The jury’s duty, the judge told them, was to “not be swayed by sympathy, prejudice, or passion…. You are to decide only whether the defendant is guilty or not guilty of the offense.” If mercy was required, the judge could apply it later, during sentencing.

  Now, however, sitting inside the deliberation room, the jurors seem uncertain how to begin.

  “Let’s choose a foreperson,” one says.

  “You’re it,” another juror replies.

  No one will be allowed to leave the room, except for short bathroom breaks, until they have a unanimous verdict. If the deliberations go late, they’ll start again early the next morning. No one will be permitted to withdraw from the conversation, or remain silent, or defer debate simply because they are tired of talking. They will have to argue over facts and theories, try to persuade and cajole one another, until everyone agrees.

  But first, they need to figure out how to start the conversation. They need to negotiate the unspoken rules for how they will speak and listen—and determine what everyone wants and needs. This is a negotiation we all participate in whenever a conversation begins, whether we realize it or not. And it’s more complicated than we think.

  HOW DO WE DECIDE WHAT TO TALK ABOUT?

  Try to recall your last meaningful conversation. Perhaps you and a loved one were discussing how to divvy up household chores. Or maybe it was a work meeting about next year’s budget. Possibly you were debating with friends about who should be the next president, or gossiping about whether your neighbors Pablo and Zach are going to break up.

  As the conversation started, how did you know what everyone wanted to discuss? Did someone announce a topic (“We need to decide who’s driving Aimee to school tomorrow”) or did a focus emerge gradually? (“Hey, just wondering, did Pablo seem distracted at dinner last night?”)

  Once you figured out what to talk about, how did you intuit the conversation’s tone? How did you know if you should speak casually? If making jokes was appropriate? If it was okay to interrupt?

  You probably didn’t think about those questions, and yet they all got answered somehow. When researchers have studied conversations, they’ve found a delicate, almost subconscious dance that usually occurs at a discussion’s start. This back-and-forth emerges via our tone of voice, how we hold our bodies, our asides and sighs and laughs. But until we arrive at a consensus on how a dialogue ought to proceed, the real conversation can’t begin.

  Occasionally, a conversation’s aims are stated explicitly (“We’re here to discuss this quarter’s projections”) until we realize, midway through, that people’s real preoccupations lie elsewhere (“What we’re actually worried about is whether there’re going to be layoffs”). Sometimes we cycle through various starts—someone tells a joke; someone else gets overly formal; there’s an awkward silence until a third person takes the lead—and, eventually, the conversation’s focus is tacitly agreed upon.

  Some researchers call this process a quiet negotiation: A subtle give-and-take over which topics we’ll dive into and which we’ll skirt around; the rules for how we’ll speak and listen.

  The first goal of this negotiation is determining what everyone wants from a conversation. These desires are often revealed via a series of offers and counteroffers, invitations and refusals, that are nearly subconscious but expose if people are willing to play along. This back-and-forth can take just a few moments, or last as long as the conversation itself. And it serves a crucial purpose: To help us find a set of subjects that we are all willing to embrace.

  The second goal in this negotiation is to figure out the rules for how we will speak, listen, and make decisions together. We don’t always explicitly state these rules aloud. Rather, we conduct experiments to see which norms will stick. We introduce new topics, send signals via our tone of voice and expressions, react to what people say, project various moods, and pay attention to how others respond.

  However, regardless of how this quiet negotiation unfolds, the goals are the same: First, to decide what we all need from this conversation. Second, to determine how we will speak and make decisions. Or, put differently, to figure out: What does everyone want? And how will we make choices together?

  The What’s This Really About? conversation often emerges when we confront a decision. Sometimes, these decisions are about the conversation itself—Is it okay to openly disagree, or should we sugarcoat our differences? Is this a friendly chat or a serious talk? Other decisions ask us to think practically (“Should we submit an offer for the house?”) or make a judgment (“What do you think of Zoe’s work?”) or analyze a choice (“Do you want me to pick up the groceries or get the kids?”).

  Underneath all those straightforward decisions are other, potentially more serious choices: If we openly disagree, can we remain friends? Can we afford to pay that much for a home? Is it fair for me to pick up the kids when I have so much work to do? Unless we come to a basic agreement about what we’re actually discussing, and how we should discuss it, it’s hard to make progress.

  But once we know what everyone wants from a conversation, and how we’ll make decisions together, a more meaningful dialogue can emerge.

  HOW A SURGEON LEARNED TO COMMUNICATE

  In 2014, a prominent surgeon at Memorial Sloan Kettering Cancer Center in New York City—someone admired for his warmth, kindness, and medical acumen—realized that, for years, he had been talking to patients all wrong.

  Dr. Behfar Ehdaie specialized in treating prostate cancer. Every year, hundreds of men sought his advice after receiving the terrifying news that a tumor had been discovered deep inside their groin. And every year, many of those patients, despite Ehdaie’s best efforts, failed to hear what he was desperately trying to tell them regarding their disease.

