The Fascinating Evolution of Surgery & Asking Questions That Connect-SYSK Choice

This episode explores the historical development of modern surgery and techniques for meaningful communication.

1. Modern surgery is relatively new, fully integrating into medicine only around the early 20th century after overcoming significant historical hurdles.
2. The development of surgery was stymied by resistance within the medical community to innovations like anesthesia and antisepsis.
3. Effective communication, particularly in new or ongoing relationships, can be significantly enhanced by asking thoughtful, curiosity-driven questions.
4. Historical medical practices, though sometimes primitive by today's standards, represented the cutting edge of knowledge at their time.
5. The episode underscores the importance of historical understanding and interpersonal skills in professional and personal growth.

1. Introduction to Modern Surgery

Dr. Ira Rutko discusses the recent history of surgery, its challenges, and key developments. The chapter offers insights into the resistance to anesthesia and the role of antisepsis in surgical safety. Ira Rutko: "Anesthesia took about 20 years to be accepted because surgeons believed the pain was beneficial for the patient's energy and survival chances."

2. Enhancing Communication

Chad Littlefield explains techniques for initiating and maintaining conversations that are engaging and meaningful, focusing on asking insightful questions based on genuine curiosity. Chad Littlefield: "Ask questions that begin with how or what to open up more meaningful dialogue and build trust."

1. Understand the audience: Tailor questions based on the interests and experiences of the person you are communicating with to foster deeper engagement.
2. Historical empathy: When reflecting on past medical practices, consider the context and knowledge of the time to appreciate the progression of medical science.
3. Practice active listening: Focus on understanding and responding thoughtfully to conversations to enhance interpersonal relationships.
4. Encourage curiosity: Cultivate a habit of asking diverse and deep questions in daily interactions to broaden understanding and connections.
5. Safety in medical practice: Emphasize adherence to proven scientific advancements, such as antisepsis and anesthesia, to ensure patient safety.

Why do you suppose it is that dogs love to hang their heads out of a moving car window? What’s the thrill? More importantly, should you let your dog do it? This episode begins with an explanation of why dogs love it so much and if it is really safe. https://www.metlifepetinsurance.com/blog/pet-behavior/should-my-dog-hang-their-head-out-of-a-car-window/

Modern medical surgery is nothing short of amazing. It is hard to imagine but many of us wouldn’t be here if it were not for the miracle of surgery. Yet, the history of surgery is remarkably short. In fact, there couldn’t have been surgery until four major problems were solved first. Ira Rutkow, MD is a general surgeon and historian of American medicine. Listen as he tells the story of modern surgery – including many of the problems encountered along the way and the amazing resistance to some important advances. Ira is author of the book, Empire of the Scalpel: The History of Surgery (https://amzn.to/3Lz8lWo). Once you hear it, you’ll be glad you didn’t need an operation 160 years ago.

Do you ask a lot of questions of other people? The truth is most people don’t ask very many questions during the day and the questions we do ask tend to be mundane things like “How’s it going?” or “What kind of work do you do?” However, by asking the right kinds of questions you can learn and understand so much more. Plus, asking questions can be a great way to connect with other people if you do it right. What kinds of questions should you ask? Here with some great advice is Chad Littlefield. He is co-founder and Chief Experience Officer of We and Me, Inc., an organization whose mission is to create conversations that matter. He is also coauthor of the book Ask Powerful Questions (https://amzn.to/380YdI8).

A nap can be wonderful. It can also leave you feeling groggy and feeling more tired. Listen as I explain the keys to taking a nap that research says will leave you feeling more rested and satisfied. https://www.livescience.com/14680-hammock-rocking-improves-sleep.html

People

• Ira Rutko, Chad Littlefield

Companies

None

Books

• "Empire of the Scalpel: The History of Surgery" by Ira Rutko
• "Ask Powerful Questions" by Chad Littlefield

Guest Name(s):

• Ira Rutko, Chad Littlefield

Content Warnings:

None

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Mike Carruthers
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.

Chad Littlefield
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.

Mike Carruthers
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Chad Littlefield
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.

Mike Carruthers
But the bad news is we probably shouldnt 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 Doctor 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 18 hundreds, early 19 hundreds. 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.

Ira Rutko
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 have patients writhing on a table.

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

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 were 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 one, 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. 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, not the discovery of anesthesia. We're trying to figure out whether it should even be used. That's anesthesia. Then antisepsis comes about. So let's talk about antisepsis, because it's a great story.

Around the 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. That is 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, till the end of the 19th century, beginning of the 20th, you had this debate about the use of antisepsis. Not until World War one was everything sort of established where anesthesia and antisepsis were used for all operations. So that's when it was then. Right.

Mike Carruthers
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, their nurses, the anesthesiologists, it wasn't until around 1920, 1930, that you began to see what you and I would describe as surgeries. We know it today. That's a century ago.

Ira Rutko
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 an 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 did not come into play totally until into the 20th century. And I can even make the story more difficult to understand.

Mike Carruthers
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 in 30 seconds. They would just cut the leg off. That's it.

Ira Rutko
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 going to have a lot more time. You've got it.

You're going to have a ton of more time. Not only you're going to 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 it 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're doing an appendectomy, you're cutting this, you're dissecting that, you're sewing everything back up, and it's taking longer and longer. Well, longer and longer translates into more blood loss, more bleeding, more everything. What happens? Patients, 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 one. 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 go into shock and they would die from the shock. So help me understand this, if they don't understand, 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, 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 doctor Ira Rutko.

