Simple Steps to a Healthy Art: A Cardiologist Shows How to Begin and End a Speech

Physician holding a heart

“It doesn’t have to be this way.”

So remarked cardiologist Robert Kelly in his TED Talk at the REDxTralee 2024 conference. While encouraging the audience to strive for a healthier lifestyle, Kelly illustrated how a speaker can involve the audience while driving home the speech’s main point.

Kelly began by engaging the audience to demonstrate their own vulnerability. He concluded his talk by giving the audience a simple action to begin their healthier lives. Problem, followed by solution, followed by the first healthy step.


Kelly's Introduction

Kelly involved his audience right away, giving them a practical experience to help them understand the danger of heart disease.

“Now, only if you are able, could I get you again to stand up, please? Brilliant.

“So, there are now about a hundred people looking at me somewhat worried. But for me, your hearts are pumping and you’re all alive. So, I’m going to ask 30 of you to sit down. Now, I have two assistants who are going to randomly pick out the 30, so don’t all sit down yet.”

That simple act of audience participation made the statistics come alive. We can hear public health officials warn us that “30% of Americans will die of heart disease.” But that is just a number! Kelly gave them the experience – he asked 30 people, chosen at random, to sit down. That kind of introduction makes an audience think. Makes an audience see the statistics as more than mere numbers on a spreadsheet.

Having started with a warning, that one-third of the audience might die of heart disease, Kelly gave them a path toward hope:

“And in fact, the great news is, if you follow the steps, it won’t be this way. And so, at this point, you can all sit down. And I’m going to share with you exactly why.”

Wanting the audience to feel positive, however, Kelly then told them that they did not have to suffer the fate of the 30 unfortunate heart patients, that there was hope, that there was a way out. He discussed stress reduction, healthy eating, relationship-building, and exercise.

Only then did Kelly introduce his solution:

“So, I’m here today as a cardiologist and as a health habits coach. And I want to encourage all of you to enjoy a long and a happy life by doing one small step for your heart health every day, starting right now today.”

“Today” was a nice touch, because right now is always the best time to do things, is it not?   

Then, during the bulk of his speech, Kelly advised his audience not to smoke, to reduce stress, to get some exercise, and to eat a more plant-based diet. The genius of his introduction is that he offered the crowd the chance to consider how lifestyle changes could help them. He gave the audience a chance to think past the platitudes. He brought heart health into their own personal experience.

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Kelly’s Conclusion

Unlike many perfectly capable speakers, Kelly did not end by listing points for the audience to memorize. Instead, he asked them to take one simple thing at a time. So, after describing the principles of heart-healthy living, Kelly asked them to take the first step – not all of the steps, just the first – which was to be grateful for what they already had:

“I want you to think of two things that you are most grateful for today. And it’s really important that you feel that gratitude of what that gratefulness is all about. And then you have to celebrate now. Show your high fives, or your thumbs up, or a big smile. I see lots of smiles. And maybe a few ‘yippees’ in the room. Very quiet room. Woo!”

By leading the audience to take one gentle first step, Kelly helped them work through the feeling that a massive lifestyle change imposes too great a burden. Instead, he asked them to take the first step. (Of course, once we take that first step, well, the second step, and the third, and the rest can fall into place, one by one.) Just one first step: 

“So this is one powerful small step that can dramatically improve your heart health. And that might save your life and the loads of people that you have around the room today.”

Final Thoughts

People pay the most attention at the beginning and end of the speech. We all know that. Kelly had begun his speech by offering the audience a personal experience. He ended by asking them to take one simple step. The audience responded. They even cheered a bit. What else could a speaker want?

In general, people learn according to what grabs their attention and relates to their own experience. They act when the action is simple, easy to understand, and easy to do. It helps if they can act right now! Kelly gave everyone a personal experience and one easy step to begin their future healthy lives. Great job! 

by William D. Harpine

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P.S. This speech stirred me, since I just got out of the heart hospital myself! It does all seem overwhelming. Terrifying. My idea that “it can’t happen to me” came crashing down. Years of hearing cardiologists telling me that all my test results were excellent vanished into a mist. Years of eating a sort-of-healthy diet turned out to be too little. But one step a day! Be grateful for my blessings and take one step at a time to live a healthier life. I am, after all, grateful beyond expression for my wife and family. Grateful that modern medicine lets me hope for many more years with them. What, dear readers, are you grateful for? 

