Career Communicator with an Intriguing Personal Trajectory: Jon Foley Sherman

Lisa Belisle: Hello, I'm Dr. Lisa Belisle and you are listening to, or watching Radio Maine today. It is my great pleasure to speak with Jon Foley Sherman, who is an inpatient experience advisor to a health organization, and also a career communicator. I believe that's just a few of the things we could suggest that you are in your professional life, Jon. So I'm hoping that you'd be willing to expand upon that further with us today.

Jon Foley Sherman: Sure, of course.

Lisa Belisle: I appreciate your willingness to jump in and be part of the Radio Maine experience considering that you're actually working in your regular job today in the hospital.

Jon Foley Sherman: I am at the hospital today, and we're not in Maine. I'm in Pennsylvania. When I was told about you and this program, I always enjoy learning more about people's experiences with healthcare, but also I'm a natural for a program about art and the artistic life, I guess. So fire away, let me know what you want to hear.

Lisa Belisle: So, Jon, I guess I'm interested in how you got to where you are, because when I look at all of your qualifications, you go from Middlebury to a degree from a French educational system to a PhD at Northwestern. You have a background in drama. You've written about phenomenology and performance. It would be trying to condense things down too much to just say that you are an inpatient experience advisor.

Jon Foley Sherman: No, I mean, of course, what I most feel like and what is most important to me most days is being a father and a husband. My professional journey has been, there's been something, I feel like I've had several careers. Most of my adult life has been spent in the world of theater. So I did go to Middlebury. I got a degree in theater and political science. I worked mostly as an actor in Washington, DC. I had a day job working as a temp and I got to work at the World Bank and the IMF. I wound up settling at Gensler, which is the world's largest architecture firm, and then I went to study for two years in Paris at L'École, and that was an extraordinary experience. I always say to people, if you can ever arrange to be 26 and in love in Paris, I highly recommend it.

Jon Foley Sherman: I came back from there to Chicago, where I started a theater company and I made theater and dance theater for about 10 years. And during that time, I did get my PhD at Northwestern and I started teaching and came out to Pennsylvania to teach here and found myself wanting to be back in the professional environment. I had gotten to work for a genius communications consultant named David Grossman in Chicago, just an extraordinary man, a great practice. I learned so much working with him and I wanted to get back into that kind of an environment. So I moved to a couple of places, but I realized after spending several years as a consultant, that it was important to me to work for a mission driven organization. And there was a door that opened at this health system that didn't lead to a room that I wanted to stay in, but it allowed me to get in the building.

Jon Foley Sherman: And so I did that and now I am on the experience team and I absolutely adore my team and I love the work that I do. I never thought I would be saying things like statistically predictable variation. If you had told me that would be something I would say when I was in college, I would have laughed, but here we are. I'm looking at patient experience data and also, the most meaningful part of the work for me for sure is shadowing nurses and PTCAs and seeing the absolutely extraordinary work they do taking care of people and trying to improve their experience as well. So the experience advisors typically are responsible for patient experience, but we all know that staff experience comes first. So a lot of what I wind up doing is just providing staff with support and I'm someone they can talk to.

Jon Foley Sherman: And then I can bring their concerns to people who can actually do something about it. But my whole career, I would say, has been dedicated to helping people become their best selves. And I've tried to do this as a teacher of theater. I tried to do it as an advisor. I co-edited a book on phenomenology and performance, but I also wrote a book on the ethics of attention, and that's something that's very important to me, how we attend to other people, how we allow other people to be strange to us instead of known to us. And that is something that I bring into my work as an advisor, as I observe people and I share what I see with others. I think I'm still constantly driven by this desire to help people be the best versions of themselves and ultimately to make the world a more astonishing place. That's very important to me, even in the work that I'm doing in front of a spreadsheet.

Lisa Belisle: So the idea of being with people in this place of strangeness, tell me a little bit more about that.

Jon Foley Sherman: Well, my general belief is that it is not possible to fully comprehend anything from a strictly phenomenological or perceptual basis. We can never see all of a thing at once. And people are no different. There are parts of me that can be attended to by other people, but not all of me. And my hope is that we can make a virtue of that instead of saying, well, this is a failure to really know everything there is about this person. We accept that in any encounter we have with another person, there is a creative element. There is a story that we unfold or that we find in the encounter with another person. And that allows for us to let the other person be astonishing to us, to decenter us so that we aren't at the center of our own story.

