I had the pleasure recently of working with a small number of health care executives on their public personas and speaking. Now, I have tremendous admiration for the vast majority of health care people because they’re in the business of saving lives, and that’s hugely important work.

And it hits close to home for me. A gifted surgeon saved my life when I was in an accident at age 17. A health care team saved my wife’s life recently with a yearlong, dedicated fight against cancer. And a group of very decent people helped my Dad (and us) through his difficult last year of life.

So when I head out to work with health care execs, I’m thinking, “You folks rock, let’s roll!”

I was struck, this time, by how much the ordinary fears of public speaking were holding this group of heroes (in my mind) back. I even got a little impatient with them, because I wanted them to show up with the same heroic intensity I was projecting on them.

What’s holding you back? These giants (in my mind) were blocked by three quotidian fears, and one big one. How do you compare?

One common source of speech anxiety in health care is the fear that you will be caught out not knowing an answer, or shown up by someone in the audience who knows more than you. Credentials, research, and evidence are big deals in health care.

How to handle this one? Your work on reducing fear should begin long before the actual speech. You can increase your comfort by thoroughly researching the topic, planning out what you want to say, and rehearsing. And rehearse in different ways, in order to get at whatever knowledge issue is the particular cause of your nervousness.

A second common source of stage fright for health care folks is endemic in other executive ranks as well. Many executives from a lot of industries are simply too busy, too stressed, and too distracted to prepare adequately in advance. So they try to “wing” their remarks, making a virtue of necessity, saying that “it will go better because I’ll be in the moment” – and it doesn’t, and they suffer accordingly. Their performances are uneven at best and gaffe-prone at worst.

Why put yourself into harm’s way? Why not know your topic and prepare well in advance of the event?

Finally, a third standard fear that many health care people have is that they’ll forget where they are at some point during the speech and go blank. Once again, this is a widespread fear, but health care people get it as much or more than most because of the information-intensive nature of their world.

The solution? Tell stories. Minimize the data and maximize the emotion. Have notes in sufficient detail so that fear doesn’t slow you down. If that means writing out the entire speech, then write out the entire speech. You will lose spontaneity in the delivery, but you won’t be afraid. As time goes on, try reducing the amount of support you give yourself, until you’re just using basic notes, and can be appropriately conversational. If, when the day approaches, you’re still quite dependent on a full or nearly full text, so be it. Better that you’re a little stilted than so frightened that it all passes in a blur and you can’t remember what you said. There’s little hope of improving when you can’t remember what you’ve done.

Finally, the big fear that I’ve found working in health care is committing your whole self to the moment of communication. Executive after executive shows up with 50% or 75% or at best 80% of themselves. So their talks are adequate, but not life-changing, or deeply moving, or transformational.

Why would anyone do that? Why would you show up mostly, but not fully? What are you waiting for? When does the dress rehearsal end and real life begin?

Come to think of it, that’s not just health care. Or even executives. That’s all of us. We’ve all got to show up completely present and ready to give it our all. Let’s rock and roll. Or we might as well have stayed at home.

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