Sometimes I listen to what people say in the elevators at the hospital where I work. Sometimes I secretly write these things down. Sometimes I just remember.

I didn’t write this down but I remember the other day when I was in the elevator with a group of three physicians, a resident (the one with the most authority in the circle) and two interns (two student physicians, if you will).

The resident was asking the interns questions. From what I could tell, they were heading to see a patient whose procedure they were discussing. The resident listened to the intern’s answer to his first question, which was something like, “What are you going to do?”

The intern was answering, and the resident asked again, “What are you going to do?” It was light-hearted; they were comfortable with each other. Still, the resident asked the same question in a different way the third time. “How are you going to do it?”

The intern improvised, gestured like he was pushing a tube up his own noise. And to the how are you going to do it question, he added a description until his mentor was satisfied.

He grasped something about his imagination, his hands, and his intent and how they communicated to his teacher that he’d both get the procedure accomplished but in a way that was not harmful.

Knowing what you’ll do gets you part of the way. Sometimes it helps to use your own noise to imagine a push from a press from a shove.