Our conversation was interrupted with a woman shouting at her husband, ‘I told you that you had selective deafness, you only hear what you want to and when you want to'. The innocent remark was bellowed across the hospital restaurant as I sat discussing practice issues with four perioperative colleagues. Interestingly, the message immediately changed our discussion to story telling about how some of us have found communicating with deaf patients challenging. One point made was that not many perioperative practitioners undertake educational classes in sign language; those who do apparently have a personal interest and often give up their own time to acquire the skills. My colleagues also talked about their limited experience of how they would slow down their speech so the patient could lip-read, but wondered if this was the correct approach. One colleague asked: ‘Are we [perioperative staff] really effective communicators with those who are hard of hearing?’ This intrigued me so much that I arranged to meet the Liverpool Signing Choir. The choir comprised of children from all ages with differing levels of deafness. I stood and watched the artistic performance of using sign language to convey a message saturated with expression and emotion. In the past, deafness has been a barrier however sign language presents opportunities for many including practitioners to converse with their patients. Difficulty in hearing is only one aspect that can impact on patient anxiety; others include the patient wondering if they would be treated with respect and have their dignity preserved. Lorraine Iott writes about how perioperative practitioners can promote patient dignity. She highlights the Department of Health's ‘The Dignity Challenge’ and that there are ten reminders of how respecting dignity can indeed make an impact on patient care. The written medium is certainly a strong vehicle for any message but it is one of many. An act of kindness is also present in the opinion piece from three South Yorkshire theatre nurses who gave up their time to help others in Bangalore, India. Their perioperative skills were put to good use as part of a surgical team offering underprivileged children a better or new life. Their weeklong activities of operating on patients who would not normally have access to or could afford the medical treatment were well appreciated and rewarding. Again, the message in both these articles is that perioperative practitioners continue to give and care about their patients. Despite the bellowing spouse in the clinic room, I am sure her husband was pleased to hear that he did not have any impairment and that his wife was able to confirm the diagnosis. The JPP is a strong medium too as it contains countless messages for the reader; I guess the medium is not only the message but the message is in the medium for enhancing perioperative practice.