Why it is good to share our vulnerabilities .
Dr Anne Stephenson GP in Torquay , Victoria . She is also the GP liaison officer at Epworth Geelong Private Hospital , Victoria .
I HAVE many faults , but when I use the last skerrick of toilet paper , I put another roll on .
Admittedly , this was not always the case .
Many moons ago , in my early 20s and queasy post-party , I was hanging out with some uni classmates at a friend ’ s kitchen table when the friend ’ s burly father unexpectedly burst in .
“ Who left this ?” he growled , brandishing the empty toilet roll . A deathly silence ensued . Red-faced , I meekly admitted that it was indeed me who had left the offending roll on the holder .
In this case , it was probably no coincidence that my friend ’ s father was an esteemed surgeon and was accustomed to throwing his weight around .
Sadly , feeling ashamed for making a mistake is commonplace in medicine . Just last week , the empty toilet roll memory came flooding back . I gave an immunisation that was meant to be administered subcutaneously , and I had given it intramuscularly .
The poor woman got a nasty local reaction , which was vividly photographed , recorded in her notes and shown to me by one of our practice nurses .
“ Surely , Anne , you didn ’ t give it intramuscularly ?” the nurse said incredulously . “ You wouldn ’ t have done that ; would you ?”
I felt like crawling under a rock ,
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desperately not wanting to own up .
I have a perpetual low-grade fever of self-doubt that lies dormant most of the time , but when I make a mistake , the fever flares into a roaring sepsis .
There are the weeks of waking in the middle of the night with Pythonesque
images of horror .
Nightmares of blackened , scarred limbs ; emergency doctors shaking their heads at the incompetence ; and newspaper headlines of ‘ Doctor misses obvious diagnosis with dire consequences ’.
Despite most doctors being conscientious , we are also highly
neurotic about making mistakes .
Many young doctors are particularly vulnerable to this , and when something goes wrong , they believe their incompetence or inexperience is to blame .
It does not help that the wider community expects perfection from
My perpetual low-grade fever of self-doubt flares into a roaring sepsis when I make a mistake .
the medical system , and it is not shy to share stories of another doctor ’ s perceived incompetence .
Mistakes are part of life and help human beings to learn . Usually , when you do make an error , you do not make it again .
Every time I am faced with an empty toilet roll , I flash back to
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PICTURE CREDIT
that moment in my friend ’ s kitchen and go out of my way to replace the empty roll .
To fully learn from mistakes , it helps to explore what happened . But doctors worry about openly sharing mistakes .
We fear being embarrassed and losing face in front of our peers . Subconsciously , we believe making a mistake reflects a failure of our entire being and that we have failed to live up to what is expected of us .
Openly discussing adverse events in a safe place can provide enormous relief for medical professionals . Done well , these discussions can prevent us from being too hard on ourselves .
By unpacking all the factors that contributed to the error , we are likely to find that systemic factors also played a large part in what happened .
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I recently rewatched Professor Brené Brown ’ s fabulous TED Talk , The Power of Vulnerability .
Professor Brown , now a household name , shares her personal journey of studying vulnerability .
She begins by acknowledging that vulnerability is often seen as a weakness , something to be avoided or hidden , and she shares her own struggle with perfectionism .
But through her research , she has discovered that vulnerability is actually the birthplace of courage , creativity and connection .
She defines vulnerability as “ uncertainty , risk and emotional exposure ” and emphasises that it is an essential part of living a wholehearted and fulfilling life .
In my opinion , Professor Brown ’ s TED Talk should be compulsory viewing for all doctors .
Can we change the way we think about making mistakes by doing less shaming of individuals and more normalising and learning ?
Here are a few suggestions :
• Create an environment where people feel comfortable discussing their mistakes without fear of judgement or retribution .
• Openly share your own mistakes , especially as senior doctors , and what you have learnt from them with your team . By being vulnerable and showing that mistakes are a natural part of life , you can help normalise the experience for others .
• When someone makes a mistake , focus on providing constructive feedback rather than solely pointing out the error . Importantly , also give positive feedback whenever you can .
• Incorporate mistake-making into education and training for trainee doctors . Teach them how to learn from their mistakes , develop resilience and bounce back stronger .
It is time to unlearn perfectionism in medicine .
Let ’ s be kind to ourselves and others when mistakes happen .
And then work on what we can do to prevent the error happening again .
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