What the No.1 Brain Surgeon Taught Us About Delivering Hard Truths

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1:50So when I speak to them, I've implemented pauses. And so when you do talk to them about what has been found, I'll put in a deliberate one to two minutes. Just let them run through all of the things they're thinking about. What does this mean? What are my kids? What am I? What is it going to be? It's going to be painful. Like, let them have some space. Welcome to the Essential Habits of High Performance, where we explore the daily practices, the mindsets, and teachable moments that shape extraordinary lives and leaders. Today's episode is about one of the most courageous and human habits we've ever explored.

2:30It's not about motivation and mindset. It's about how to do something incredibly difficult. Today's essential habit is how to deliver bad news well. The power of the pause. Now why does this matter? Well we all face moments where we need to share hard truths. What separates the best communicators isn't what they say, it's how they say it. And this isn't just for doctors or leaders, it's for all of us. When you've got to tell a friend something they don't want to hear, when you're a parent navigating hard conversations, or when you lead a team through change or disappointment. Knowing how to deliver bad news well is a skill that helps us build trust, reduce harm and lead with empathy.

3:12When done with care, honesty and presence, delivering bad news becomes an act of strength and compassion. And today, we're learning from someone who delivers the hardest news of all. One of the world's leading brain surgeons, neuroscientist, and an incredible best-selling author, Dr. Rahul Jandil. I'm Damien Hughes. I've worked as a visiting professor of organisational behaviour, I've advised World Cup-winning coaches and business leaders, and I've co-hosted this podcast for over five years. Above all, though, I'm someone who wants to understand how high performance actually works, so we can all apply it in our own worlds.

3:53Rahul Jandial is a man who has literally held lives in his hands. He's opened skulls, he's delivered devastating news, he's witnessed the final moments of thousands of patients' lives. And he's learned something extraordinary about humanity, about grace, and about the power of silence. I have shaken 10 ,000 hands. I have opened several thousand skulls. I have three sons. I've had my own difficulties. But out of those several thousand patients that I have cared for, most of them cancer from the breast or the body that spreads to the brain, they're not around anymore. In the beginning, the invitations to their funerals and stuff.

4:40My drawers are packed with hundreds of invitations. And then some people say, man, this sounds like it's depressing. I said, no, man, it's triumphant. I never thought I'd hear the word triumphant used in such a discussion. But it got me thinking. Why? Because what he saw time and time again was people not falling apart when given the worst possible news you can imagine. He saw people demonstrating strength and dignity, and surprisingly, finding peace. When you see cancer patients with the finish line in view, if I hadn't witnessed, I would say 95 % are going to fall apart. But what I'm seeing is the opposite.

5:23And in that observation is a truth that very few of us ever witness. When the end is near, many people don't collapse. Instead, they rise. But how do you actually tell somebody that they're dying? How do you sit across from a mother or a husband or a child and say, So I always show their scan, this is your name, this is your brain. This big white thing is a cancer. Once that brutal truth lands, he offers context, a timescale. And I think they understand things like, you have months and likely years, but not decades. In that moment, they need a framework, and sometimes that framework is as simple and profound as a holiday.

6:03And I give them holidays, so the next few months will be tough. But when we get to Christmas, you will have a wonderful Christmas. And so they have a pace, they have a finish line. This is what the finish line looks like. He's not giving false hope, but just a tangible moment to hold on to in the midst of that insufferable pain. That's where Dr. Jandil's skill shines through. Not just in the operating room, but in the art of communication. His secret? The pause. So when I speak to them, I've implemented pauses because it's too easy to just roll it out for them. And so when you do talk to them about what has been found, I'll put in a deliberate one to two minutes.

6:51just let them run through all of the things they're thinking about what does this mean what are my kids what am I what's just gonna be it's gonna be painful like let them have some space to think about cancer then I try to read their energy I try to understand their story then I get into if it's appropriate the hope and the positive options in front of them the implemented pause. What a term that is. In that silence, he's not being distant, he's being present. He's creating space for the patient to process the unimaginable. And that might be the most underrated skill in any high-performance field, knowing when to stop talking.

7:33This ability, this pause, might seem specific to medicine, but it's not. Think of a leader delivering some bad news, or a coach pulling a player from the starting line-up, a CEO announcing layoffs, or even a mate telling another mate that a relationship has changed. In every one of these moments, we've got a choice. We can either rush through it, or we can hold the space. Rahul Jandil has taught us that high performance isn't about skill or speed, but instead it's about timing, intuition, and showing just a little bit of humanity. But perhaps the most elite skill of all is just knowing when to stop and just be there.