Jon Foley Sherman: We can share that center with another person. It can be between people, and that happens best, I believe, when I allow you to be someone who I know something about, and I can have whatever feelings I have about those parts of you that I understand, but I also honor the fact that you are bottomlessly mysterious to anybody. And I'm not trying to fix that. I'm trying to respond creatively to that in a way that enlarges everyone's experience of each other. So it's not something you can do all the time. You would never move if you allowed everyone to be truly astonishing to you or everything to be truly astonishing to you. And so part of this ethics is living in failure. I fail to do this constantly, but my choices are hopefully always about where I can try to do this. While acknowledging that I can't always attend to everybody the way I would want to, I do have to make choices and those are part of how I make it through the day. But it's allowing myself to be mindful that I am making that choice. If I don't attend to you completely, I shouldn't pretend that I have, and I should accept the consequences of not having done so.

Lisa Belisle: I think what you're describing is really so important, particularly in today's culture, in today's workplace, because we have, fortunately, moved to a place of greater inclusivity and bringing people into our space that don't look exactly the way we do or experience life exactly the way that we do. And at the same time, I think that there's an ongoing struggle with the idea of the otherness and the idea that you bring someone in who may not be like you, and because you can't fully comprehend them or their life, they still cause you to feel discomfort. So this possibility that each of you could be strange to the other person, and you could still be respectful of each of your experiences, I think is really very important.

Jon Foley Sherman: You know, I haven't specifically put this idea into a diversity, equity and inclusion framework, but I do think it can live there. And I am on the DEI council here at the hospital. And I can tell you, there are definitely tensions around trying to break down the barriers to diversity, because we are a diverse society, we just haven't allowed power to be shared diversely, frankly. Even when we talk about inviting people into spaces, well, that's a power. Who owns the space, who gets to welcome someone in, who is the we? When you say that you don't look like us, who's the us there? But I think that it is important to say that this is part of the work of DEI activism, to acknowledge we are different.

Jon Foley Sherman: We're not saying that we're all the same, that we have the same experiences. And what we do have in common may ultimately be the ability to not just tolerate, but celebrate the fact that we have different experiences and that we do come from different places. And at a certain point, I believe we need to have a shared language. I'm not very tolerant of intolerant people and I personally struggle with people who are dismissive of this idea, that diversity, because it is a naturally occurring phenomenon that has been proven in many contexts, scientific and philosophical, to be something that is a strength. There are many people who reject that idea for complex reasons of their own. And I'm sure I could have more patience with those people. But at the end of the day, I think you're right that some important work for anyone who's part of an institution is to continue to increase access to that institution and to honor the differences that are going to come into it as a result, instead of trying to say, well, we know what this is, and we've got you figured out. None of us ever really gets to do that on a personal level, anyway.

Lisa Belisle: You raise a great point about the language and even the idea of allowing, and who is the one doing the inviting and who has dominance over the space. What does it mean if someone else is the other, then you've already created a construct around the idea that someone is kind of the one who has the right to be in a place. And yet this is something that I think is relatively late to the conversation, because I still think we are saying things like allow others to have a voice, and who's allowing whom and what does that even look like? So even trying to understand the fundamentals of all of this, I think has been profoundly discomforting to many people, myself included.

Jon Foley Sherman: And I used to teach full time and I used to tell students, if you feel uncomfortable in this class, that is not a sign that something has gone wrong. That may be you learning something, you are literally seeing things differently. And that often feels uncomfortable. You're letting go of what you know. So don't think that if you're uncomfortable in here that you've had a bad day. That might be your best day this week. I'm very invested in this idea, and as someone who was making art for a while, I never shied away from a room where I didn't know what was happening. But you have to learn to be comfortable with the discomfort. You have to be able to trust that that can be productive, because obviously there are many different kinds of discomfort, and some of them are extremely unhealthy and we need to protect ourselves, but it's part of what I find.

