical and surgical wounds to get infected. Before around 1870, the concept of pus in a wound was a good thing. I know this is difficult to grasp in the modern world, but they felt the more pus there was in a wound, the better the wound was healing. Now patients were dying from sepsis. Lister says,

I think you ought to wash your hands and maybe use this spray that I have, and it will stop the introduction of bacteria into surgical incisions. Lo and behold, he does that, and infections stop.

The problem was, like many other things, traditional thinking took over. And many surgeons said, I'm not going to do what Lister wants. It's just too difficult. I'm not washing my hands. I'm not washing the instruments. I'm not spraying the room with this carbolic acid spray that he wants. I'm not going to do that. So for till the end of the 19th century, beginning of the 20th, you had this debate about the use of antisepsis.

Not until World War I was everything sort of established where anesthesia and antisepsis were used for all operations. So that's when it was then, right? The beginning of the 20th century where those four elements got solved, those problems got solved, and off we go. Yes. And so I would say that it wasn't until around 1920 or 1930 that you began to see surgery

Meaning if you looked in an operating room and saw the surgeons, the nurses, the anesthesiologists, it wasn't until around 1920, 1930, that you began to see what you and I would describe as surgery as we know it today. That's a century ago. It's 100 years. That's it. And what did it look like before then?

Nothing that you and I would enjoy. Let's look at this American Civil War. So the American Civil War, they had anesthesia because it had been discovered 20 years before, but they did not have enough ether and chloroform to use on all the patients, all the soldiers who were wounded. So frequently the operations were still done without anesthesia.

During the Civil War, they had no understanding of sepsis, of infections. Patients would have an amputation done. The stump would get infected. The infection would spread throughout the body and the patient would die. So these elements, these foundational elements for a safe and effective operation truly are

Did not come into play totally until into the 20th century. And I can even make the story more difficult to understand. Go ahead. When anesthesia was discovered and the patients were no longer writhing on a table, let's make believe you're the surgeon.

And you before used to rush through an operation. Let's say, I mean, there are many instances published records of an amputation of the leg being done, you know, in 30 seconds. They would just cut the leg off that day. Well, but if I told you now you're the surgeon, hey, patient doesn't have any pain. You don't have to worry about it anymore. What does that mean to the time you're going to spend on the operation?

you're gonna have a lot more time you've got it you're gonna have a ton of more time not only you're gonna have a ton more time but by the fact that you have a ton more time you're going to do more what dissection you're going to do more cutting you're going to do more sewing so let's go forward a little bit once antisepsis was founded

it wasn't quite accepted yet but had been invented they were beginning to open the abdomen they didn't really start opening the chest well into the 20th century but they could open the abdomen so you're opening the abdomen the patient is not having any pain you're roving around inside the abdomen you know you're doing appendectomy you're cutting this you're dissecting that you're sewing everything back up and it's taking you longer and longer well longer and longer translates into more blood loss more bleeding more everything so what happens

Although they might not have an infection, they go into what they call shock, surgical shock. That's from blood loss. Surgeons did not understand the concept of blood loss and causing shock until, let's say, World War I. So, yes, we had the four foundational elements, but they were doing these larger and larger operations with more and more blood loss and patients would go into shock and they would die from the shock.

So help me understand this. If doctors don't understand that infections will happen if you amputate in the Civil War, how did anyone survive an amputation? It was called a four-letter word, L-U-C-K, LUCK.

It was just serendipity. Some people did, some people didn't. There was no reason as to who did and who didn't. It was a matter of luck. It was a matter of what was going on. It was a matter of how bad was the initial injury, how much bacteria got in from the cannonball or from the bullets, or how long were they lying on the battlefield. You know, it had mud surrounding them and they were lying in mud. There's a million things.

