Spring is here and the flowers are starting to blossom around us, adding more beauty to our physical surroundings. As we know, these spring flowers need three main ingredients to grow: sunshine, water and soil. Now let's take this same concept and apply it to a universal human experience, that also happens to be rampant in medicine: shame.
According to shame researcher Brené Brown in Dare to Lead, a perfect way for shame to grow is to place it in a petri dish and "cover it with judgment, silence, and secrecy." Again, three ingredients, however, with a very different, undesirable outcome.
In reality, we really can't discuss physician well-being without considering the role shame plays in the world of medicine. And we need to discuss it because as Brené says, "The less we talk about shame, the more control it has over our lives." Her definition of shame in Dare to Lead is as follows: "Shame is the intensley painful feeling or experience of believing that we are flawed and therefore unworthy of love, belonging, and connection."
Take a very common experience for many physicians - the dreaded college or regulatory body complaint. As many of us have been forewarned, it will often be the case you least expect to hear about again, that will result in you being on the receiving end of a complaint. Or perhaps, it's even a colleague or someone in a position of leadership, filing the complaint. Regardless, we would immediately and invariably be filled with shame. The dialogue in our head might run something like this: "I don't belong in medicine after all. I'm not good enough." This becomes an ideal environment for shame to grow - being judged, being instructed to remain silent about the complaint during the discovery process, and the long lasting secrecy of not wanting others to know it happened to you.
This is just one of MANY examples of where shame exists in medicine. As Brené also says, if you don't think you can spot shame right away in your organization, here are a few other signs its growing and thriving: perfectionism, comparison, harassment, bullying, and the list goes on. Sound like familiar threads within the medical culture?
Thankfully, we have a way out. We can kill this pervasive shame with acceptance, empathy, openness and shared experiences. As our Australian medical colleague and Twitter friend Dr. Geoff Toogood wrote in a Medical Journal of Australia piece this past week titled Embracing Our Vulnerability in Medicine: "The lived experience is the way forward. We must embrace vulnerability in medicine."
If you're here reading this, you're already part of the solution. Shame can't exist from a place of shared vulnerability. Onward and upward we go together.
"Giving people permission to talk about shame is liberating. It shines a light in a dark corner. People realize they're not alone." ~ Brené Brown, Dare to Lead