8:16Because it's in that stillness that something powerful tends to happen. The other person steps into the silence and they find their own footing. Now you might think that the pause is a small thing, that it's insignificant, but research shows it has a profound impact on how we communicate and how well others listen. This approach is backed up by science and, as ever, links to the research I reference are included in the show notes. The brain is incredibly fast when it comes to processing speech. On average, the brain can process speech at a rate of about 400 to 500 words per minute, but most people speak at a rate of around 125 to 150 words a minute.

9:01So what this means is that the brain has got a significant amount of processing buffer to think ahead while someone is speaking. Now this is one of the reasons why pauses can be so impactful. When someone pauses, it gives the listener a chance to catch up, to reflect and to process more deeply. This pause can help us overcome the tendency to think ahead too much and instead to be present in the moment, truly absorbing what's being said. In a 1997 study published in the Journal of American Medical Association, Dr Wendy Levison and her team at John Hopkins University and the University of Rochester recorded hundreds of doctor-patient conversations to figure out what actually made a difference in care and in lawsuits What they found was shocking in its simplicity Doctors who got sued spent less time with patients Now on average they spent 15 minutes The doctors that never got sued though they spent around 18.3 minutes now that's just simply three minutes that was the difference so they were giving the same medical advice the same outcomes but one group made more space for the human experience and in those extra three minutes they tended to listen more they asked what the patient thought they explained the next steps really clearly but they didn't rush Dr Levison said The medical community has long had a belief that if you practice good medicine, then you don't get sued.

10:36This is scientific evidence that shows that communication is critically important. In fact, in another study, the average patient got 11 seconds to talk before a doctor would interrupt them. 11 seconds. Imagine trying to say goodbye to a version of your life in less time than it takes you to tie your shoes up. Dr Jandil's pause isn't just about emotional intelligence it's clinical best practice so why don't we all learn to pause a bit better like this? why does it feel so uncomfortable to hold silence? there's several reasons why that's the case one is that culturally we see silence as awkward or unproductive instead, in truth, it creates space for reflection and connection Research from the University of Michigan found that when people pause for just two seconds before they responded in a heated conversation, they were more likely to make a constructive, solution-focused decision.

11:37The second reason why we're often so uncomfortable with silence is the fear of emotions. Because pausing gives space for real emotion to emerge, and that can sometimes be terrifying. So we often keep talking to avoid feeling or witnessing pain in others The third reason is simply about cognitive overload Under stress our brains default to what's automatic Keep talking, keep fixing, keep moving The fourth reason is about cultural conditioning In fast-paced environments, slowing down can feel more like a weakness We're trained to believe that quick equals smart However, in a Harvard Business Review study called how to stop saying mmm and ah and, you know, on executive communication, they found that leaders who inserted intentional pauses during speeches or briefings were rated as more confident and competent by their teams, even when the actual content was unchanged.

12:33So what's your challenge for this week then? Well, here are three ways that you can learn to deliver difficult messages with a little bit more care and clarity. Number one, don't fill the silence. Let the other person speak, react or just sit with it. Resist the urge to explain everything. See silence as part of the process. Number two, use the 30 second rule in difficult conversations. Let me explain. In difficult conversations like delivering bad news or handling conflict, try to wait for at least 30 seconds after saying something important before you speak again. Why does this work? Well it allows the other person to process the information and start reflecting on what you've just said.

13:21It creates space for their thoughts and their emotions to emerge. This silence can be incredibly powerful for the ability to cope and respond calmly. And number three, designate pause moments in your day. Incorporate small intentional pauses throughout your day, especially during meetings or phone calls or before you make important decisions. Try pausing for 30 seconds at the start of every day just to collect your thoughts. Why does this work? Well in short it helps you focus on what's important to prioritise your time and to set a tone of intentionality. These pauses also encourage mindfulness and help to reduce stress in fast-paced environments.

14:06practice the pause and learn how to deliver bad news well because some of the most powerful moments in life come not from what we say but how we hold the silence after we've said it now i'm going to be joined by our brilliant producer will who's been with us here on the podcast since the very start and we're going to listen to rahul speaking to us about the sense of awe that he experiences when he opens up a human skull how he keeps calm in life or death situations and how dreams have a hidden superpower of high performance.