We are discussing the rather short and amazing history of surgery. And my guest is general surgeon Dr. Ira Rutko. He's author of the book Empire of the Scalpel, The History of Surgery. A bloodbath tonight in the rural town of Shinem. Everyone here is hiding a secret. Four more victims found. Some worse than others. I came as fast as I could. I'm Deputy Ruth Vogel. And soon, my quiet life will never be the same.

Realm presents a 30 Ninjas production, Chinook, starring Kelly Marie Tran and Sanaa Lathan. Listen to Chinook wherever you get your podcasts.

So Ira, the earliest type of, let's call it routine surgery, was what kind of operations were they doing where things got pretty good, pretty easy, survival rates were pretty good? Well, I understand what you're asking. The first operation that became...

let's say like a fad that everybody was doing it was that were appendectomies. And that was around 19. The first appendectomies were in the very tail end of the 19th century. And then by 1920, 1930, everybody was having an appendectomy done.

What do you mean? What do you mean everybody was having an appendectomy done? I mean that everybody was having it. The number of operations that were being done for a supposed sick appendix was overwhelming in 1920s, 1930s. I've seen statistics that 50% of patients admitted to the hospital in the 20s were for an appendectomy. That's a lot of surgery. Why was that? Why was that? Because there was this thinking that the appendix and the tonsils, for that matter,

served as harbors for bacteria, and these bacteria would cause infections. So let's get rid of the source, i.e. appendix and tonsillectomies. Yeah, I know a lot of people have had their tonsils out and their appendixes out, and you often hear people say, well, you don't really need them. But I've always wondered, like, well...

You know, the human body is the way it is probably for a reason and maybe you do need them. So what do you think? I mean, do you need your tonsils or are you fine without them? Oh, that's an interesting question and that gets into all sorts of things. For instance...

Now we know that the tonsils and the appendix probably have some role, be it major or minor, in the immune system and keeping the immune system competent. So they cut out all these tonsils and appendices on people. They might have done harm to their immune systems without realizing it, obviously, at the time. Michael, surgery is a very powerful tool.

And it's not something just to be taken very lightly. Now, in today's world, and I say this repeatedly, in today's world, in the industrialized world, I don't think there's anybody who during the course of their lifetime

does not meet the surgeon's scalpel or scissor or whatever. I, for one, like I said, appendectomy, tonsillectomy. I've had three dental implants, three screening colonoscopies, and I'm healthy. I'm not even on any medicines. And any number of little lesions on my skin that have been removed. Each one of them, call it major, minor, whatever you want, was under anesthesia. It was a surgical operation.

And when you look at the kinds of surgeries that are being done today and how sophisticated they are compared to just 100 years ago, it kind of boggles the mind of what will surgery be like 100 years from now. So let's talk about a phrase that I use all the time, and that's called frame of reference.

Frequently, I'm told when I discuss the history of surgery, oh, those old operations were barbaric. They were ghastly. There was maltreatment. There was malpractice. It was horrible what they were doing. It was butchering of human beings. Well, if you apply our state of knowledge that we have today to something that happened two, three, four, 500 years ago, yes, we look at it and say, boy, that's barbaric.

But understand one very, very important thing. And that is that whatever doctors, surgeons, physicians are doing back when was always state of the art. It's state of the art. So what we're doing today is

whether it's robotic surgery, laparoscopic, chemotherapy is considered state of the art. I would hate to think that 200 years from now, when none of us are around anymore, somebody says, what were they doing in 2022? Well, whoever heard of giving poisons, i.e., you know, chemotherapy, it was nonsensical. Why were they poisoning people? You understand what I'm saying about a frame of reference? I

I'll give you a perfect example. I'm going to tell you a great story because it involves an American president. 1876, Joseph Lister, who discovered antisepsis and hand washing and washing of tools, comes to America. He's on an evangelical tour about antisepsis. He goes over the country. He goes out west.

He lectures at a medical conference that's being held as part of the International World's Fair in 1876 in Philadelphia, first World's Fair the country ever had. And he speaks for four and a half hours. He demonstrates all his equipment about antisepsis. And he says, basically, listen, gentlemen.