  Treating prostate cancer involves a complicated trade-off: The surest course of action is surgery or radiation to prevent the cancer from spreading. But because the prostate gland is located alongside nerves involved in urination and sexual function, some patients, after treatment, experience incontinence and impotence, sometimes for the rest of their lives.

  So for most people with prostate tumors, doctors advise against surgery or any other form of treatment. Low-risk patients, instead, are counseled to choose “active surveillance”: Blood tests every six months and a prostate biopsy every two years to see if the tumor is growing. But, otherwise, no surgery, radiation, or anything else. Active surveillance carries its own risks, of course: The tumor might metastasize. But prostate cancer usually grows very slowly—in fact, there’s a saying among physicians that older patients will usually die of old age before their prostate cancer kills them.

  Nearly every day, a new patient would enter Ehdaie’s office, overwhelmed by a recent diagnosis, and confront a difficult choice: Have surgery and face a potential lifetime of incontinence and sexual dysfunction? Or leave it alone and hope, if the cancer grows, the tests will catch it in time?

  Ehdaie believed these patients had come to him for practical medical advice, so he followed what, to him, seemed a logical script: For the vast majority of people, he felt active surveillance was the right decision, and he provided evidence supporting the wisdom of that approach. He typically began by showing patients data indicating that, for 97 percent of men who opt for active surveillance, the risk of the cancer spreading is roughly the same as for those undergoing invasive treatments, and so they are better off with a wait-and-see approach. He would hand over studies—with the important sentences highlighted in yellow—explaining that the risks of waiting were minuscule, while the downsides of surgery were potentially life changing. Ehdaie tends to speak in full paragraphs, like a medical textbook come to life, but he kept these conversations short and sweet: The right choice was active surveillance. “I thought these would be some of the easiest discussions of my life,” he told me. “I figured they’d be overjoyed to hear they could avoid surgery.”

  However, again and again, his patients failed to hear what he was saying. Ehdaie was talking about treatment options, but running through patients’ minds were questions of a very different sort: How will my family react to this news? Am I willing to risk dying so I can continue enjoying my life? Am I ready to confront my mortality?

  As a result, the patients, instead of looking at the charts and studies and feeling relief, would inevitably begin asking questions: What about the 3 percent of patients who hadn’t benefited from active surveillance? Had they died? Were their deaths painful? “We’d spend the entire meeting talking about the three percent,” said Ehdaie. “And then, when we’d meet again, the three percent was all they’d remember, and they’d say they wanted the surgery.”

  It was bewildering. Ehdaie had spent his life perfecting his knowledge of prostate tumors—these patients had sought him out because he was an expert!—and yet, no matter how much he told them they didn’t need surgery, many of them insisted on going under his knife. Sometimes patients would take the highlighted studies home and start searching online for counterevidence, diving into obscure journals and medical abstracts until they had convinced themselves the data was all contradictory, or the doctors didn’t know what they were talking about.

  “Then they’d come back suspicious,” Ehdaie said. “They’d say, ‘Are you the active surveillance guy? Is that why you’re suggesting this?’ ” Other patients would simply ignore his advice. “They’d say, ‘I have a friend who had prostate cancer and he told me the surgery was fine.’ Or ‘I have a neighbor who had brain cancer and she died in two months, so it’s too risky to wait.’ ”

  This problem wasn’t limited to Ehdaie. Surveys indicate that, even today, an estimated 40 percent of prostate cancer patients opt for unnecessary surgeries. That’s more than fifty thousand people, each year, who fail to hear—or decide to ignore—the advice their physicians are giving them.

  “When it happens again and again, you start to realize: This isn’t a problem with my patients,” Ehdaie told me. “This is a problem with me. I’m doing something wrong. I’m failing at this conversation.”

  * * *

  —

  Ehdaie started asking friends for advice and, eventually, a colleague recommended he speak with a professor from Harvard Business School named Deepak Malhotra. Ehdaie sent a long email asking if they could talk.

  Malhotra was part of a group of professors studying how negotiations occur in the real world. In 2016, one of his colleagues had helped the president of Colombia negotiate a peace deal to end a fifty-two-year civil war that had killed more than two hundred thousand people. After the 2004 National Hockey League lockout, which canceled half the season, Malhotra analyzed why discussions between players and team owners had broken down and what it took to get them back on track.

  When he received Ehdaie’s email, Malhotra was intrigued. His scholarship sometimes describes formal negotiations where, say, union leaders and managers battle around a conference table. But Ehdaie’s situation was different: The doctor and his patients were engaged in high-stakes negotiations—only, most of the time, no one recognized they were negotiating with each other.

  Malhotra flew to Sloan Kettering to gather more information and, as he shadowed Ehdaie, saw opportunities where these conversations could improve. “An important step in any negotiation is getting clarity on what all the participants want,” Malhotra told me. Often, what people desire from a negotiation isn’t obvious at first. Sometimes a union leader might say her goal is higher wages. But then, over time, other goals are revealed: She also wants to look good to her members, or one union faction hopes to take power from another faction, or the workers value autonomy on a par with higher paychecks, but they don’t know how to express that at the bargaining table. It can take time, and the right inquiries, to help define people’s desires. So an important task in any negotiation is asking lots of questions.