Jon Foley Sherman: So what I find so frustrating about some of these laws that are being passed in Florida and Indiana and Texas, that are making it illegal to teach American history if it makes anyone uncomfortable on account of one of their identities. It just seems very strange to me. If I'm learning about American history as a white man, why wouldn't I be embarrassed and ashamed of parts of our history? I think it's absolutely appalling to believe that I wouldn't be, and I'm not invested in my feelings in a particular way. I'm invested in understanding things better so that I can help continue to improve my environment or my relationships. But obviously there are people who don't share that belief, but I really am committed to that idea that, certainly in matters of power and matters dealing with race, I would never expect to have growth without discomfort. I would never expect to make progress without feeling strange or uncomfortable. And I would also hopefully not prioritize my own comfort. I think this is something that we've seen a lot of, where the owners of spaces prioritize their own wellbeing over everyone else's, and they're not wrong to pay attention to their wellbeing, but it's often not what's most important to attend to.

Lisa Belisle: Even the idea that any of us has a particular right to something like comfort is a fascinating concept. Is it because we live in the United States and that we're used to a certain level of comfort that we believe that we now have a right to that comfort? I think there's so much that can be said around that idea. And yet I understand why we gravitate to that. I understand why we want to feel secure, that we feel like it's our basic right to not have dissonance in our lives, but it's a weird idea, because not everywhere has access to comfort.

Jon Foley Sherman: But I do think that it comes from a desire that may be universal, which is for care. I think we know that life is impossible without care. Every infant needs to be cared for. And even an infant who doesn't receive as much care as someone might want for their survival, depends on the attention and care of someone else. And I think what carries forward into our lives from that is a desire to be cared for and be attended to. And I think there's some pretty good research on how people who feel like they're part of a team, people who feel like they have someone to care for and someone who cares about them, these people are happier, they're more productive.

Jon Foley Sherman: The challenge is to accept that being cared for may feel like a different thing depending on the situation you're in. But we've definitely seen, during the American response to the COVID pandemic, that there are significant portions of the country who are not willing to inconvenience themselves in order to protect the health of their community. And I think that has less to do with comfort and more to do with, as I think you were kind of gesturing towards, ideology or belief about their individual worth or the possibility of being an independent being. I find this to be frankly quite bizarre, that anybody who lives in society would imagine themselves to be independent. You know, I don't get it. And the idea of bodily autonomy, I mean, the air that I breathe, I don't choose the air that I breathe. The air that I breathe is as clean as the people that I elect allow it to be. And it will be as dirty as the people who are running factories are allowed to let it be. I literally don't get to choose the air I breathe. So how can I imagine that I'm an independent agent or that I have total liberty? Anyway.

Lisa Belisle: Well, I do think that what you're describing in this basic impulse toward feeling cared for is important for us all to understand about other people, because it's hard for me to know what that might look like for someone else. And maybe someone else who doesn't share my ideology has a different sense of what their needs are in order to achieve that level of care. So I think it can sometimes be very frustrating because it feels like we're so far apart in the way that we look at the world. And yet, if we can acknowledge that at its core, there is a sense of this need, as you've described, for care in order to really have basic survival needs met, then it provides us a means of having compassion for those that maybe we don't really understand at least ideologically.

Jon Foley Sherman: Hopefully. I mean, on our team, we often are talking to providers about motivational interviewing technique, because a lot of providers are still attached to the information deficit model of communication, which as you must know, is a very outdated way of understanding how to change people's behavior. And I think what we are often trying to do is to find out what is important to the person we're talking to, and to try to link that to any change that we want to see in them. A meeting that I just came from was with some nurse leaders who are trying to improve intentional hourly rounding at the hospital. And this is a huge challenge at the best of times with the national staffing crisis that we have with nurses and PTCAs. It's an incredible challenge.

Jon Foley Sherman: And when you add to that, that there's a staffing problem with environmental services and with food services, and the nursing team generally are the ones who are asked to pick up that slack, saying, did you get into every patient's room this hour, is something else. And in part because of that, but also because I don't really believe telling a nurse or a PTCA what to do is going to end well, we're trying to find out what they get out of it. What's important to you? What fills your cup as a nurse, as an aide? And have that conversation, because we know it's going to wind up with, well, guess what, if you can spend time in the room connecting with your patient, you get all of the above. But if we start out by saying, here's the process standard work, here's where you are in the skills matrix.