Copyright © 2025 by William D. Harpine

Image by asawin (PxHere user), Creative Commons license

Biden's 2024 State of the Union Warned of Impending Calamity

Joe Biden, 2024 State of the Union

A good introduction sets a speech’s tone. In his March 7, 2024 State of the Union Address to Congress, President Joe Biden warned the members—and the nation—that our way of life was under assault:

“… freedom and democracy are under attack at both at home and overseas at the very same time.”

Biden painted a dark, dark picture: forces, domestic and foreign alike, threaten our way of life. Yes, a good introduction sets a speech’s tone. Beginning this speech, Biden laid out two historical analogies of times that the United States was attacked from without, and within. 

As they begin their presentations, good speakers want to gain the audience’s attention while pressing home their key point. Starting the speech, Biden first linked the United States of America’s current political crises with the onset of World War II:

“… in January 1941, Franklin Roosevelt came to this chamber to speak to the nation and he said, ‘I address you at a moment unprecedented in the history of the Union.’”

Biden’s startling historical analogy set the speech’s central message. In January 1941, Roosevelt had worried that neither Congress nor the nation understood the growing threat of totalitarian governments abroad. Like Roosevelt before him, Biden wanted to alert the nation of the growing catastrophe. Biden continued:

“Hitler was on the march, war was raging in Europe, President Roosevelt’s purpose was to wake up Congress and alert the American people that this was no ordinary time. Freedom and democracy were under assault in the world.” [italics added]

Pushing for aid to Ukraine, Biden then carried his analogy to the present day:

“Overseas, Putin of Russia is on the march, invading Ukraine and sowing chaos throughout Europe and beyond. If anybody in this room thinks Putin will stop at Ukraine, I assure you he will not.”

The war in Europe is not, Biden insisted, not our only threat. Making a second historical analogy, Biden warned:

“Not since President Lincoln in the Civil War have freedom and democracy been under assault at home as they are today. What makes our moment rare is that freedom and democracy are under attack both at home and overseas at the very same time.”

After all, January 2021 represented the first time in United States history that we failed to have a peaceful transfer of power.

Biden’s goal was to “wake up Congress and alert the American people.” A mild, mealy-mouthed introduction would wake up no one.

Did Congress wake up that night? Given the amount of heckling and cat- calling from the republican side, well, probably not. Maybe, however, Biden’s introduction may have been the opening salvo to break the United States out of its complacency and to remind us that we live in perilous times. I only wish that Biden had said these things a year ago. As the speech continued, Biden laid out the importance of aiding Ukraine, addressing the southern border, protecting women’s rights, and other key themes. 

Two historical analogies established Biden’s theme. Those starting analogies gave the speech a powerful framework. Biden referred to President Franklin Roosevelt and the onset of World War II, making a second reference to Abraham Lincoln and the American Civil War. Both of those times plagued the United States with terrible danger. Biden alerted Congress and the nation alike that we face great dangers today. Are we listening? No one wants to think about oncoming calamity. Yet, if we face calamity unprepared, do we not choose to become lifeless victims?

Did Biden overstate his introductory analogies? I don’t think so. If we forget history, we will relive history. World War II, the worst disaster in human history, did not break out in one gigantic attack. In fact, the long gap between the September 1939 invasion of Poland and Germany’s June 1940 assault on France was called “the phony war.” Yes, today, Ukraine seems a long way away. All the same, today, while Russia brutalizes Ukraine, does the United States confront growing danger? ­Do we need to wake up?

by William D. Harpine

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Earlier Posts:

Heckling and Anti-Heckling in Joe Biden’s February 7, 2023 State of the Union Address

Trump's Speech of January 6, 2021: A "Firehose of Falsehood"

Franklin Roosevelt’s Pearl Harbor Speech: A Lesson for Our Own Time

Dr. Margaret Chan Organized Her Public Health Speech for Success

Copyright © 2024 William D. Harpine

Image: Official White House photo, via Wikimedia Commons

Biden Sold His Legislative Agenda in His Detroit Speech, but Let His Opponents Set the Agenda

Joe Biden speaking in Detroit

My wonderful high school music teacher, Mr. Matt Hines, told us that the most important parts of a performance were the beginning and the end. That’s when people are paying the most attention. The same is true when speaking. People pay the most attention at the speech’s beginning and end. No aspect of speech organization has more impact than the speech’s beginning

