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Tact, Tone And Timing: The Power Of Apology

JOHN DONVAN, HOST:

This is TALK OF THE NATION. I'm John Donvan in Washington. Neal Conan is away. I was heading out to do an errand a while back and I decided to drive, and as I approached my car, which was parked in the street, I walked up from behind and, drat, I spot the rear taillight has been smashed, somebody obviously trying to park behind me had bumped into it and cracked it open.

And of course now there's nobody parked behind me, that space is empty. So whoever did this is long gone. And I'm really annoyed as I head to the driver's side door to get in until I notice a note had been left. I am sorry I damaged your car, it reads. My phone number is da-da-da-da-da-da-da. Wow, it can still happen, fessing up to a mistake, saying I'm sorry.

And you know what? I forgave whoever did this instantly, and I didn't even call the number. It's true, apologies can be hard to pull off in any setting to friends or to spouses or to people whose taillights you might wreck. Some of us can do it, though. But there is one setting where saying I'm sorry can really get you into trouble, and that's when you've made a mistake at work.

Say you're doctor, say you're sorry, and you could get sued. But some doctors and people in other professions are now beginning to push back against the no-apology reflex with some good reasons, and we're going to get into those reasons. And we want to hear your story on this. Did you ever owe a patient or a client or a customer an apology? And did you carry through? Our number is 800-989-8255. Our email address is talk@npr.org. And you can join the conversation at our website. Go to npr.org, and click on TALK OF THE NATION.

Later on in the program, the gut-wrenching science behind hot peppers. But first Dr. Manoj Jain, who wrote a recent Washington Post article that was titled "Medical Errors are Hard for Doctors to Admit, But It's Wise to Apologize to Patients." He is an infectious disease specialist in Memphis and a Washington Post contributor and joins us from member station WKNO there in Memphis. Welcome back to TALK OF THE NATION, Dr. Jain.

MANOJ JAIN: Thank you very much, John.

DONVAN: So what was your error? What was the medical error that you were writing about?

JAIN: So, you know, some years ago, I was called at about 3 A.M. in the morning by the nurse at the hospital, and she told me my patient was having a fever of 103 and writhing in pain. And as I often get a little bit of a history, and I ordered some antibiotics and some Tylenol. I gave the patient Levaquin and Vancomycin.

And then about two hours later, at 5 A.M., the nurse called me now, and she was frantic. She was quite concerned because now the patient was having welts and was wheezing and had developed a tremendous rash. And I asked her: Just read me the note that I had just written. And in the note was a note that I had written saying allergies to Levaquin, the very antibiotic that I had ordered.

DONVAN: So you had totally made a mistake, and it was totally your fault.

JAIN: It was totally my fault.

DONVAN: So what did you do?

JAIN: And, you know, when that happens, I had this deep sense of embarrassment, guilt and fear all at the same time. I was embarrassed because of the very fact that I had made an error. I'm a doctor. I'm a professional. I want to do the right things for my patient. But I had made an error.

I was guilty because I had caused harm, suffering, which was avoidable to my patient. And then also I had fear. I was feared about litigation, a lawsuit that could happen from this whole thing.

DONVAN: And in terms of action - so that's what happened inside you. In terms of action, what did you do?

JAIN: So at - then I went to the hospital at that very moment. I saw the patient, and she was in a terrible situation. I ordered the appropriate medications, and then I apologized to her. I told her that I had made an error, and at that time I didn't know very much about medical errors disclosure. And I just fessed up to making the error.

Now we know that we need to not just say that we've made an error, we need to take responsibility, we need to apologize, but we also need to tell the patient what we will do in order to not have this happen again.

DONVAN: I'm interested that you just said now we know, which means you're talking about there was a time when that wasn't the standard practice. So I'm curious, back when this occurred, it sounds like several years back, and you did apologize, did your colleagues know that you had done that, that you'd admitted the mistake and apologized? And if so, what did they say?

JAIN: Sure, so I wrote about this in the local paper, and some of my colleagues said why admit to the mistake? You know, you know, it just happened, it's something that happens in our day-to-day life as doctors. But I had a deep sense in me - and I think many doctors do - that when something like this happens that you feel guilty, and you want to share that with the patient and be open to them.

And when I started talking about this, I found that there was a great deal of literature and also policy changes that were happening in order to have doctors disclose medical errors.

DONVAN: What's the case - I'm not saying that you shouldn't disclose, but I want to know what's the argument being made that you should, other than a sort of it's the right thing to be honest.

