Narrative Matters: The Paralyzing Power Of Shame
August 16th, 2010
by
Chris Fleming
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Precisely two weeks after completing my medical internship, I proceeded to nearly kill a patient. July marked the start of my second year of residency at New York City’s Bellevue Hospital, and it was my first time being fully in charge of a patient.
So begins Danielle Ofri’s Narrative Matters essay in the August issue of Health Affairs. Through the lens of her own “near-miss,” Ofri discusses the factors that prevent physicians from apologizing for medical errors. Worries about legal liability can be addressed through policy steps, but the paralyzing power of “shame” is a more difficult obstacle to overcome. “No doctor will easily confess to error when a core sense of self is at risk,” writes Ofri, now an attending physician at Bellevue, an associate professor of medicine at New York University School of Medicine, and cofounder and editor-in-chief of the Bellevue Literary Review.
“It’s difficult to develop policy that addresses such a murky and uncomfortable issue as shame,” Ofri observes. “But it wouldn’t hurt for the senior faculty—the chairs, the division chiefs, the master clinicians—to talk publicly to trainees about their own errors, and to specifically address how they dealt with the shame. The very fact of these doctors’ continuing to be doctors—highly successful ones—despite their errors and the attendant assaults on their egos, would itself be a potent lesson to the students and interns.”
Ofri’s essay was excerpted in the Washington Post, and she has also discussed it in the Huffington Post.
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