  But as Ehdaie interacted with patients, he wasn’t asking the most important questions. He wasn’t asking patients what mattered to them. He wasn’t asking: Did they want to extend their lives if the treatment robbed them of things like travel and sex? Would you want an extra five years of life if the trade-off was constant pain? How much of someone’s decision depended on their own desires versus what their family wanted? Was the patient secretly hoping the doctor would just tell him what to do?

  Ehdaie’s biggest mistake was assuming, at the start of a conversation, that he knew what the patient wanted: Objective medical advice, an overview of options to make an informed choice.

  “But you don’t want to begin a negotiation assuming you know what the other side wants,” Malhotra said. This is the first part of the What’s This Really About? conversation: Figuring out what everyone wants to talk about. The simplest method for uncovering everyone’s desires, of course, is simply asking What do you want? But that approach can fail if people don’t know, or are embarrassed to say, or aren’t certain how to express their desires, or worry that revealing too much will put them at a disadvantage.

  So Malhotra suggested that Ehdaie take a different approach. Instead of starting the conversation by presenting patients with an overview of options, he should ask open-ended questions designed to get them talking about their values and what they wanted out of life.

  “What does this cancer diagnosis mean to you?” Ehdaie asked a sixty-two-year-old patient a few weeks later.

  “Well,” the man said, “it makes me think of my dad because he died when I was young, which was tough on my mom. I would hate to put my family through that.” The man talked about his kids and how he didn’t want to traumatize them. He spoke about his worries regarding the world his grandchildren were inheriting, what with climate change and all.

  Ehdaie had expected the man to talk about his medical concerns or his mortality, or to ask questions about pain. Instead, his preoccupations were focused on his family. What he really wanted to know was which treatment would make his wife and kids worry least. He didn’t care about data. He wanted to discuss how to avoid upsetting the people he loved.

  A similar pattern emerged in other conversations. Ehdaie would start with a broad question—“What did your wife say when you told her about your diagnosis?”—and instead of talking about their disease, patients spoke about their marriages, or memories of a parent’s illness, or about nonmedical traumas such as divorces or bankruptcies. Some spoke about the future, how they hoped to spend their retirements, what they wanted to leave behind as a legacy. They started working out how to fit the idea of cancer into their lives, debating over what this disease means. That’s how a quiet negotiation works: It is a process of people deciding, together, what topics we’ll discuss, and how we’ll discuss them. It is an attempt to figure out what we all want from a conversation, even if we’re not, ourselves, sure at first.

  Some patients, Ehdaie’s questions revealed, were scared and wanted emotional reassurance. Others wanted to feel in control. Some—seeking social proof they weren’t taking unusual risks—needed to hear how other people had made this decision. Still others wanted the most cutting-edge treatments.

  Often, Ehdaie only managed to figure out what a patient wanted to talk about by asking them the same basic questions, again and again, in different ways. “Eventually they would say something that revealed what was important to them,” he told me. This explained why Ehdaie had failed to communicate with so many patients over the years: He hadn’t been asking the right questions. He hadn’t been asking about their needs and desires, what they wanted from this conversation. He had assumed he already knew. And because he hadn’t bothered to figure out what mattered, he had deluged patients with information they didn’t care about. He resolved to change how he communicated, to stop lecturing and start asking better questions, to begin having proper dialogues.

  Within six months of Ehdaie’s adopting this more inclusive approach, the number of his patients opting for surgery fell by 30 percent. Today, he’s training other surgeons to negotiate about topics such as opioid use, treatments for breast cancer, and end-of-life decisions. It’s an approach we can all use, even in less dire discussions, when we’re talking to a friend about, say, their dating life, or a work colleague about an upcoming project, or our partner about how we should raise our kids. In many conversations, there’s a surface topic—but also a deeper, more meaningful subject that, when we bring it into the light, reveals what everyone wants most from the conversation. “It’s important to ask what they want,” Ehdaie told me. “It’s an invitation for people to tell you who they are.”

  THE SUPERCOMMUNICATOR IN THE JURY ROOM

  “I know some juries like to take a vote right off the bat,” the freshly appointed foreperson tells his fellow jurors. But maybe, he suggests, they could avoid committing to positions right away and, instead, go around the room and offer their general impressions of the trial.

  His goal is obviously to sidestep kneejerk reactions, but some jurors can’t help immediately taking a side. One, a firefighter named Karl, says there’s no question in his mind that Leroy Reed is guilty. “To me, they proved it beyond a reasonable doubt,” he says. “The extenuating circumstances, as far as what his intent was, his awareness of the law, his ability to read and understand, is not for us to determine, as far as guilt or innocence. That’s for the judge to take into consideration in the sentencing.” He reminds everyone of the three questions the judge instructed them to answer: Was Reed a felon? Had he acquired a gun? Did he know he had acquired a gun?

  “As far as I’m concerned, they met the three points, the burden of proof,” Karl says.

  Two other jurors quickly agree with Karl: Leroy Reed is guilty.