In his speech in Detroit yesterday, November 17, 2021, President Joe Biden said all the right things to sell his legislative agenda. Unfortunately, Biden did not organize his speech for the greatest persuasive effect. Instead, he debated on his opponents’ ground. Biden’s point was that his agenda would help people. His opponents’ point was inflation. Yet, Biden began by refuting the accusation that his legislative program would cause inflation. That was defensive. He put the issue on his opponents’ ground, not his own:

“Before I begin, I just want to mention three pieces of good news today. First, two of the leading rating agencies on Wall Street confirmed today — not a liberal think tank, two Wall Street outfits — that the economic proposals we put forward for the nation — the infrastructure law we just signed and the Build Back Better plan are being considered this week in Congress — will not add to inflationary pressures in the economy. (Applause.)

“And at one — and here’s what one of the agencies said, and I quote, ‘The bills do not add to inflation pressures.’ Let me repeat that: ‘do not add…inflation pressures.’

“The reason? Because the policies I proposed, quote, ‘help…lift long-term economic growth via stronger productivity… labor force growth,’ as well as taking ‘the edge off of inflation.’”

As a speech technique, that’s both really good and absolutely awful. It is important to preempt your opponent’s arguments. It is more important to put your own best points first. An old debate textbook by the late Robert Huber, a mentor from my younger days, suggested a better way to organize refutation. Begin by stating your own positive point. Always. Then, and only then, state your opponent’s point. Don’t explain your opponent’s point. Then state and prove why your opponent is wrong. That keeps the debate on your own ground. Always emphasize your own positive points. You don’t win debates – ever – just by proving that your opponent is wrong. You win a debate by proving that your point is right.


What Was Good?

Biden preempted his critics’ main argument. Republican members of Congress, media pundits, and even some of the Democratic caucus, complain that government spending for infrastructure and other needed projects will cause inflation. Biden needed to attack that. 

Now, Federal Reserve Board Chairman Jerome Powell has been insisting that inflation (a 5.6% annual rate in the most recent monthly report) will be transitory. He thinks prices are spiked by the pandemic and supply chain bottlenecks. All the same, people who want to sound serious are hysterical over a one-month inflation spike. In any case, Biden wanted to confront the issue right off.

Furthermore, Biden tackled the inflation issue exactly. He cited two Wall Street investment studies that the recent infrastructure law and the proposed Build Back Better legislation “will not add to inflationary pressures in the economy. “ He noted that neither of these reports came from “a liberal think tank.” That was important, for so many people try to politicize simple economic information. Indeed, Biden may have worried that people would reject factual news as liberal propaganda. So, that was a good way to make his point.

To drive the point home, to eliminate any possible misunderstanding, Biden directly quoted one of the Wall Street reports: “here’s what one of the agencies said, and I quote, ‘The bills do not add to inflation pressures.’ Let me repeat that: ‘do not add…inflation pressures.’” He didn’t just quote the point. He repeated it.

That was all good. If you know that something is on your listener’s mind, you need to confront it. Congress surely knows that the Build Back Better and the infrastructure bills enjoy overwhelming public support in the polls. Biden’s opponents’ only hope for stopping the much-needed legislation is to complain about inflation. Recognizing what people were thinking, and noticing his opponents’ persuasive strategy, Biden refuted their argument. That’s good. But what wasn’t good?


What Was Absolutely Awful?

The problem is that Biden let his critics set the agenda. He started his speech with the inflation issue—his opponents’ issue. As I have said many times, the side that sets the agenda wins the debate. The public loves projects like safe bridges and highways, broadband access in rural areas, safe drinking water, and childcare. When I was a child, legislation like that passed automatically. “Highway bills pass” used to be a District of Columbia proverb. However, the group that economist Paul Krugman calls “very serious people" (VSP) never cease to panic about inflation. Prices can plummet, and the VSP’s will still panic about inflation. Wishing to appear serious, I guess, Jason Furman just warned that the Federal Reserve is “behind the curve on inflation.”

