“It’s like a dance,” I explained.

“You take their right elbow with your right hand, then use your left hand to feel their armpit for lymph glands. Then swap hands to do the other side. Just like one of those square dances they made you do at school.”

I was talking to medical students again, getting them ready for their first clinical exams.

 “In fact, the whole thing is one big dance,” I said, “especially when the examiner is there.”

“Take notice of where your feet are, put them in the right place. Watch where your arms are, where you are looking, what words you use and what your body language is saying. And always look in the rear view mirror before you signal and manoeuvre.”

We play our parts during every clinical encounter and rarely does either partner go off script.

Working in medicine can be like acting on a ‘stage’

It is the same when we come to talk to our patients. We both know the unspoken rules, the questions we can ask and the answers we can get to those questions. Medicine is a stage, a theatre, a performance and we are actors on that platform. You and your patients hold the leading roles.

There are many other platforms we all have to somewhat reluctantly get onto at times. We teach, we lecture, we chair, we take charge and we manage. They are all dances of some sort. Dances where certain words and positions need to be taken. Dances where we are expected to behave in some way which may not quite be natural for us. Dances where there are strict rules and some where there are not.

I can stand in front of 500 strangers and talk, but ask me to make small talk with any of them afterwards and I would rather hide in the corner behind the shield of a book or phone.

Being an introvert and speaking to a crowd

I am one of those introverts that can speak to a crowd. I can stand in front of 500 strangers and talk, but ask me to make small talk with any of them afterwards and I would rather hide in the corner behind the shield of a book or phone. The version of me talking to the 500 just knows that particular dance quite well. I know how to stand in front of a crowd, how to move, what volume to use, how to keep things to the point, how to move around the stage and how to stay in control. I am absolutely sure it’s just a version of me though – just like there is Doctor Me, there is Speaker Me.

Many of us are often asked to take charge of something big that could make us uncomfortable in front of others. These are all things you can learn to do. Learn the dance, learn the script, step on the stage and become the character, even if it feels like being someone else. I often hear how professional actors feel the same – that it’s not them on stage, it’s someone else, a part they are playing.

Don’t be embarrassed to think about being an actor when you are asked to do something outside of your comfort zone. You can learn the language. It’s the way I think about difficult situations.

I have learnt how to lecture, teach, take histories and examine. I have practiced a thousand times. It comes more easily to me now but I hated public speaking at first.

As Shrek said, “Ogres are like onions… onions have layers, we both have layers. You get it?”

You can create those layers so that you aren’t exposing the real you underneath. You know, the one who can't possibly speak in front of a crowd.

I have learnt how to lecture, teach, take histories and examine. I have practiced a thousand times. It comes more easily to me now but I hated public speaking at first. I am still aware when I step into doctor or teacher character. I prepare, know my lines, then press go. I step back out of character on my cycle home. I become Dad, Husband, Neighbour. Me.

Act the part, build the part and then become the part. Then bring something of yourself into the script too, you are not a robot.

Public speaking tips

• Watch how other people do it. See what body language makes them look good, listen to how they use volume, how they move around and where they put their arms.
• Work out your main messages – there may even just be three things you want the audience to know at the end.
• Plan the talk – beginning, middle and end. Create a logical sequence perhaps on bits of paper so you can shuffle it all around.
• Know your topic, never agree to give a talk you know nothing about.
• Act the part, build the part and then become the part. Then bring something of yourself into the script too, you are not a robot.
• Think of stories to illustrate these messages, an alternative view, a different way of explaining things. Use an everyday example people can identify with and things that you love talking about (the further off topic the better).
• You might be tempted to write a script to read from and that might be the way you cope the first time. I really advise ripping up a script once you have been through it. Turn it into bullet points on some cards in front of you instead.
• Go lite on the PowerPoint slides. Reading slides out loud should be a crime. It’s dull and no one will be paying attention. The best slides have few words, a picture, a meme, a simple message.
• On the day itself do not drink too much coffee, be well fed, wear the clothes that make you feel good, shine your shoes and smile.
• People are there to listen, use that medium to its fullest, otherwise you could have just made handouts.
• Speak to an invisible person at the back, or a friend on row 4.
• Always finish early – everyone is happy that way.
• Afterwards, get someone you trust to give you some feedback.

Maybe this helps a bit for those of you that struggle to speak in front of a group, however small or large. I hope it helps you to think how you can manage difficult situations. It’s good to go off script when you get the hang of it. But don’t do that until you really know what you are doing. That's what expertise is.

My dread of small social gatherings persists. No one ever taught me how to handle parent's night at school or retirement parties, or team-building exercises. I am none too inclined to learn those dances, I can get away without knowing them. I can just stick to my books and the dances in my head.