Associative Memory During A Formal Presentation - Keeping It Real

I just completed a formal presentation this morning at about 9:15 AM.  It was in a big conference room at a plush hotel near the Mall of America.  There was a little pressure because I was the lead off man in terms of the scheduled presentations.  I walked into the venue early and got up on the stage.  It was a black elevated platform about 25 feet square.  It looked like it was built to be portable.  There was a lectern with a fixed microphone.  The platform was positioned between two large 20 x 25 foot screens.  In order to see the screens or use a laser pointer, I had to walk out from behind the lectern to bring me about 12 feet away from the back wall.  I looked out over the audience filing into to 4 sections of tables and thought: "Not the most convenient set up - but I have done this before."

My experience with presentations like this is mixed over the years.  A lot of that has to do with neurotic behavior.  I have given many presentations that I became disgusted with and was glad they were over.  They were probably the ones that I did not think were good enough or up to my often unrealistic standards.  In the old days before everything was standardized as PowerPoints, the formatting and graphics would often throw me off.  For 5 dark years I was using a presentation program called Aldus Presentation followed by Harvard Graphics and there was always a lot of luck involved in what that final presentation looked like.  Those were also the days of 35 mm slide sets and projecting from carousel projectors.  There were also services that would charge significant fees to convert your presentation images to 35 mm slides.  Nowadays I can obsess about the presentation right up until the last moment and walk in with presentation, several modified versions, and several alternative graphics on a USB drive and make a last minute change.  Technically about the only thing I have to complain about is getting copyright permissions but all of the hardware and software is good.

Getting mentally prepared is much harder.  I received instructions that I had to make sure that the presentation was exactly 45 minutes long.  Right before I started I was told about 5, 2, and 1 minutes cards that would let me know how the time was running out.  I was supposed to rehearse it and I did.  I digitally recorded it and it ran 45 minutes exactly.  I went back and recorded as many key concepts as I could.  I thought about my self acknowledged deficiencies as a presenter.  I can suddenly start to isolate affect and drone on in a rapid and obsessive manner.  I can remember giving a presentation about medications to a large crowd and at one point I made eye contact with a fellow staff member in the audience as he mouthed the words: "Slow down!" - rather emphatically.  I am fairly humorless.  At least that is the general audience experience.  My humor is dry - often bone dry.  It is the humor that only introverts get at times.  When I hear more than a muffled response, I wonder: "What just happened?"  There is also the fear that I will choke in the same way I choked in a pharmacology seminar in medical school.  My seminars generally consisted of the same group of people.  They were all friendly and not threatening in any manner.  The same thing was true of the professor.  I knew the material on the cardiovascular pharmacology of calcium channel blockers cold.  There was no good explanation for me just blanking out at the ten minute mark.  I remember I was thinking about hiking through Glacier National Park.  I had the image of a photo I took of the moon high in the sky over Nebraska.  Everything seemed right with the world until my reverie was interrupted by the Professor saying: "Hello?  Mr. Dawson?  Are you going to get on with it?"  I don't know how long I was staring blankly in front of my fellow students.  I snapped out of it and completed my presentation.

I have given thousands of presentations since that pharmacology seminar incident and no similar episodes have occurred.  Even at the time, I don't  remember being embarrassed about it.  Also unusual.  That does not mean that I am any less neurotic.  Since reading Yalom as an intern, I have always seen the truth in existentialism,  so I was not surprised about this spontaneous thought on my drive to the hotel: "What do you care what people think about this?  You are going to be dead soon anyway and nobody is going to talk about it at the funeral."  .... Okay - focus George - you can only die after the presentation.  Don't work yourself up into a lather of death anxiety in addition to the fairly well controlled performance anxiety.

After surveying the venue, I decided to forgo the conference coffee and go to one of my favorite chain of coffee shops.  The conference rooms were set up so that they intersected a main skyway into the mall.  The coffee shop was about 100 yards away.  I had about 15 minutes until I started, so I headed down the hallway.  At about the 50 yard mark, there was a set of three steps followed by a landing and then another set of four steps.  I failed to notice it at the time but the height of the steps was unusually low and I was headed down these steps.  This is a major thoroughfare and the hallway was about 20 feet wide.  I made it to the third step tripped and went crashing onto my right knee and hands.  That's right - I fell almost flat on my face shortly before my presentation was scheduled to start.  The same thing happened to me in O'Hare one day as I was waiting to catch a flight to Boston.  I was balancing with a brief case against a guard railing in one of those large central areas that everybody seems to stream through headed to the other side of the airport at O'Hare.  I slipped sideways and hit the floor, the metal edge of my brief case making a loud cracking sound.  No fewer than a hundred people came sprinting over to me as if I had been shot.  It took a good ten minutes for the crowd to clear after they confirmed that I was apparently unscathed.

This morning I immediately pushed myself up off the floor and braced for the onslaught.  There were at least a hundred people in the area.  To my amazement, nobody seemed to have noticed the old man hitting the deck. I moved quickly to the coffee shop, placed my order and moved to a back corner where I could pull up my baggy trouser leg and inspect the knee damage.  Ten minutes later I was at the podium.  One of my colleagues commented on the way up that I never looked nervous.  He didn't see me just hit the floor like a bag of dirt.

This is it.  I am finally ready for the show.  I always have a number of jokes ready that I never use.  Instead I go to a few controversial remarks about the topic.  I am actually a student of PowerPoints.  I have attended the Tufte seminars and have his books.  I try to apply principles of good design to the slides and to use as many graphics as possible.  Tufte doesn't like PowerPoint.  He thinks it doesn't contain enough information.  I attended one of his seminars and he was using large sweeping graphics with no text.  It was visually interesting but content?  It reminded me of a TED talk - a lot of affect and minimal content.  TED talks are useful for that mode of communication, but the crowds I talk to deal in facts and a lot of them.

I know it is not going to be the Dave Chapelle show, but I know there is some important information I need to convey.  I want the slides to contain the information and where to get more information, but I never want to read them.  I also don't want to focus on talking points or read a script.  I just realized today that what I have is free association points on the slides, and I need to say whatever comes to mind when the slide pops up.  While the audience is reading the slide or looking at a graphic, I need to come up with the best illustration from my personal experience.  It went something like this:

And that is pretty much how it went.  Matching my associations to the lecture content.  It is only slightly more to obsess about.

And nobody had to die.

Oh well - on to the next presentation........


George Dawson, MD, DFAPA