Do you ever wonder what the staff in hotel conference rooms think about what we talk about in presentations and lectures? I talk about sensitive stuff—sexuality, fertility, etc.—and I use words that many people have not said out loud in front of hundreds or thousands of people. I’m used to the words, of course, and they roll of my tongue with ease: “Penis, vagina, vulva. Testicles…”. Others talk about topics that may be fascinating to the audience but really boring to those not immersed in the details of this or that molecule or gene.

I’ve asked some of the members of this unintended audience what they thought about what they heard. One of the people I talked to is a long-time AV support person who works at an international conference I attend every year. I often present at this conference and I am used to him “mic-ing me up,” when he gets to touch parts of me that even my friends don’t. The presentations don’t bother him, he says; most of the stuff is so boring and besides, he has a job to do to ensure that the slides work and the videos don’t crash. But, he adds with a twinkle in his eye, some talks are more interesting than others.

Earlier this year I gave a talk at a dinner meeting. I don’t like dinner meetings; it can be difficult to talk over the clanking and scraping of silverware on plates and inevitably someone spills their water or wine and there is a flurry of mopping that distracts both me and the rest of the audience. This was a well-attended event with 30 tables and this time most had finished eating before I started my presentation. My talk went well. The audience laughed in the right places, applauded with enthusiasm at the end, and asked interesting questions. A portion of the presentation was about communication about sexuality, an area where many oncology care providers fall short. I always include my contact information on the last slide and encourage those who are too shy to ask questions or who think of something later to contact me by phone or email.

Two days later I received an email from an unexpected source. It was from the bartender who stood in the corner of the room and whose presence I barely registered. He wanted me to know that he appreciated my encouragement to the audience to talk about sexuality with their patients. He had recently experienced a sexual problem and he was going to see an urologist and, after hearing my talk, was determined to make the specialist talk! I responded with gratitude that my talk had struck a chord with him, however unintentional, and encouraged him to write down his questions and to start his interaction with the urologist with a statement about how he had questions that he would like answered. I hope that appointment went well…

But there is more to this issue. The staff serving the food or drinks, clearing the tables, controlling the lights or audiovisual equipment are listening. They may be waiting for the results of a biopsy themselves or for their family member. They may have been treated for cancer and may hear the cold, hard facts about their disease that they had not been told by their own doctors. I have heard speakers talk glibly about cancers with poor prognoses, giving details of side effects that are hard to hear, even for professionals. What if the person rearranging the food on the buffet has that exact cancer, or their child or parent does? We commonly use images from CT scans or MRIs that project in vivid color the extent of a tumor, not to mention photos of altered bodies and mid-surgery details that make sense to most of us, but must be terrifying to the uninitiated.

I admit that I have not really thought about the effects of my presentations on the nameless staff who serve us and clean up after us, who make sure we can be heard and our presentations seen. They tend to fade into the low light as we start talking, and so we forget that they are there and may be affected in a very real way by our objective and professional words. But that email from the bartender in the back of the room reminded me that they listen and hear, and he was encouraged by my words to act differently when next he sees a health care provider. I fear for those who are frightened by our facts.

While the staff from the hotels or conference centers where we share our knowledge are not our intended audience, we need to be cognizant that they listen and are affected by what and how we say things. In many ways we represent the health care providers that care for them; if we act or speak in a unfeeling fashion about a disease that they are affected by, they may assume that their doctor or nurse does too. So we need to watch our words because you never know who’s listening….