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16:45Dr. Rahul Jandil, I remember this day because we recorded five podcasts in one day. wouldn't recommend doing that again but you guys were unbelievable at like keeping up the energy of the pace but it was a very eclectic day of guests none more so than this guy well none more good looking either i'd say this was like george clooney turning up one day like just the he was the alpha in that room when he came in handsome smartest most charismatic absolutely he had slick care like for 50 over 50 as well i forgot i forgot that uh but he looked a million dollars spoke really well it was like an like an episode of er yeah well i did like i was in awe of him because i'd read his first book lessons from a knife edge and it's such a beautiful book it's like a book where he talks about his own story so he wasn't like a grade a student at school he was a guy that sort of left school at quite a young age and he'd worked as a security guard and he'd been a valet driver and things like that so he had like quite an eclectic story before he became this eminent brain surgeon so i was really excited to meet him because i'd read that book and he was coming to plug his book about dreams at the time but it was the confidence of a man that stood on that precipice between life and death so many times that he just knew who he was he had an air of confidence a swagger about him that left a lasting impression do you like doing guests that have that you know like we don't know not every day we have a neuroscientist on the podcast yeah yeah so it's like almost like a really different way into high performance a really different lens yeah i like people sometimes like that i've got just this encyclopedic knowledge of a certain topic you know and he's the sort of bloke that if he was operating on me i would want him to do it with that sort of sense of certainty if this is the way it is this is what i'm going to do i'm going to tell you the truth you're so right actually i've never thought of it that way Would you want this guy to operate?

18:44Yeah, you would. Because he's just got almost confidence that can be misplaced for arrogance, but it's not. It's just an air of someone who's mastered their art. What clip should we talk about first? Well, the first one is this idea of a sense of awe that happens. And there's research on this from Jonathan Haidt, who we've had on the podcast, and a guy called Geltner, where they studied the psychology of awe. That's A-W-E. The idea that when you see something, it just changes your view of the world and how you see your standing in it. So again, another guest we had on was the astronaut Tim Peake, who talks about the overview effect.

19:23So many astronauts say that when they leave Earth and see Earth from orbit, it changes the way you perceive life on Earth. Rahul talks about the inner view effect, which is seeing life at its most basic by looking at the brains. Let's have a listen to the way he explains this. It's beautiful. I mean, it's opalescent. Under the operating lights, it's not gray matter. That's for cadavers, right? It's like pearly white. The arteries, it's like a Jackson Pollock painting. I mean, it's stunning. And it's just weird because you go through flesh and bone. It looks like in the movies, you know, they show flesh and bone.

20:03So is there a lot of blood? No, actually. That's a very interesting question. It gets 20 % of the blood flow from the heart. You know, the heart, when it sends out material, 20 % goes to just a 5-kilogram organ. And you think it's going to just, you're getting all of this blood coming in there. It should be red. It's white. It has to do with some of the myelin that wraps it. So when you look at it, it doesn't make sense. It's immediately something sacred. And I don't think that's completely ever gone away from, I still have that moment. I mean, it's always about the person, the family waiting outside, the pitfalls.

20:41I'm running through my drill scenarios. But that first time you see the surface, that's something different. And so that feeling, I think it was something I realized that this is a craft that I will always take seriously. I'm never going to be good enough at this. I'm always going to bring my next level for this. so what I particularly love from that message there was the fact that he's a bloke that's connecting to the deeper meaning of his work you know the fact that he still allows himself to feel that excitement that tingle down his spine at what he's doing that this isn't mundane for him he's thinking of the person their family outside the waiting room while still dealing with matters of life and death I think that sense of purpose in what he does is a reminder for all of us that sometimes you've got to allow yourself to be excited about what you do.

21:32Yeah, what also shone through is that he still has that sense of fear when he's operating, but he's developed all these tools to deal with it, almost like an elite athlete would. Yeah, definitely. And there's something that is resonated with what Dan Carter told us about how breathing was a technique that he would use when he was kicking important points for the All Blacks. I actually met an amazing man recently in Northern Ireland, a guy called Bill McCallion, who's one of Northern Ireland's leading surgeons. And I was asking him, I said, what's one habit you would pass on from the operating theatre to the layman?