Jon Foley Sherman: I don't know, there are people in the world who would probably be like, I cannot wait to fill in all four boxes of that skills matrix. I don't know that that's why any nurse walks into a room, though. I don't think that's what they're getting out of it. I don't know what they're getting out of it. I need to have that conversation with them. I don't assume that all nurses want the same thing, but you do need to find out, in the context of care, what does care feel like to you, and how can you feel cared for by me, and then move from there. But you do need to ask and you do need to be available to the answer.

Lisa Belisle: And that does take a commitment of energy, time, attention, that many people I know feel pressured by, because especially in the field that you and I both work within, healthcare is very numbers driven. You have your productivity, your RVUs, everything is measured. And so you're often feeling like, okay, I have to tick all of these boxes. I have to have patient experience, quality, productivity. I have to get it all done and I have to do it with a smile on my face and make sure that everybody feels good about being on the team and that we're collaborating with the patients. And so I think it is easy to kind of fall into that trap of scarcity. I don't have enough to accomplish any of the above. And so when you take that into a patient conversation, or even a conversation with a colleague, then it's hard not to come across in a way that kind of promotes the idea of scarcity.

Jon Foley Sherman: Absolutely. But I've taken to this term, toxic positivity. Are you familiar with this?

Lisa Belisle: Absolutely.

Jon Foley Sherman: I do like the idea that if you acknowledge your context, maybe you're not happy about that. Maybe you're not happy because of an institution's behavior or a system's behavior. It's true that if you think about things positively, if you make plans for the future, I mean, what is neuroplasticity? This is pretty well studied. That is going to help you be happier. I loathe the idea that I am entirely responsible for my own happiness. I believe that how we respond to events is part of who we are. But I'm not alone in the world. I'm in a context. And if that context is repeatedly telling me that I'm worthless or that I'm not valued, not being happy with that is the healthy response.

Jon Foley Sherman: And healthcare is very numbers driven, and there's a good reason for that. But I've heard somebody say repeatedly, you know, I love data because data doesn't have feelings. And every time, my eyes start shooting to the back of my head, because are you a person looking at this data? Well, then guess what, there are feelings. Did a person put this data together? They definitely had feelings about that data. There's no such thing as an objective viewpoint. We are people embedded in a world of incomplete perception and no one should believe that they are able to have an objective view of anything. I think in terms of how to keep humanizing healthcare, we have to just keep going back to, why are you in the room?

Jon Foley Sherman: What is this going to do for you? What do you get out of this? I love telling the story about an early meeting I had when I joined this team. I met with a doctor who is the chair of the medicine department. And I said, how do you know you've had a good visit with the patient? When you're leaving the room, what does that feel like? And he said, I know I've had a good visit when I've touched their souls. And I thought, wow. What if that was the bar? We asked people to clear it every time. And I'm not even a religious person, but I love the idea that this person wasn't saying, I mean, he shared with me that he's most worried that he's got the diagnosis right.

Jon Foley Sherman: But he knows that that's not the only work he's doing in the room. And if he only takes care of their condition and only treats what ails them, but hasn't seen them as a person, hasn't engaged with them as a person, that will be an unsuccessful visit. Because, as I'm sure you know, when you succeed as a doctor, you are not solving a medical problem. You are improving somebody's life, and you can't really expect to do that if you're not engaging them as a person. And I will always advocate for people to pursue that engagement and keep your numbers tidy and show me the data, but show me as a person. Don't talk to me as if I'm going to process it.

Jon Foley Sherman: And don't expect that I'm going to look at you that way either. I will always allow people to have emotion and I always feel so bad when people say, I'm sorry, getting emotional, and I'm like, I'm emotional all the time. You don't have to apologize for being emotional in front of me. But I know we have a lot of responsibilities, and I'm not clinical. Those of you who are, you need to maintain a certain character, a certain role for patients. But when we're dealing with each other as colleagues, I think it's pretty well established that engaging the whole person is the best way to have a productive team, to have an engaged team, and to get the most out of each other.

