Hi everyone,
I’m not the silent type.
Once during my surgery clerkship, I was assigned to hold retractors for a prolonged laparotomy, to lean back and pull. I couldn’t see the surgical field, so my mind wandered to my aching wrists, wet scalp, and the hot, humid air behind my mask. The clock crawled. Occasionally, I was pimped about eponymous anatomy—triangles, ducts, and such—but mostly, I was relegated to the background, like the tiles lining the OR wall.
Hours later, the surgery suddenly stopped. A resident was sent to fetch a camera to memorialize a fascinating finding. The overhead lights were adjusted to enhance the view, as I retracted and the assembled awaited the coming of the camera.
I pondered the group’s indifference to the woman lying under the lights, oblivious to the excitement her insides created. As the minutes passed, I wondered what the delay meant for the patient. So I asked:
“Is there a correlation between time on the table and surgical outcomes?”
It’s hard to read facial expressions behind masks, but I knew my question rattled the surgeons, who were appalled by my disinhibition, disrespect for science, and disregard for hierarchy. For better or worse, I’d betrayed tradition and said the unsayable.
I didn’t get honors in surgery, though my feedback noted that by the end of the rotation I’d acquired maturity and learned my place. You can decide if that’s true.
Injustice in medicine is as old as our profession. Often it’s the most junior among us who witness mistreatment and then have to decide whether to speak up or stay quiet, expose themselves or hide, risk censure or moral distress. But how can it ever be right to stay silent in the face of injustice?
I’ve evolved from the indignant student unable to contain my outrage. I’ve studied books on feedback, negotiation, and ways to speak candidly while nurturing relationships. Now more than ever, the world needs to hear our voices. Please use yours.
Enjoy your Sunday, everyone.
Mark
What I’m reading and listening to and books I recommend:
- Netherland By Joseph O’Neill
- The Ashes By Dwight Garner
- 100 Years of ‘The Great Gatsby’ on The Daily
- How Seeking Food in Gaza Has Become So Deadly on The Daily
- If Only My Father Could Choose to Deny the Holocaust Ever Happened By Orli Peter
- The Amen Effect: Ancient Wisdom to Mend Our Broken Hearts and World By Rabbi Sharon Brous
- Many Lung Cancers Are Now in Nonsmokers. Scientists Want to Know Why. By Nina Agrawal and Allison Jiang
- The Perverse Economics of Assisted Suicide By Louise Perry
- Competency-Based Medical Education at the Front Lines of Patient Care By Dawn Cooper and Eric S. Holmboe (H/T to our CCC Chair, Dr. Cindy McNamara)
- Thanks For The Feedback By Douglas Stone and Sheila Heen
- Crucial Conversations: Tools for Talking When Stakes are High By Kerry Patterson, Joseph Grenny, Ron McMillan, and Al Switzler