We
FEATURE
GOOD ENOUGH : VULNERABILITY AND SHAME IN MEDICINE
AUTHOR Natalie Henderson , MD
“ regret to inform you …”
Five words . Five words that anyone who has ever taken a standardized exam , waited for acceptance to a school or program or team , or applied for a much-anticipated job does not want to see . Your brain instantly reads nothing else . Likely , you have been waiting for a different five words , “ It is with great pleasure …” You would settle for a single “ Congratulations .” Yet , more people than we realize have found themselves sitting in a state of disbelief wondering what is next . We instinctively start thinking even more dangerous five-word phrases like , “ How will people judge me ?” “ Will I get a residency ?” or “ Will I lose my job ?”
Let ’ s be real here . Failure is something we will all face in our careers . It may manifest itself as a failed exam , a missed diagnosis , a lawsuit , poor teaching evaluations , marital strife , parenting struggles , financial mishaps , visa issues or student loan burdens . For far too many of us , these failures lead to shame .
Brené Brown , a well-known researcher on shame and vulnerability says , “ Shame is the most powerful , master emotion . It ’ s the fear that we ’ re not good enough .” I would argue that shame , rather than success , is the emotion driving our desire never to see those words . In medicine , we strive , toil and sacrifice our money-making , baby-making , tailgating years to spend our time learning , cramming and dissecting only to have numerous exams tell us whether we are “ good enough ” or in many cases , “ not good enough .”
In her book Daring Greatly : How the Courage to Be Vulnerable Transforms the Way We Live , Love , Parent , and Lead , Brown expands on the idea of shame in the way that intimately illustrates the experience faced by many in medicine . She says “ We live in a world where most people still subscribe to the belief that shame is a good tool for keeping people in line . Not only is this wrong , but it ’ s dangerous . Shame is highly correlated with addiction , violence , aggression , depression , eating disorders , and bullying .”
Research is emerging to support this idea . An American Medical
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