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The Most Powerful Drug

April 20, 2022

May 2022

Joseph R. Mikhael, MD, MEdJoseph R. Mikhael, MD, MEd
Professor, Translational Genomics Research Institute (TGen), City of Hope Cancer Center
Chief Medical Officer, International Myeloma Foundation




Rudyard Kipling once said, “Words are, of course, the most powerful drug used by mankind,” and I tend to believe him. Despite there being multiple languages and styles, words have a powerful effect and are no doubt critical to the art and practice of medicine.

I do not consider myself to be a master communicator, but I enjoy speaking immensely. I give more than 200 talks annually, and although I have been racking up innumerable Zoom miles these past two years, I am now preparing myself to present in person again – which means I will actually have to wear pants and shoes! As we all emerge from our make-shift home offices to gather again, I thought it might be helpful to share my list of the top 10 things to remember when giving a talk. When I share these as a presentation, I call it, “A Talk on a Talk.”

Let me suggest from the outset that this is a critical topic. I know most people tend to roll their eyes when someone offers unsolicited advice on how to communicate better (worse if someone suggests a “role play” exercise to practice), but we all can be better communicators. I am always terribly disappointed when I see a brilliant scientist present information poorly. To avoid this, commit yourself to being better, even if only one of these tips resonates with you.

  1. Embrace the first 10 seconds. Your first impression is critical, so plan your introduction carefully, make eye contact, don’t play with the microphone, be very aware of your posture, and don’t wander around the stage. Like flipping through TV channels, you have a few precious seconds to connect to the crowd.
  2. Know that your slides are not your talk. You are speaking, not your slides. Include a mix of slides that are informative and illustrative, monitor your audience to ensure they are looking at you and not just the slides, and please, please don’t just read the slides (a presentation is not a remedial reading class).
  3. Wahh wahh wahhh – Don’t be Charlie Brown’s teacher. Avoid the monotone massive data dump that is sure to lull the audience to sleep. Carefully choose which data to present with strategic use of slides to highlight key findings. Your data are not that interesting on their own.
  4. Master the use of silence. This is a very powerful intervention to engage or reengage the crowd. Learn when to pause, but don’t overuse silence or it will irritate the audience. By contrast, avoid awkward or unintentional pauses, which are more painful than country music is to me.
  5. Value the audience’s time. The shortest talks are the hardest to deliver, so be extra careful in preparing for them. However, also consider the value of people’s time and respect it by starting and ending on time. Consider a plane that is delayed – it isn’t just 30 minutes late, it is 30 minutes multiplied by the number of passengers. Similarly, you are given the privilege of the audience’s time, so respect every minute.
  6. Set clear objectives. Whether explicitly stated or not, this is not just an accreditation requirement, it is a best practice. Stating your objectives clearly allows you to “plan the trip,” effectively inviting the audience on your journey. It also allows a structure for those who may miss part of the talk and helps them to remain on course.
  7. Learn to use PowerPoint. We all may think we know how to use PowerPoint, but an hour-long tutorial could vastly improve everyone’s performance. Balance the use of animations, and always make sure they work in the space in which you’ll be presenting. (Bonus tip: The A/V team at your meeting space is your friend – don’t ever blame them for a mishap.) Avoid apologizing for a “busy” slide, but more importantly, avoid including one to begin with – I consider it a “lazy” slide.
  8. Humor can help, but it can also hurt. We all enjoy humor, but before using it, obtain objective evidence (from someone other than your mom) that you are genuinely funny. If a joke bombs, make fun of yourself and don’t attempt to repeat it, which happens more than you might think.
  9. Know and assess your audience. Take time in advance to know whom you will be speaking to, as a mismatched speaker is a disaster. “Listen” to your audience as you speak to detect the cues of interest and lack of interest. I typically try to make eye contact with every single person and then return to those who show interest. If everyone is looking at their phone, it is urgently time to change tactics.
  10. Seek honest feedback and heed it. You will improve and may be able to reduce many of the common errors of public speaking: being an “uhm”-er, moving too much, trying to cover a three-hour talk in 10 minutes, rushing at the end, being too casual, or not genuinely listening to the questions asked of you.

This is by no means an exhaustive list of how to give an effective talk, but I hope it will help you on your way to giving better talks. As we become more of an international community, I would also add that when speaking to an audience whose first language is not English, follow the 30% rule (i.e., reduce the length of your talk by 30% and slow your pace by 30%), and connect with the interpreter before and during the talk to ensure you are in sync.

Let me close with a quote from the late journalist, Sydney J. Harris: “The two words ‘information’ and ‘communication’ are often used interchangeably, but they signify quite different things. Information is giving out; communication is getting through.”

I look forward to hearing your next talk soon!

Joseph Mikhael, MD, MEd
Associate Editor


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