JAIN: I think one aspect of why we should do it is because it enhances doctor-patient relationship. You see, the doctor-patient relationship is based on trust. And if we can enhance that trust by having the patient become aware of an error that may have happened, you know, at a later point the patient may find out that there was an error. And what if they realize that you as a doctor didn't tell you about that error? That would be horrible for the patient.

DONVAN: So she forgave you, this patient?

JAIN: She did. You know, she was very understanding. And, you know, I presented the situation, and I was quite empathetic about, you know, the situation as well. And patients very often understand that doctors are doing their best in very difficult circumstances.

I had a case of - a conversation with a surgeon when I told him about my situation, he told me how he at one point had left a sponge in a patient's chest after doing surgery. And at that time...

DONVAN: That just sounds like a nightmare if you're a doctor.

JAIN: That's a horrible situation. And then the surgeon went up to the family, discussed the situation, told them honestly what had happened, and he offered to have another surgeon take over the case and obviously waived all the medical charges. The family elected to have that same surgeon do the surgery again.

DONVAN: So he said you don't have to ever deal with me again because I've caused you harm, and they said, no, we still want you because you've apologized?

JAIN: And you've apologized, and they did not file a lawsuit.

DONVAN: We're also asking our listeners to call in, people who have been in a professional situation. It doesn't have to be medicine, but it can be medicine, where you didn't do what you were supposed to do, and it caused harm, and you were faced with the question of whether to, number one, admit and, number two, apologize. And those two things are not exactly the same thing.

And I want to bring in now Guy Winch, and he is the author of the Squeaky Wheel blog on PsychologyToday.com. He's a psychologist and author of "Emotional First Aid: Practical Strategies for Treating Failure, Rejection, Guilt and Other Everyday Psychological Injuries." And he joins us from our bureau in New York. Guy Winch, thanks for joining us.

I want to get to you this - put to you this question, the difference between admitting guilt and apologizing. Are they the same thing?

GUY WINCH: Well they're actually very different. Admitting guilt is saying that you did something wrong. But apologizing is actually an effort to garner authentic forgiveness from the other person. And admitting guilt might do that, and I might add when the threshold, when the bar is low, for example we don't expect doctors to apologize, and so when they do we might feel very, very warm and fuzzy about that incident, just as you didn't expect someone to take responsibility for breaking your taillight.

And the fact that they did without an apology, just taking the responsibility was sufficient for you. But in most scenarios, we actually need to feel a little bit more than just the person taking responsibility if we are to actually forgive them.

DONVAN: You've actually broken this down in your writing into a series of the elements of an apology, what really makes an apology. And you've broken it into six parts. I'm not sure we'll have time for all six parts, but if you can kind of, you know, break it down so that our listeners get a sense of what's involved in an apology that really isn't an apology.

WINCH: Well, first there has to be an I'm sorry statement, which we often skip because we think it's implied, when it's not; some kind of statement of regret, which refers to the specifics of the incident; and a request for forgiveness. If we're actually wanting to be forgiven, then we need to ask for forgiveness.

But the most important element, I think, is that we really need to display empathy. We have to let the other person know that we actually get how they felt, we get the impact of our actions or inactions on them. And if the other person feels that we really, truly get it, we're much, much more likely to get a truly authentic forgiveness from them and to be able to move on, than if they just think we're going through the motions by saying I'm sorry but without really understanding what the implications of our actions were.

DONVAN: So if you simply say, sir, I know that should not have happened, and it won't happen again, that's nowhere close to sir, I'm really sorry that I did this to you, and I know that it hurts you, and it's not going to happen again. Those are two very different kinds of experiences.

WINCH: Very different and have a very different impact on the other person.

DONVAN: I want to bring in Mary from Oklahoma City, who is going to join us as a listener to this conversation. Hi Mary, you're on TALK OF THE NATION. Mary, hi, you're on TALK OF THE NATION.

MARYANN: Hi. It's Maryann(ph).

DONVAN: OK, hi Maryann.

MARYANN: OK. I am a retired teacher and principal, mostly in public schools, not in Oklahoma. I'm a recent resident here. But being a principal or a teacher, you really come across many little things that happen during the day, you know, when you're dealing with a classroom of 25 students or a school of 1,000 students, and you double that with maybe 1,500 to 1,800 parents.

(LAUGHTER)

MARYANN: And some things just are we would consider little in the sense that they're fixable, really fixable. For example if a teacher misgrades a paper, rather than say, well, I really felt that this was not - you know, that this was not an appropriate answer, but it really was, to just say I'm sorry, I made a mistake on grading the paper and will change the grade.

DONVAN: Well, what's a more serious kind of error?