Lisa Belisle: In our organization, one of the most important things that we do when we bring people in is to talk about patient experience and then moving on into people's professional careers. With the medical staff, the chief medical officer of the entire health system will actually sit down one on one with each person who has been a medical staff member for a certain amount of time and discuss patient experience. And I think it's in the nature of helping people to understand the importance of this ongoing engagement, which is wonderful. And one of my favorite people in our organization is our patient experience lead. And he is always so grateful that I try to read everything that he sends and all the comments and try to comment back, most to him, but sometimes to a group. And I have the sense that the work he is doing is very challenging because it is not always valued by everyone, because it is sometimes seen as the softer side of things. And I'm always very glad that he's grateful and simultaneously feel badly that he feels not as valued as he probably should feel.

Jon Foley Sherman: Well, it's great that the CMO at your organization is having these regular conversations about patient experience. And for sure it can feel nice, because it is often tracked separately from other quality measures, but patient experience is a quality measure, because if patients have better experiences, then they're more likely to be engaged with their health. And they're more likely to have better long term healthcare outcomes. So this isn't a cherry on top. There is a common misconception that patient experience, in part because when it first came into healthcare, it was called patient satisfaction. So there are a number of people who see it as smiles and unicorns. No, this is about engaging your patient. And if they feel treated as a person, they are probably going to do a better job following their doctor's orders, taking their medications.

Jon Foley Sherman: I also want to say, and this has been something that I've been doing a lot in the past couple of weeks, when you say that your patient experience lead is concerned that people think of experience as something soft, I know exactly what you mean. I just want to start normalizing for everybody the idea that something is weak because it is soft, or that it is less valuable because it is soft. Let's just make sure we are clear that that is part of what I would describe as toxic masculine culture, and that what is soft is sometimes best, sometimes most vital and most appropriate. And we do live in an overwhelmingly misogynist culture. And I know why people use it that way, but it always just makes me, I just always want to say, hey, can we just acknowledge that that's the world we're living in, but let's fight for a world where saying this is a soft skill doesn't mean it's not gendered and it's not less valuable.

Jon Foley Sherman: But it is actually, you know, that's the most important thing for you to have, is this softness and this gentleness or this malleability. Those are essential qualities in different contexts. So I apologize for getting up on a soapbox there, but that is something that I feel like I need to push, because we hear it all the time and we all just kind of understand and we make do. But I don't want to make do with that being how we see things. I want to push against that.

Lisa Belisle: Well, on the off chance that this individual ever watches this or listens to this, I want to be clear that he has never suggested to me the word soft. So that was me and I will own that particular word. And I will also acknowledge that what you're saying is really very true. And in the work that I do, which is very qualitative and quantitative, I think that what we're seeing is the qualitative side of things has been brought in as a way to recognize the importance of demarginalizing people and demarginalizing voices, because sometimes the so-called hard data actually has the opposite effect. If you're always dealing with the majority, then it gives you good information, but only about the majority. So again, just backing off a little bit, I don't want this person to be blamed for my word.

Jon Foley Sherman: No worries.

Lisa Belisle: And also, in my place of discomfort, I am always interested in learning how words do impact us, because I, like you, am also a career communicator. And my construct has been mostly media on one side and medicine on the other. And even those two worlds are so far apart in the way that we use words, the way that we interact with people. And it's funny to float between the two sides. And then for me, add in the academic side as well, because different things mean different things in different contexts.

Jon Foley Sherman: Yes, for sure. I'm married to an extraordinary woman who is trained as a social scientist. And at one point she was looking at how the way political science was measuring participation was producing a preordained picture of civic engagement, and whether intentionally or not, continuously and pretty rigorously excluded a whole realm of activity that was mostly undertaken by women. And so the quantitative data wasn't able to capture a complete picture, but everyone was satisfied with it because you had these numbers. And this is something in the experience world that we think about when we are measuring the patient experience. Most of the questions that are on the government mandated survey that patients get are about suffering. If we ask how frequently did a doctor explain things in a way that you understood, that is about their anxiety. If it's, did they listen, how frequently did they listen to you carefully, that is about being seen as a person and not just a symptom.