Please, you've got to wash your hands and you've got to wash the instruments. You cannot just stick your fingers into wounds. Now, of course, there's great controversy. People don't want to listen to Lister. Some of the biggest names in American medicine and surgery are at this conference. Let's go forward another five years. It's 1881. Discussions about antisepsis are still going on. We have a brand new president in the United States. Brand new president is James Garfield. He gets inaugurated in 1881, March 1881.

In July, he, the president, is getting ready to attend his college reunion. And he's getting ready to leave the White House and to board a train at the train station in Washington, D.C., where he is shot with a Derringer, a very low velocity gun. So the surgeons come in.

Buy horseback. They're holding the reins. They come in, tie the horse to a post. They come in, they see the president. And what's the first thing they do? They take their hands that are obviously full of bacteria from horse manure and they stick their finger down the bullet hole.

So what have they done now? They've introduced horse manure and bacteria into the president's wound. And eventually, 80 days later, this poor man succumbs not to, you know, you know, whatever, not to his intestine being shot. He succumbs to abscesses, sepsis that take over his entire body. I think it was something like he lost 100 pounds in 80 days. He's a human skeleton and he dies.

So I want to, I only have a few more minutes left and I want to ask a couple of questions and get some quick answers. And that is, so we're now at the point where we're transplanting organs. Is that like a whole new level of surgery or is that just part of the progression? I think it's both progression and a new level. It's a progression because it's been going on, you know, the first kidney transplant was in the 50s. So it's going on 70 years already.

But the progression is the fact that we're beginning to have these genetically modified, genetically engineered organs. And what's going to happen is that the transplants are no longer, I don't know when this is going to happen, are no longer be a kidney from you or from somebody else going into a patient who needs it. It might be a kidney that's genetically engineered that they're able to grow in a laboratory. That is going to happen.

You know, whether it's, you know, 50 years from now or 100 years from now, I can't tell you. So that is progress, but it's a different type of progress than from 70 years ago. Are there anything in the world of surgery, and I know it's kind of a hard question, but that stumps doctors, that we just can't seem to quite get?

Well, the obvious answer is we haven't cured cancer. Yeah, right. I mean, all right. So this is all...

And it's easy for me to say, you know, 200 years from now, when someone's listening to this podcast and they said, oh, Dr. Rutger Hosey is saying, I mean, it's easy for me to say now, maybe 200 years from now, cancer won't exist. I don't know. But clearly the sophistication and the progress in medical and surgical technology is out there. It is more expensive. Granted, it's not cheap to be able to do this stuff, but it's clearly present. It is clear.

It clearly continues. And if there's one thing that I could say for sure is that progress, however you want to define it, progress will continue in surgery.

Well, it's quite a story. You tell it well. And the benefits of that story, of the amazing advances in surgery over the last hundred years or so, will likely benefit all of us at some point in our lives. Ira Rutko has been my guest. He is a general surgeon, and he's author of the book Empire of the Scalpel, The History of Surgery. And there's a link to that book in the show notes. ♪

One of the primary ways we learn and understand and connect with other people is by asking questions. And the better the questions, most likely the better the conversation and the more we all get out of it. Yet we tend to be not that curious, especially as we get older. Probably the question we ask more than any other when we see people is some variation of, how are you?

And the truth is we probably don't really want to know the answer anyway. Chad Littlefield is a speaker, author, and trainer who is co-founder and chief experience officer of We and Me Incorporated, an organization whose mission is to create conversations that matter. He's co-author of a book called Ask Powerful Questions.

