Like many physicians, I was very used to seeing, hearing, and then experiencing negative feedback in real time – that was the way of medical training. It was shame and humiliation all the way. Often hard to swallow. Fortunately, this was not the case for every teaching encounter – but that it existed at all made the experience of accepting any form of positive feedback difficult to hear or accept. After all, I was “just a student” or “just a resident” – I knew nothing, really. Especially as a student. You could not get past a procedure or encounter without having some esoteric factoid asked in the effort to publicly stump and shame. And then the humiliation could set in.
Feedback in the moment? Read more. You need to prepare more. Read your text. Read more articles. Pay closer attention to the patients you encounter.
And so I would work even harder, ashamed of my “inadequacies”.
Imagine my surprise when I would be offered some positive feedback? It was like I temporarily lost my hearing – unable to fathom how I could be worthy of any bit of praise.
Accept a compliment? Hardly.
I can even remember pausing to inspect well placed surgical knots during surgery as a resident- verifying they were doing their job and holding the large vessels they were tying off. I must have paused just a little too long, as I heard “stop admiring your work” from my attending across the operating room table one afternoon.
I was relieved the knot was holding – not admiring any great work. But that was the irony. Even when you were humble and insecure, even the humility was humiliated out of you.
“Better to be lucky than good” was a line I picked up and went with. I could not accept that I might be skilled and could not accept the acknowledgement of a job well done.
It was messed up. And it carried over into practice years later.
It was sometime between 2 and 3am – the witching hour. I had finally put my head down an hour or so before following a busy day and evening. I always found it so fascinating – that ever since I was in training, you could set a watch to me. At 2am, I would start to shiver. My body knew, thanks to the Circadian rhythm that it was time to sleep. On this particular night, I was given the opportunity to put my head down, until the phone rang and I was called out to the labor floor urgently. A patient of one of the midwives was bleeding heavily and the midwife was asking for my assistance.
I jumped out of bed, wrapped myself in a blanket and ran to Labor and Delivery. I tossed the blanket as I entered the unit, got a quick update from the Charge Nurse as I trotted to the patient’s room and pulled my hair back in a low messy bun. Once I entered the room, the calm would wash over me. I went into automatic mode. I calmly but quickly introduced myself, assessed the situation, got a report from the midwife and examined the patient. The bed was covered and soaked and the stains down both of her legs told me the details of the story I needed to know most. She was bleeding excessively and a bevy of orders began to fly out of my mouth calmly and firmly. I did an ultrasound at the bedside and then summarized what I was finding, what I thought was going on, and what I thought we needed to do – and why – to help her in this critical moment. She looked at me, pale – almost ghostly and asked me if she was going to die.
That question makes me shiver. Deep to my core.
It wasn’t the first time I heard a patient ask this question.
And it wouldn’t be the last.
And I never try to make a promise I cannot keep. I am not God.
So I promised to do everything I could do to quickly and smoothly get her through this and back with her baby.
But then she asked me again: Am I going to die?
I took a deep breath, looked her in the eye, and told her I was going to do everything in my power to keep her alive. I was not going to let her die. Even if that meant taking out her uterus. We talked about the possibilities of what severe, life-threatening bleeding can mean as we were doing all.the.things. She was getting blood, we were en route to the OR, I was fielding questions from her husband. We talked about the possible procedures I may need to consider doing once she was under anesthesia and were able to do a more thorough exam.
Both she and her husband understood the gravity of the situation. She said please take care of me. He said please bring me back my wife and my baby’s momma.
And off we went to the OR.
Such was an Obstetrical emergency. Life and death. Sometimes baby’s life, sometimes mom’s. Occasionally both their lives hung in the balance.
The procedure went well. She got lots of blood. And she was able to hold her baby later that day with her husband at their side.
After literally saving my patient’s life – her husband thanked me. And I replied that no thanks were necessary. I was glad she was well and that she pulled through. I didn’t want to be thanked for doing my job. But really, I was just uncomfortable with praise of any sort… because I was comfortable with and accustomed to negative feedback. And I did not know what to do with the discomfort of accepting their gratitude. I did not know how to accept it.