Mike Carruthers
He's author of the book Empire of the the History of Surgery. Seeking the truth never gets old introducing June's journey, the free to play mobile game that will immerse you in a thrilling murder mystery. Join June Parker as she uncovers hidden objects and clues to solve her sister's death. In a beautifully illustrated world set in the roaring twenties, with new chapters added every week, the excitement never ends. Download June's journey now on your Android or iOS device or play on PC through Facebook games.

As a listener to something you should know, I can only assume that you are someone who likes to learn about new and interesting things and bring more knowledge to work for you in your everyday life. I mean, that's kind of what something you should know is all about. And so I want to invite you to listen to another podcast called Ted Talks Daily. Now, you know about Ted talks, right? Many of the guests on something you should know have done TED talks.

Well, you see, TEd Talks Daily is a podcast that brings you a new TED talk every weekday in less than 15 minutes, join host Elise Hu. She goes beyond the headlines so you can hear about the big ideas shaping our future, learn about things like sustainable fashion, embracing your entrepreneurial spirit, the future of robotics, and so much more. Like I said, if you like this podcast, something you should know, I'm pretty sure you're going to like Ted talks daily. And you get TEd talks daily wherever you get your podcasts. So, Ira, the earliest type of, let's call it routine surgery was what?

What kind of operations were they doing where things got pretty good, pretty easy. Survival rates were pretty good? I understand what you're asking. The first operation that became, let's see, let's say, like a fad that everybody was doing it were appendectomies, and that was around 19. The first appendectomies were in the very tail end of the 19th century.

Ira Rutko
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 supposed sick appendix was overwhelming in 1920s, 1930s.

I've seen statistics that 50% of patients admitted to the hospital in the twenties were for an appendectomy. That's a lot of surgery. Well, that's. 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 that is 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, in 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.

Surgery is, 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, 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.

Mike Carruthers
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.

Ira Rutko
There was malpractice. It was horrible what they were doing. It was butchering of human beings. If you apply our state of knowledge that we have today to something that happened two, three, 4500 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 were doing back when was always state of the art.

It's state of the art. So what we're doing today, 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? Whoever heard of giving poisons? That is chemotherapy.

It was nonsensical. Why were they poisoning people? You understand what I'm saying about a frame of reference? 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 all 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 listeners.

Some of the biggest names in american medicine, 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. 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, DC, where he is shot with a derringer, a very low velocity gun. So the surgeons come by 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, 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 we 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.

Mike Carruthers
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. The first kidney transplant was in the fifties, 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.

Ira Rutko
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 whether it's 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?

Mike Carruthers
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. So this is all, it's easy for me to say, you know, 200 years from now, when someone's listening to this podcast and they said, oh, Doctor Rutka Hoey 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.

Ira Rutko
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. 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 surgery.

Mike Carruthers
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. Hes co author of a book called Ask Powerful Questions. Hey, Chad. So I like to think I ask good questions. Im 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.

Chad Littlefield
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 six to twelve questions per day. As we get taller and we know more stuff, I think we start to develop a national or personal curiosity deficit. I say, I think culturally, sociologically, there's a national curiosity deficit.

I think in some ways, Mike, it would be great if everybody had your job or had at least had your skillset 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 is something to be said for being less curious about. You know, if a kid's asking why is a red light red? Why is the 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 six and twelve questions a day, and I assume in that list of six to twelve questions are some very shallow kinds of questions, right? Yeah.

How you doing? Where are you from? What do you do? So when I ask a group of, whether it's ten 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.

They're 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.

Mike Carruthers
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.

Chad Littlefield
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. 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. For me, one of the essential ingredients to creating a conversation that actually matters 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 the way that we listen and hear each other in 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?

Mike Carruthers
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.

Chad Littlefield
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 mic, because why? Is a very journalistic question. It's a very interviewy 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. 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, 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 necessarily taking a whole 8 hours to read a book, I think that questions are one of the most powerful tools to develop ourselves and other people.

Mike Carruthers
Good answer.

Chad Littlefield
Satisfy the why? Yeah, well, because 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. It's to establish better relationships with people that questions like what do you do?

Mike Carruthers
And how are you? Isn't gonna 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 co author will wise, who's since passed.

Chad Littlefield
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 was 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 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, 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?

Mike Carruthers
How do you know what to ask? Who. How do you. Just be curious? Yeah, actually, no.

Chad Littlefield
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, etcetera. 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 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 none of them want to be there. It's at 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 hundred 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 is life teaching you right now? Because I probably wouldn't be naturally curious about that. 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 you're, 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.

Mike Carruthers
I don't know what they want. So how do you have that conversation? I'm gonna say, I'm gonna answer that question in a seemingly, like, 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.

Chad Littlefield
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, and 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. 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.

Mike Carruthers
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 3 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 minutes 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.

Chad Littlefield
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 3 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 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. 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.

54321. 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 up group of 1000. So if I'm doing a keynote for a group of 1000, 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 a few rogue extroverts who are happy to tell a long story on the microphone to everybody and hardly ask a question.

So just the difference between theirs 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 twelve questions per day.

If you literally just aimed to double your count, twelve 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 asked 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. And then I asked, okay, who are we talking about right now? 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.

Mike Carruthers
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.

Chad Littlefield
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, etcetera. 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.

Mike Carruthers
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.

Chad Littlefield
The conversation's been an absolute joy.

Mike Carruthers
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 N one and n two, 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. 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. The bigger pockets portfolio of podcasts are worthy of your investment. We're having a real conversation as real real estate investors.

New episodes available every day. It's important to buy where it makes it money and not necessarily where you. Want to travel to bigger pockets on the market. Rookie Real Estate or money podcast? The purpose of flipping is to create.

Ira Rutko
More cash so then you can reinvest into other types of properties. The Bigger Pockets podcast on YouTube or wherever you listen.

Mike Carruthers
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