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Similarly, writing for the mainstream CBS News, Aimee Picchi asked, “Could Biden’s Spending Plans Push Inflation Even Higher?” She quoted Lawrence Summers’ warning about long-term inflation. If we turn to Bloomberg BusinessWeek, we read Joshua Green’s warning that inflation is eating into people’s paychecks. And, of course, a Fox News pundit frantically shrieked that, “Inflation is running hot; rising prices are everywhere and are here to stay.” In contrast, as we’ve seen, many responsible economists still agree with the Federal Reserve that inflation is transitory. 

Still, Biden let the Very Serious People set the agenda. That is why, when Biden began his speech by talking about inflation, he was debating on his opponents’ ground – not his own. The strong point about Biden’s legislative program is not that it is inflation-free. The strong point is that it provides what many people believe are badly needed improvements to the American economic structure.

And, indeed, Biden talked about those improvements – later in his speech. About 1/3 of the way into the speech, for example, Biden zoomed in on the United States’ desperate need for infrastructure:

“The kind of conversations that take place around your kitchen tables — conversations, as profound as they are, are ordinary: ‘How am I going to get to work on time if I-75 is flooded again?’ ‘How can I be sure that my job at the auto plant is still going to be here a few years down the line?’ ‘How can I afford to get my child degree — a degree beyond high school if they don’t start with the same opportunity?’ And more broadly, ‘How do we emerge from this pandemic not just with a little breathing room but with real fighting chance to get ahead?’”

Exactly! How can the economy function if the roads are flooded? Guess what, it can’t! How can people improve their lives if education is unaffordable? They can’t! How do we recover from the pandemic and get the economy rolling again?

That was a wonderful passage. Biden focused on the lives of ordinary people and how they will be better off with his legislative agenda. It’s hard to argue with any of it. That, and not inflation, needed to be Biden’s agenda. Put your own agenda first! Put the refutation later in the speech! Every champion debater knows this.


Sell the Project!

All along, Republicans have done a terrific job of branding their ideas. Most of their ideas are, in my opinion, utterly silly. They are, nonetheless, clear and precise. They scare people about socialism and inflation. They put up pictures of poverty-stricken migrants trying to come to the USA to work. Everybody knows what the Republicans stand for. What do the Democrats stand for?

Yet, what Biden stood for is that he was not making inflation worse. That’s because he began his speech with a piece of good news – but it was good news relevant to the Republican’s agenda. Biden began by telling people that the Republicans and their allies were wrong. He said that his plan would not cause inflation. He was probably right. So what? Nobody is going to vote for a plan if its selling point is that it doesn’t cause inflation. People will support a plan if they see its positive benefits. Unfortunately, Biden waited several minutes before he told people about the benefits.

My friend, college classmate, future big-time business professor, and one-time college debate partner Kathy Micken once told me how important it was to emphasize my key points. One of the best ways to emphasize a point is to put it first in the speech. Mr. Hines was ever so right about that. People pay attention at the beginning. No one pays attention to the middle of the speech. Dear reader, you know this.


Conclusion

Biden actually said all the right things in this speech. He gave positive points for his ideas. He proved those points. He put his points in simple, human terms. He related to people. He showed why inflation fears were wrong. In fact, he proved that inflation fears were wrong.

The only problem is, he said things in the wrong order. Organization is one of the five classical parts of public speaking theory – dating back to ancient times. We often forget how important it is. Biden said all the right things, and he said them wonderfully. But he didn’t put his own point first.

This was, otherwise, a fine speech. Nevertheless, Biden’s opponents are using up too much media oxygen. Biden’s opponents use up the oxygen by saying ridiculous things. I’d love to see Biden take consistent command of the public agenda on his own ground.  

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Research Note: my colleagues who study rhetoric and communication often stress deep-seated ideas. They like to talk about historical and cultural contexts and intellectual history. That’s excellent and I’m glad they do it. I’ve done that kind of research myself. Sometimes, however, we overlook the basics. Audiences respond according to what speakers emphasize. The simplest way to emphasize something is to put it first.

Ancient Greek and Roman writers divided the study of public speaking in the five parts (canons), which all had fancy Latin names. In contemporary English, those five parts would be (1) ideas and proof, (2) organization, (3) language, (4) delivery, and (5) memorization. We don’t worry much about #5 today. The other four are as important as ever. Yes, the content is what we should care about – but speakers need people to understand and believe the content. That’s where, among other things, organization becomes vital. For more information, click on the button above to see my brief essay about the canons.

Image: from White House YouTube Channel

Copyright Ó 2021, William D. Harpine