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The Nocturnists

5 - Shame in Medicine: Indoctrination

The Nocturnists

Emily Silverman

Medicine, Personal Journals, Society & Culture, Health & Fitness

4.8614 Ratings

🗓️ 11 October 2022

⏱️ 40 minutes

🧾️ Download transcript

Summary

In medical culture, shame is often wielded as a teaching tool. We shame learners for not knowing, for forgetting, for making mistakes. When does this serve us? When is it harmful? Is there a better way?

Find show notes, discussion guide, transcript, and more at thenocturnists-shame.org.

Transcript

Click on a timestamp to play from that location

0:00.0

Support for the Nocturnist comes from the California Medical Association.

0:04.2

At the Nocturnist, we are careful to ensure that all stories comply with health care privacy laws.

0:09.1

Details may have been changed to ensure patient confidentiality.

0:12.5

All views expressed are those of the person speaking and not their employer.

0:16.7

Thanks for listening to The Nocturnist's shame in medicine, The Lost Forest.

0:21.5

If this is your first time tuning in, I recommend that you rewind and start at episode one.

0:26.9

This is a series that builds on itself over time, so we think that starting at the beginning

0:31.4

will offer the richest listening experience for you. Enjoy the show.

0:44.1

When I was a medical student on my surgery rotation, every time I went into the OR, I felt like I was being watched. There's this very involved scrubbing process where you have to wash your hands down to your elbows

0:57.5

and then put on a gown in a very specific way and then twirl and have it be tied and snapped

1:02.5

in a certain way.

1:04.0

And as I went through these motions, it felt like the scrub nurses were watching me like hawks and just waiting for me to make a mistake.

1:14.8

And when I did make a mistake, even a small one, like just stepping an inch too close to a tray of

1:20.2

instruments or bumping my butt against something, they would tell me to go outside and try again.

1:24.7

Go outside, try again.

1:26.3

And then once you're in the operating

1:27.6

room, you're surrounded by these men. They're shooting the shit, talking to each other, over

1:33.8

this anesthetized patient. And sometimes it's a good natured sort of poking fun at each other,

1:41.0

but sometimes even the attending would say demeaning things to his learners.

1:46.1

People would laugh, but I'm not sure they really liked it. And my instinct was just to be as small

1:53.3

as I could. And so that's my headspace when the attending turns to me and says, medical student,

2:00.8

sew this wound, and he hands me a needle.

...

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