Hey Chad, so I like to think I ask good questions. I'm about to ask you several, but generally do you think people are curious? Do we ask a lot of questions? So kids, and you can ponder it yourself, but imagine how many questions kids ask between the age of three and five. So there's actually been some research done on this and between the age of three and five, kids ask on average,

300 to 400 questions per day. Adults, on the other hand, very different story. On average per day, adults ask, and there are a couple studies conflicting, but the best that we could find was adults on average tend to ask 6 to 12 questions per day. As we get taller and we know more stuff,

I think we start to develop a national or personal curiosity deficit. When I say, I think culturally, sociologically, there's a national curiosity deficit, but

I think in some ways, Mike, it would be great if everybody had your job or had at least had your skill set to ask really intentional, curious questions. Well, couldn't it just be that kids ask more questions because they don't know, but once they know what the color red is, oh, that's red. Well, they never have to ask it again. So the number of questions they are going to ask would diminish, but does that necessarily make you less curious just because you already know the answers?

So there totally has something to be said for being less curious about, you know, if a kid's asking, why is a red light red? Why is a green light green? Why is the grass green? Why am I asking about color so much?

There's something to be said for like you figure out those facts. But the world is really, really, really big. I don't know that anybody's really got beyond 0.2% understanding of all the things you could possibly learn. And yet our question count has reduced by 80%, 90%. Well, when you say adults ask between 6 and 12 questions a day...

And I assume in that list of six to 12 questions are some very shallow kinds of questions, right? Yeah. How are you doing? Where are you from? What do you do? So when I ask a group of whether it's 10 or a thousand, what questions do you typically ask when you meet another human being for the very first time?

I get the same four or five questions in all groups and nearly all cultures, right? The really basic questions. There's nothing wrong with where are you from? How are you? What do you do? And yet that is fundamentally small talk and introverts, extroverts, 90 plus percent of the population gets a little bit drained by having the same conversation over and over again. Because when somebody asks you, what do you do? You just plug in the tape and let it play.

The conversation doesn't have a ton of novelty or intrigue involved. But it seems that small talk is kind of the lubricant that gets the conversation going. You can't meet somebody and ask them some big, huge question. You kind of have to warm it up.

Totally. Yeah, so I have a sign sitting in my office right now with the question, what is one thing life is teaching you right now? Pretty big question. If I rolled up to a bus stop and sat down and turned to the person next to me and said, what is life teaching you right now? Their answer would be to run, right? So sure, you don't just jump into that. I do think that it can be lubricant and I'm totally not bashing those small talk questions.

And I think there is another entry point that is equally as powerful of a social lubricant to meet people and start conversations that matter that don't involve those questions. And for me, one of the essential ingredients to creating a conversation that actually matters is

is that your own natural curiosity has to be turned on. So you could ask the question, what do you do or how's the weather right now? And if you were naturally, genuinely curious about that question, I would say you could have a fantastic conversation that I wouldn't even put in the category of small talk. I don't think that the content of what we talk about actually differentiates between what matters and what doesn't. I think it's actually all in the process and in the way that we listen and hear each other and the way that we ask.

I guess what I need to get clearer on is why are we having this conversation? This is like an examination of how people interact and we're trying to improve what? What are we trying to get to? So let me experientially answer that question. So the question you just asked, and this is going to create a funny dynamic for this conversation, but the question you just asked, why are we having this conversation, right?

When you ask me that question, that question puts me in the position I need to rationalize and justify and come up with reasons to convince you to believe why this is important. So one of the things that I teach people when I'm working with the group is to ask questions that specifically only begin with how or what and not why. And I'm curious about your take on this, Mike, because that why is a very journalistic question. It's a very interviewee question.

However, if your aim and the realm and the context that I'm operating within is teaching people how to ask powerful questions to build and establish a relationship of trust, right? So if your aim is to build a relationship of trust, asking questions that begin with why or asking questions that are really closed tend to shut down a conversation or put somebody on the defensive to some degree, right?

And so when you ask questions that are more open, rooted in your own curiosity, there's this idea and quote, one of my favorite quotes from Bill Nye, the science guy goes like this, everyone you will ever meet knows something you don't.