22:07And he said, understanding the power of emotional contagion. So how emotions can be captured by other people. So when you're in the operating theatre and if you feel that sense of panic and other people perceive it, it will create chaos. And he said, so learning how to just stay calm to project the image of control is such an important skill. And Rahul describes it really, really powerfully here. You're going to go see your boss. Things aren't going well. You think there may be an issue here. You take that moment a few minutes before. You just have that time to just pace your breathing. When something goes wrong, I've got somebody's skull open and there's something going on in there.

22:48The room doesn't even know. I'll just fight the panic. that you know you're doing something important if you don't feel panic if you don't feel fear so i'll fight the panic and i'll fight the fear by just pacing my breathing that is my ally sending calming signals to my emotional brain as well as i'm 51 now have some i think i have more control of my prefrontal cortex but also saying you've done this before you've been in this bad situation before. Pace your breathing. So there's a dual approach to calming down that emotional limbic instinctive part of my brain. That's a take home approach based on big, big science.

23:33And the reason I approach it like that is because I don't like being told what to do. Do this. Don't do this. Hold this. Stand on one leg. Eat one blueberry. I just, but how, but why? if you know the one step past it, that breathing can send calming shivers up a nerve into your brain, I think people are more likely to do it. So what about people that say, oh, I'm just a naturally anxious person, so that wouldn't work for me? Right. Well, the thermostat is set differently for all of us. Yeah. And the thermostat gets thrown off course as life hits us with different things. But that same approach, wherever your level of anxiety is, that's your built-in coping kit another thing that shone through in this interview it was just a bit of a mind bender this part is when he started talking about dreams how we need dreams and how sleep and how our brain functions when we sleep and how important it is one of those bits where i actually had to listen to a couple of times yeah well you think about in popular culture you know like the famous example is paul mccartney dreaming of yesterday and the lyrics and the tune to it that he woke up in the morning and started just playing it.

24:42And he was like, I'm sure I've heard this somewhere before. And he continued playing it for months afterwards and asking people, where have I got this from? And people were like, I don't know, mate. And it turns out he'd literally dreamt yesterday. And it was in that moment between sort of your conscious brain kicking in and your subconscious that is activated when you're dreaming, sort of taking you to all these weird and wonderful places. So for the first time ever, we've heard somebody explain the neuroscience behind how that creativity can be untapped. Wow. Dreaming the lyrics to Yesterday.

25:18Yeah, yeah. That is mad. Yeah, yeah. I dreamt about a dog. I'm like, why can't I dream the lyrics to a worldwide global smash? Well, yeah, like another example Bahool shared with us was about Thomas Edison that would hold a ball in each hand when he was falling asleep. And then when he dropped the ball, that was when he'd gone too far into the sleep state. But it kept him in that sweet spot of being able to tap into his subconscious imagination while still trying to solve an active problem he was working on. Let's listen to Rahul explain this in more detail, why dreaming is the ultimate superpower for all high performers.

25:57You may not have that experience. I may not. It's not your dream. It's not my dream. but it's sleep and dreaming when you look at 10 000 dreams when you look at 3 000 years of people writing about it from aristotle to freud you see that pattern and that's called uh sleep entry they call it hypnagogic it's got a fancy word for it but i'm trying to bring those down to sleep entry for centuries and now understood with the science of brain waves recording the sizes make patterns. There are a lot of people that report that. So our brains are operating totally differently when we're asleep. They're doing something fundamental.

26:39That pattern, that much energy that they're using, that much blood flow that they're using, and they're putting you at risk of injury and predation, that's not happening on accident. So I believe that sleep is in order to dream when I believe the dreaming brain is keeping those edges of your brain and mind fully engaged. I believe it's high intensity training for thought and cognition and emotion that without it, if it were just the day, we would become so narrow. If we were just taking them, just based on lived experience, how inflexible. I found that fascinating, that wild but brilliant idea that your brain is rehearsing chaos and creativity while you rest.

27:21It's brilliant, isn't it? Yeah, I very recommend everyone to go back and listen to that episode. Yeah, well, often it's like these guests that maybe are not household names that actually contain so much wisdom that, like these are the ones I love passing on to people, that they go, oh, actually I got so many nuggets out of this. And I hope that today's episode has whetted the appetite of anyone listening to go and explore Rahul's wisdom and knowledge and all that deep experience. If you've enjoyed it, please consider passing this episode on to somebody that you think might benefit from understanding how to deliver bad news well by practicing the pause.

28:00So thanks for joining us today on the Essential Habits of iPerformance. I'm Damien Hughes, and I'll see you next time.

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