MARYANN: Well, a more serious one would be if a child at the end of the day, of let's say elementary school - you walk the children to the school bus area, and for some reason the child gets on the wrong bus. Now, the child is taken care of by the bus driver, but the child does not get dropped off at the right time, et cetera.

DONVAN: Did that ever happen?

MARYANN: Oh, yes. I mean, that does happen, especially with, you know, younger children, not a lot but it does happen. They get distracted...

DONVAN: Mary, I apologize - Maryann, I apologize for jumping in because we only have about 20 seconds left. So I just want to get to this point. When you apologize to the parent, do you get fury or forgiveness?

MARYANN: Well, the apology from the school system, from the principal, breaks down that fury. They're angry; of course they're angry. Their precious children - we believe they're...

DONVAN: All right, Maryann, I'm going to have you hang on and finish that thought when we come back. We're talking about the power of apologies, and we'll be back to continue this conversation. I'm John Donvan. This is TALK OF THE NATION from NPR News.

(LAUGHTER)

MARYANN: And some things just are - we would consider little in the sense that they're fixable, really fixable. For instance, if a teacher misgrades a paper, rather than say well, I really felt that this was not - you know, that this was not an appropriate answer, but it really was, to just say I'm sorry, I made a mistake in grading the paper, and we'll change the grade.

DONVAN: Well, what's a more serious kind of error?

MARYANN: Well, a more serious one would be if a child at the end of the day of - let's say elementary school, you walk the children to the school bus area, and for some reason the child gets on the wrong bus. Now, the child is taken care of by the bus driver, but the child does not get dropped off at the right time, et cetera.

DONVAN: Did that ever happen?

MARYANN: Oh yes, I mean, that does happen, especially with, you know, younger children, not a lot but it does happen. They get distracted...

DONVAN: Mary, I apologize - Maryann, I apologize for jumping in because we only have about 20 seconds left. So I just want to get to this point. When you apologize to the parent, do you get fury or forgiveness?

MARYANN: Well, the apology from the school system, from the principal, breaks down that fury. They're angry; of course they're angry. Their precious children - we believe they're...

DONVAN: All right, Maryann, I'm going to have you hang on and finish that thought when we come back. We're talking about the power of apologies, and we'll be back to continue this conversation. I'm John Donvan. This is TALK OF THE NATION from NPR News.

(SOUNDBITE OF MUSIC)

DONVAN: This is TALK OF THE NATION from NPR News. I'm John Donvan. Apologies can be hard in any setting, for friends to friends, from friends to spouse, from co-workers to co-workers. Admitting fault and empathizing is just one piece of the puzzle, when I'm sorry can mean big professional or legal implications for you, it complicates the calculation.

And that's what we're talking about, and we want to ask you if you've ever owed a client or a customer or a patient an apology, tell us what you did about it, and did you go through with it. Our number is 800-989-8255. Our email address is talk@npr.org. And you can join the conversation at our website. Go to npr.org, and click on TALK OF THE NATION.

Maryann in Oklahoma City, are you still with us?

MARYANN: Yes, I am.

DONVAN: All right, I'll give you 35 more seconds just to sort of tell us the bottom line on your decision to go ahead and apologize, is it because you feel bad, because you want to diffuse the situation, because you're legally obliged to? What happens?

MARYANN: Well, first of all, we want to diffuse the parents - we're very - want to be empathic and compassionate to the situation. That's number one. Number two, it was a system missing - getting on the wrong bus is a systems failure. And we need - you know, we tell the parents that we need to correct that, you know, and we will talk to the teachers, whatever.

DONVAN: Right, but Maryann, what I want to get to is kind of the impact on the dynamic between the parents, how much does the parent forgive and continue to trust the school after all of this if you've apologized versus if you don't.

MARYANN: Right, yes, that depends parent to parent. Just as in any situation, personalities enter into that. But as long as we make an effort to, you know, get the child on the right bus, and it doesn't happen again, typically the parents are good. I mean, they really are - parents want to support, at least in my opinion, in my circumstances, parents want to support the teachers and the principal.

DONVAN: All right.

MARYANN: And they just want it to work well for everyone.

DONVAN: Maryann, thanks very much for your call from Oklahoma City.

MARYANN: Oh, you're welcome.

DONVAN: And I want to bring in Taylor(ph) from Denver. Hi Taylor, you're on TALK OF THE NATION.

TAYLOR: Hi, thanks for taking my call.

DONVAN: Sure.