Negative feedback and I were old friends.We had the chance to revisit one another when we debriefed on the obstetrical case. Debriefs are when we gather the physician and nursing teams together with risk management and other C-suite members (department chairs, CMO) and discuss the case to see what went well and where there were opportunities for improvement. Sounds constructive, right?
They usually end up with the physician second guessing on his/her own – and sometimes their judgment or decisions being called into question after the fact by those who were not there.
Feedback is such a critical part of our development both personally and professionally. What is often overlooked, however, is the quality of that feedback and our willingness to listen. And our selection bias toward the negative when choosing what we hear and tune into.
I found myself in Master Coach training after many years out of a formal learning situation where I was a pupil. Sure, I had been giving and receiving feedback in the clinical teaching environment and within my organization among our clinical team – but I had not been a “learner” in quite some time. Brand new to this deeper learning experience and mentorship opportunity, I found myself recoiling at the Feedback module.
Giving & Receiving Feedback. Oy.
“Feedback is such a critical part of our development both personally and professionally. What is often overlooked, however, is the quality of that feedback and our willingness to listen.”
I was there to learn new coaching skills and admired my Mentor – so I welcomed her feedback. But in the beginning, I wanted her to tell me all the things I was doing wrong. I did not like to listen to the positive feedback she wanted to share. My relationship to feedback was the same as it had always been: messed up. The more I allowed myself to hear and listen to positive feedback, to sit in that discomfort a bit, things started to shift a little. I found that I was hearing the negative feedback differently. In fact, instead of awaiting it eagerly, I listened respectfully, but did not always agree with the points made. Sometimes I recognized they were based on an incomplete picture and so they lacked a fullness in their dimension or depth. I had a deep curiosity about my mentor’s observations, but also held her opinions lightly and her wisdom close to my heart. I could choose what I indulged in and what did not resonate.
I discovered myself at the Feedback Buffet.
Not all buffets are equal. There are definitely varying qualities among them in both the offerings and the presentation. Some buffets are sloppily thrown together. Is that meatloaf or vegetable lasagna? Others may be unappetizing as they are unattended and it’s questionable if patrons are using the utensils as offered to take the dinner rolls from the bread basket.. But at an insanely good price and all you can eat…who could refuse it?! Is that my hair in the salad? Ah, nevermind. What a deal!
I am not judging. Suffice it to say, there are less than desirable buffet options out there.
Others, like at a beautiful reception, may be carefully crafted and put together thoughtfully. The menu is divine. There are tiny chalkboards written out on the table in front of the chafing dishes to display the food as you walk by. There are stunning flowers adorning the table. Behind the table are the kind faces of the wait staff who will be serving you the food as you move down the line. They are dressed uniformly with silver serving spoons. Your plate is fine china. You receive the aromas of all that food, you take in all the visual splendor… but you can decide how much and exactly what you consume. Or if.
Now imagine that the buffet above is serving a variety of feedback entrees. Some you will like, some you may not. You might decide to try some bits of feedback and take a “no- thank-you-bite” where you take one small spoonful, anticipating you will not like it, but will respectfully give it its due. Sure enough, it is bitter – and you move on to the next dish. Each option was prepared with care, with expertise, with the whole big picture in mind. As was your feedback. And you get to decide what you ultimately consume.
You also get to offer your feedback about the meal. What were your likes and dislikes? How might it have been even better? And so the exchange goes on.
Now, it may seem like a sit down dinner would be the most indulgent meal option of all. But, it is less interactive. You have a meal choice, it is served and you eat it. That’s it. With an elevated buffet, you can have more options offered, choose what serves your appetite, your needs, and leave behind what does not serve you.
It is all about nourishing yourself. And variety.
Expertise and care goes into the preparation in either case. And if served with respect, care and intentionality, then a feedback buffet allows for information to be offered for improvement & growth. You get to take what you like, try some new things, and ultimately allow for nourishment of your body, mind and soul.
So the next time you find yourself receiving or giving feedback, consider what you are hungry for in your professional or personal pursuits.
What will help you attain those goals?
Seek out the sustenance that will help you reach them.