Behind the Mask of Shame Part 1 - The Background

Behind The Knife: The Surgery Podcast

Education, Science, Health & Fitness, Medicine

4.8 • 1.4K Ratings

🗓️ 13 April 2026

⏱️ 51 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

A career in surgery has a profound impact on those who practice the craft. High rates of poor mental health are well described but incompletely understood. One potential mechanism for advancing our understanding of surgeon well-being is studying surgeons’ emotional experiences. Shame, a self-conscious emotion reflecting how an individual feels about themselves, could be a particularly powerful lens. In this series on shame in surgery, we explore what we know about shame in surgery and what shame can tell us about learning and working as surgeons.

In this first episode, we talk with Dr. Will Bynum and Professor Luna Dolezal about how they understand shame in medicine, why it's so hard to see even when it's everywhere, and how developing what they call "shame competence" might be one of the most important steps we can take toward humanizing surgical training.

Host: Steven Thornton

Guests:

Will Bynum (Associate Professor of Family Medicine, Duke University)
Luna Dolezal (Professor of Philosphy and Medical Humanities, Exeter University)

Publications Discussed:

Dolezal L, Bynum W. Shame competence: addressing the effects of shame in health care. Lancet. 2024 Oct 19;404(10462):1514-1515. doi: 10.1016/S0140-6736(24)02269-4. PMID: 39426826. https://pubmed.ncbi.nlm.nih.gov/39426826/
The Nocturnists. Shame in Medicine: The Lost Forest [podcast series]. The Nocturnists; 2022. https://thenocturnists.org/shameinmedicine
Nguyen LN, Bynum WE 4th. When I Say…self-conscious emotions. Med Educ. 2021 Mar;55(3):291-292. doi: 10.1111/medu.14425. Epub 2020 Dec 23. PMID: 33289140. https://pubmed.ncbi.nlm.nih.gov/33289140/
Tracy, J. L., Robins, R. W., & Tangney, J. P. (Eds.). (2007). The self-conscious emotions: Theory and research. The Guilford Press.

***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6

Transcript

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0:00.0	Behind the Night, The Surgery Podcast, Relevant and Engaging Content to help you dominate the day. We want you want you, yes, you, to join the Behind the Knife team as a surgical education fellow.
0:39.9	We're looking for enterprising surgical residents to take the bull by the horns and build something new and exciting.
0:46.6	Fellows will benefit from ample support from the Behind the Knife team, including the use of our digital education platform, and access to all of our resources like
0:54.8	illustrators, video editing, AI tools, social media, and more.
0:59.7	Get your name out there and build your CV by being part of the number one surgery education
1:04.2	platform in the world. We're offering a two-year fellowship starting July 26 and ending in June 28.
1:12.4	Only residents beginning their two-year academic development time will be considered.
1:16.9	Check out the show notes for more information, including the application link.
1:20.4	All applications are due on April 20th.
1:23.7	Again, all applications are due by April 20th.
1:27.4	Now, get out there and dominate the day.
1:30.6	Hello, everyone. I'm Stephen Thornton, a surgery resident at Duke, and one of the behind
1:36.1	the knife surgical education research fellows. Today, I'm really excited to be bringing you a special
1:42.9	series on shame in surgery, with a particular focus on shame and surgical training.
1:50.7	First things first, what is shame?
1:54.1	Well, scholars conceptualize shame in a variety of ways.
1:58.5	One way to understand it is that it is the feeling of being globally flawed,
2:04.1	inadequate, or unworthy. In BTK language, it's when you feel like you're not the kind of person
2:11.2	who dominates the day. Does that sound relatable? I wonder how many of you listening may have felt this way about yourself while training
2:22.0	in surgery or working as a surgeon.
2:25.7	So why talk about shame?
2:28.8	Surgeons forever change their patient's lives.
	...

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