And so when you ask, you know, what's the point of asking powerful questions and paying attention to this is if you want to stay at the same level of knowledge and intelligence and improve zero over the course of your lifetime, then it doesn't matter. But if you want to get smarter and smarter frequently and in little bites and sips without, you know, necessarily...

Taking a whole eight hours to read a book. I think that questions are one of the most powerful tools to develop ourselves and other people. Good answer.

Satisfied the why? Yeah. Well, because, you know, people listen to this and they would wonder, well, why am I listening to this? What am I supposed to be getting from this? And you just explained it, that it's to establish better relationships with people that questions like, what do you do and how are you, isn't going to do it. Yeah. So I'll give you an example. My grandmother, I had known her all my life.

And when I first started, when I first learned from my coauthor, Will Wise, who's since passed, when I first learned how to ask powerful questions, I was sitting down on a couch with my grandma, who I had known at that point for 25 years of my life. And for the first time in those 25 years,

I tapped into my natural curiosity about her and I was like, okay, you've lived this whole life. You've lived three lifetimes, three of my lifetimes. What am I curious to know about? And for whatever reason on that particular day in that particular moment, what came up was who is one of your favorite presidents that I've never even seen or speak because they were around before I was born. And she lit up like a light bulb. It was like that question, Mike, turned her brain on.

And that's all these stories and shared about the, you know, watching the moon landing and JFK talking, right? All this stuff started pouring out and it was beautiful. And it was in that moment, in that personal conversation with somebody that I had known for so long that I realized, wow, like the right question has the ability to actually change your relationship with somebody you know really well and somebody you don't know.

So how do you, if I'm listening to you thinking, all right, I understand, I need to do this, ask better questions that elicit a better conversation. How do you start this? How do you know what to ask who? How do you just be curious? Yeah, actually, no, be curious would be step two, step one. And I could teach, and I have already alluded to the mechanics of how to ask good questions, what words tend to begin with them, etc.,

But none of that actually matters. The mechanics of asking powerful questions don't matter at all unless you get really crystal clear on what your intention is in asking a given question and you actually share that intention with the person who it affects. And here's what I mean by that, right? So very rarely do we actually pause long enough to come up with what is our intention and

in this conversation. And when we have conversations that don't actually really have an intention, we haven't established a purpose. You know, Priya Parker, the author of The Art of Gathering has this idea of meeting for purpose, not for time. And if we added just

5% more intention to all of our conversations, they would be immensely more productive. So here's what that looks like. When I'm working with a, let's say in a work context, I'm working with a group of 80 senior leaders and

And none of them want to be there. It's a training workshop. They all have tons of stuff to do. They're busy, right? And yet I'm taking their time right now. And so it's really important that very quickly in that moment, I get clear about what my intention is and I make sure that I stretch that intention to include what they actually care about.

And so I might say something to the effect of, "Hey, my intention in the next 90 minutes is to be a painkiller for the next 100 conversations that you wind up in." The idea here is when we have intentions that affect other people but we don't clue them into what those intentions are, that is manipulation. Or I would argue that that is manipulation. When we have intentions that affect other people but we don't clue them into what they are,

That is fundamentally manipulation. So if you want to ask really good questions or if you want to sit down at a bus stop next to someone and ask them, what is life teaching you right now? You might consider first saying, hey, I know this is really strange and out of context, but I'm just really curious.

And then ask your question. I still might not go with what it's like teaching you right now because I probably wouldn't be naturally curious about that as somebody at a bus stop. So one of the tools that we actually teach people if you're starting a conversation with a new person or somebody that you know well is to pay attention to what they are wearing, caring, sharing, or presenting.

and ask a question rooted in your natural curiosity. Many of the conversations that I can think of, though, I don't necessarily have an intention. And if somebody else initiates a conversation, I have no intention. They're initiating it. I don't know what they want. So how do you have that conversation? I'm going to answer that question in a seemingly very blunt way. And it might almost be heard as almost an aggressive way.

