The Thing You Didn't Say
Fling.Everybody flinched when the large forceps hit the wall and fell down on the speckled OR floor with a metallic sound.He was losing his temper again, and the single reason for that was the experienced surgeon to the left of him not doing his job fast enough for his standards.Before that he had hit that surgeon on the fingers with the soon-to-be-thrown forceps. The escalation of the situation included him getting off his stool, walking around the operating table, semi-sterilely kicking the other surgeon in the butt and later throwing him out of the OR altogether.I didn’t know what to say. Or rather: I knew exactly what I wanted to say, but the words locked somewhere between my diaphragm and my throat and never made it out. I was a fourth-year med student on exchange in a foreign country, and I was afraid.The same fear that kept the scrub nurse staring at her tray. The same fear that kept the anesthesiologist suddenly very interested in his monitors. At least seven people who were silently witnessing the tantrum.Looking back, I understand that silence is also a way of venting. Just a very self-destructive one. It keeps living on inside of you, it spills into your evening. It changes your own behaviour going forward. And it creates a gap between your values and your actions, between how and who you want to be and how you actually show up. And that nagging discrepancy of bad conscience is the real price you pay for your silence. And that even though it wasn’t even you that inflicted the harm to begin with.Every institution falls back to what it tolerates.In hindsight it is unfathomable to me how this could have been accepted by anyone over what was his entire surgical career.That surgeon wasn’t born throwing forceps. At some point, he learned that this was an acceptable way to handle his pressure, and nobody ever taught him otherwise.Most of us are running on similarly borrowed scripts. I believe that many things we take as natural behaviour in certain situations are copied or uncorrected behaviours from others and from ourselves.And it is easy to identify these behaviours in others. It is much harder to do so for yourself, and even more so to admit them.What do you actually do when you are the most junior person in the room and the cost of speaking is real?Most of us live in some sort of dependency, real or perceived. The right thing to do would obviously be calling behaviour like this out. Either directly or to his superiors. That, though, requires an understanding of what is acceptable and what is not. I believe we are born with a pretty well-developed sense for that, one we only question because we trained ourselves out of it through thousands of minor interactions like these. It also requires taking responsibility for whatever comes after, and valuing your ethics higher than your personal gain. That is a lot to ask of any single one of us.Looking back, I would tell my younger self to talk. Not in the moment, and not to the surgeon first. To the scrub nurse, afterwards, in the corridor. Just: that was not okay, was it. Because what made the room the way it was, was that all seven of us were silent separately. One sentence to one person ends that.The harder version, and the one I would have wished for myself already back then, is asking the surgeon himself. Not confronting him, but asking, with genuine curiosity, why he did what he did. I have felt reflection get sparked in myself when someone asked me that plainly, without accusation, and it does more than any reprimand.It is also one of the reasons why I went for a position that allows me to make a structural difference in the culture we create. We have a no-tantrum policy. That has required me to let go of extremely skilled and competent colleagues.Because, again, every institution falls back to what it tolerates.To more from life,Nicco---Hum along:https://on.soundcloud.com/FpIVzkeevabP9SzU8Z This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit letters.niccokrezdorn.com