Jon Foley Sherman: But there are a couple of questions that people in suits tend to look at, which is likelihood to recommend and rate the hospital. But these are moved by things that we don't even measure. The reputation of the hospital being one thing. For example, if your hospital had a vaccine mandate for COVID, that will impact how people look at the hospital and no one's measuring that. But that doesn't mean that it's not driving it. So when we try to look at what's driving our scores, well, we can only call something a driver if we're measuring it. And something that may be moving us may be something that we're not measuring.

Jon Foley Sherman: So I think that is exactly part of, as you're describing it, this kind of reorienting and enlarging our vision so that we understand there are different kinds of data. That's not all the same. And our team is big on saying, don't be data driven, be data informed. There's context. There's a lot going on beyond these numbers. If you're looking at a unit's performance, do they have a new nurse manager? What is their operational vacancy rate right now? And are they fully staffed with food services people? All of those things you would expect to impact patient experience, but if you're just looking at the one number, you're going to miss a lot. So we always try to make sure we're enlarging people's vision, and taking in more than just a number.

Lisa Belisle: Well, I feel like you and I could go down a whole other path of the introduction of bias into big data, not to mention how things are asked, but also how things are interpreted, but we'll save that for another day, because I know that in your busy schedule, you have other things to do. But before we go, I do want to pull in the connection between you and art and the Portland Art Gallery, and how we even came to know this person, Jon Foley Sherman, and bring him onto Radio Maine. So would you mind just giving me a little bit of background on the art connection for you?

Jon Foley Sherman: Sure. So Linda, my wife, and I have wanted for years to not collect art, but to have art in our home. One of the great joys that the two of us have as a couple, but also as parents. The happiest I've ever been in my life was the first day that my family and I went to Dia Beacon, which is an extraordinary museum in Beacon, New York, that has some very large works of art. And discovering art with my family is a great joy in my life. And so we wanted to have some art in our home, and we've struggled to find art that we like, that we can afford. I don't want to have a print of a painting. I want to have the real painting. And neither one of us makes a great amount of money, so our options are limited.

Jon Foley Sherman: And so we've struggled to find what can work for us, and we were on a family trip in Maine, and we had some time in Portland and she was with the kids somewhere else. And I went in and I thought, oh boy, I think we might have some possibilities in this gallery, and that's never happened. I've never walked into a gallery and been like, wow, there's a couple of things in here that might work for us, both in terms of, I think Linda might like it, but also we can afford it. And so I went and got her and made sure we got to go into the gallery. And the gallery does have this great little feature where they have the QR code by the artwork. So you can scan that, get it up on your phone's browser.

Jon Foley Sherman: And we had other things to do with the rest of the family. So we left the gallery. But then later in the week we got back home and we could use the virtual feature to see it in your room, which is a fantastic innovation. And so we were able to do that and then communicated with the gallery about buying our first work of art, which, it's too bad I'm not at home, in the place that I normally sit for virtual meetings, our dining room, which is where we hung up the work. So this was our first time purchasing art like that. And we were very happy with it. And we'll probably continue to enjoy art, mostly in museums and galleries, but hopefully this is the beginning of our slowly adding to the art that's in our home.

Lisa Belisle: Well, I have a Matt Chamberlain piece behind me. It kind of is in your honor, knowing that you couldn't be at your house with a piece of art behind you. So I'm doing that for the two of us. And I really do appreciate your willingness to have this conversation with me, because I know that you're not an artist. You're not trying to promote anything. We just asked you to be on our show and you said, okay, all right, I'll do that. And I feel like I've learned a lot from you, so it's really been a pleasure to talk with you today.

Jon Foley Sherman: Well, I appreciate that and I definitely would probably have been less interested if I didn't know that you were in healthcare and that we might be able to have an interesting conversation about our shared work. So I appreciate your hosting this and I'm very happy to give you the time.

Lisa Belisle: Well, thank you very much. I've been speaking with a career communicator and also an inpatient experience advisor, and I mean that with all the utmost respect, Jon. I'm not in any way making fun, as a fellow career communicator, but I've been speaking with career communicator Jon Foley Sherman, and I really wish you all the best, and the next time you're up in Maine, I hope you and I can connect.

Jon Foley Sherman: Absolutely.