But if you don't have an intention in a moment and you want that conversation to matter more than it is currently mattering, I would say come up with one.

pause where you are in that moment because intention is actually, coming up with intention is just a choice. The Latin root of the word intention actually means to stretch. And so an intent is very different than an objective or a goal for me, right? So it's not like I'm trying to get something out of this person. An intention, I believe, stretches over the needs of everybody and pulls people together. So here's a way to make that very practical.

Two of my favorite words to stretch your intention and actually a tool to come up with intentions when you don't have one are the words, so that.

Right? So, my intention is to go out to lunch with you. I've had lots and lots of lunch meetings that didn't have a specified purpose. In fact, when I used to live in Asheville, North Carolina, when I moved there, I kept actually people's business card. I had about 200 or 300 individual lunches with people. And I realized about 100 conversations in that most of them were meetings just because. And the intention was loosely to connect, but it wasn't more focused than that. So, let's say I schedule a lunch meeting with you, Mike. Okay.

I say my intention is to connect. So that Mike has a really brilliant conversation that makes his day and perhaps his dinner conversation even better. So, adding so that and then after those words inputting or inserting a currency that that person or those people care about.

Don't you think one of the reasons that people tend to stick to superficial conversations is they're very automatic. They don't take a lot of thinking. And to have the kind of conversation that you're talking about requires perhaps pausing, thinking about it. And people don't like that silence. In a conversation, silence is uncomfortable for a lot of people.

People have a hard time with silence. Even three seconds of silence feels like a lifetime to some people. When you think about going back to college age or high school or school age, you had a teacher who gave a 45-minute lesson and at the end they asked any questions. And at least in my class, the only thing I heard was the sound of backpacks zipping up. And I think the reason is not because people didn't have any questions.

I think the reason that there wasn't a lot of engagement after asking any questions,

was because two to three seconds is not enough time for the brain to process a ton of content data ideas a particular moment in time convert it into a sentence that ends in a question mark then tell your arm to raise up above your head signaling that you want to answer a question and then gather the courage to publicly speak which is one of our greatest fears as a as a uh

species. And so one of the greatest gifts, or I think one of the lost arts of creating conversations that matter is silence. And so before I invite people to ask a question at the end of a session I lead or something, I'm actually, I used to say, all right, Q and A time, what you got? Hit me. And now I actually say, questions take a little bit to formulate. You've got 10 seconds and I want to just sit in quiet and

Well, everybody, whether you're going to ask it or not, I'd love for everybody to come up with a question rooted in their own natural curiosity. Five, four, three, two, one. And then I invite people to raise their hands or come up to the mic or toss out their question. And I would say, and this is not an exaggeration, let's just pick a group of a thousand. So if I'm doing a keynote for a group of a thousand, I would say that

30 to 40% of the room will raise their hand after giving 10 seconds of silence to come up with a question. Whereas if I just ask any questions, I might get like a few rogue extroverts who are happy to tell a long story on the microphone to everybody and hardly ask a question, right? So just the difference between there is so, so vast. So what's the big takeaway here? And perhaps more specifically, knowing what you know about this, what's the advice?

If you just, if you take one thing from listening here, if you just double your count, on average adults tend to ask six to 12 questions per day. If you literally just aimed to double your count, 12 to 24 questions a day, I would argue that you would double your learning. You would double your connections. You would double the depth of relationships that you have in your life just by doubling your count.

So I imagine that if you're going to ask these powerful questions, you need to actually listen to the answers. And I am anxious to hear what you have to say about listening because a lot of people don't listen very well. I would argue, and a whole bunch of neuroscience would also argue, that there are two dominant ways that our brains tend to listen to and process information. The first, I'm going to give some non-neuroscientific language that I think is a little bit more sticky.

The first way that I would argue our brains listen comes from our amygdala, that fight or flight response. And it's listening to win, right? So if I ask somebody, I did this yesterday. I asked somebody as a demonstration, I asked them, where are you from? And they said, Boston. I said, no way. I grew up just 30 minutes south of Boston, blah, blah, blah, blah, blah. And then I asked, okay, who are we talking about right now? Me. Me.

That's weird because I asked that person a question and within a couple seconds, we were talking about me again. And so this idea of listening to win is where it's not necessarily with the intention to actually win or one-up someone. In fact, I think it's oftentimes we ask somebody a question, what's the most adventurous thing you've ever done? And they say scuba diving. If you're a certified scuba diver, there's no way that your next comment isn't going to be

oh my gosh, I'm a scuba diver too, right? Because that is what you have in common. That aligns you with that other person. So now the conversation can continue and you can talk about scuba diving or whatever. But now that you have that bond, that you do the same thing. Yes, it's really important to let people know that you're also a scuba diver because it makes a connection. But I think we mistake...

commonality as a synonym for connection. All of us have some overlapping commonalities and that's useful to connect over, but most of our life was not shared. And so we have all these differences. And I think it's very easy to actually transform a difference into a connection

If you are intentional and naturally curious and open to getting perspectives that are not the same as your own, et cetera, you know, this idea that it's much more important to be interested than interesting. The characteristic of being interested in somebody else is really appreciated because I think we live in a world where most people go most days without feeling seen, heard, and understood.

And so when just for a minute, we shift into that prefrontal cortex, we listen to understand, we really hear what somebody's saying and we respond in a way that lets them know that we really got you. We really heard you. We're actually really with you. Then a really powerful transition happens.

Well, after listening to this conversation and being part of this conversation, it makes me think to be a little more intentional about the questions I ask other people and also to listen to their answers in a different way that makes the conversation more beneficial to everyone. Chad Littlefield has been my guest. The name of his book is Ask Powerful Questions, and you'll find a link to that book in the show notes. Thanks, Chad.

Thanks, Mike. The conversation's been an absolute joy. I don't take naps very often, but boy, when I do, I really enjoy them. And if you like to take naps now and again, research has found that you'll actually drift off to sleep faster and sleep sounder in a hammock. It's the swaying action. It turns out that adults can benefit from that rocking or swaying motion just as much as babies do.

Researchers say that rocking or swaying actually affects your brain waves while you drift off to sleep and enhance the initial light sleep phase, known as N1, and N2, the next deeper phase of sleep.

The volunteer nappers in the study experienced a more satisfying sleep and greater mental refreshment after they slept in the hammock compared to people who slept somewhere else. And that is something you should know. You know, one way a podcast can lure new listeners is to have a lot of really good ratings and reviews on the various platforms like Apple Podcasts and Spotify, iTunes,

And it would really help us. It would mean a lot to me if you would just take a moment and leave a rating and review on whatever platform you're listening on. Because people like to read reviews, and those reviews influence people's decision to give a podcast a try or not. So it would be very helpful. I'm Mike Carruthers. Thanks for listening today to Something You Should Know.

Welcome to the small town of Chinook, where faith runs deep and secrets run deeper. In this new thriller, religion and crime collide when a gruesome murder rocks the isolated Montana community. Everyone is quick to point their fingers at a drug-addicted teenager, but local deputy Ruth Vogel isn't convinced. She suspects connections to a powerful religious group. Enter federal agent V.B. Loro, who has been investigating a local church for possible criminal activity.

The pair form an unlikely partnership to catch the killer, unearthing secrets that leave Ruth torn between her duty to the law, her religious convictions, and her very own family. But something more sinister than murder is afoot, and someone is watching Ruth. Chinook, starring Kelly Marie Tran and Sanaa Lathan. Listen to Chinook wherever you get your podcasts. No. What lies within nothing? No. Do you know where it lies?

Do you want? Yes.