TAYLOR: I just graduated from medical school on Friday, from the University of Colorado School of Medicine. And essentially from day one we're taught to apologize for mistakes that we make in the hospital. And I can remember a few times in a clinical setting when I was a student where I made a mistake, and it came very naturally to me to say oh my goodness, I'm so sorry. I, you know, I told a patient once that they could go home before they could.

And at the end of the encounter, the mother of the patient was apologizing and comforting me, and so I think that training these days, it just - it came very naturally to me to admit that I'd made a mistake without embarrassment.

DONVAN: But Taylor, is your training to just apologize from the heart as you feel at that moment, or is there a way to apologize so that you can not get yourself into trouble?

TAYLOR: I think it's important. They teach us to be honest. I mean, when you make a mistake, you know, you know what kind of mistake you've made, and just being honest really resonates, I think, with the patient.

DONVAN: All right, Taylor, thanks very much for your call.

TAYLOR: Thanks.

DONVAN: I want to go back to Guy Winch, a psychologist who writes the Squeaky Wheel blog on PsychologyToday.com. And Guy Winch, my question for you is about the sincerity of an apology. You know, it could be the situation that people have kind of figured out that maybe apologizing will get them off the hood. And if an apology feels like that that's its purpose, is that a stillborn apology?

WINCH: I think it is because we might not be able to put our finger on exactly what the ingredients are, but emotionally we will either feel oh yeah, that actually sounded really sincere, and I really do, you know, forgive that person, or we'll feel no, they were just checking the box. So we have a good instinct, and the idea of the apology in the first place is to kind of touch us emotionally in the way that it does kind of smooth things over.

So we're either touched in the correct way, or we're left indifferent.

DONVAN: So what's the very wrong way to do it?

WINCH: A very wrong way to do it, first of all, is - and a lot of people make the mistake - is when somebody's trying to complain about something, they'll actually interrupt them before they're finished, saying yes, yes, I know, I'm very sorry about that. And the problem with that is unless the person's finished telling you what happened to them, then you don't really know what you're apologizing for, and the other person understands this and feels that apology is not sincere. So that's a bad apology.

DONVAN: All right, I'm interested in how it plays in the legal culture, in fact in the world of litigation, which is what a lot of people seem to fear. I would certainly think doctors fear litigation when they admit a mistake. And there is a professor of law and psychology at the University of Illinois named Jennifer Robbennolt, who has studied the impact of apologies in the legal setting, and she joins us now on TALK OF THE NATION. Jennifer Robbennolt, thanks for joining us.

JENNIFER ROBBENNOLT: Thanks, John.

DONVAN: And you are talking to us, via Skype, from your office. What does your study show about the impact of apologies in a litigious situation, where people want to sue each other?

ROBBENNOLT: So I've looked at comparing people who receive different forms of what we might call apologies, some of them more complete - the way Dr. Winch was describing - and some of them with only some of the elements, as compared to no apology at all. And what I find is that potential plaintiffs, people who are injured, who get apologies from the people who have injured them, are more positive about the encounter, they're less likely to blame the person who injured them as much.

And importantly in the legal setting, they're more amenable to coming up with a financial settlement with the other person than they are when they don't receive an apology.

DONVAN: In other words they'll say let's not go to trial, let's just work this out between us.

ROBBENNOLT: Yeah, you know, most cases that happens anyway. Most cases don't actually go to trial. But what I find is that people, when they're getting ready to go in and negotiate a financial settlement, are thinking about lower dollar amounts as they get ready to negotiate that settlement.

DONVAN: Earlier, we were talking about doctors in particular being under pressure not to apologize. Has the situation shifted where your research is now suggesting that an apology could actually lower the damages that you might have to pay in a lawsuit after making a mistake, that lawyers are now actually telling their clients that you should apologize and just do it the right way?

ROBBENNOLT: Yeah, I think we're seeing a shift. It used to be both among people in the medical profession and people in the legal profession, that the sort of standard advice was do not apologize.

DONVAN: Because?

ROBBENNOLT: Because we're worried that an apology will be admissible if a case does go to trial, and it will be...

DONVAN: Admissible as evidence of guilt?

ROBBENNOLT: Exactly, it'll be interpreted as a confession, right, evidence that the person should be found liable for damages in the case. And what this research shows is that, you know, given that most cases are going to be negotiated between the parties, there could actually be, in addition to non-legal benefits to an apology, there could actually be legal benefits - that a settlement might come at a lower cost to a defendant, might come more quickly.

It's easier for the parties to work out their financial differences when there has been an apology between the parties.

DONVAN: All right, let's bring in Lilian(ph) from..

JAIN: Oh John.

DONVAN: Oh go ahead.

JAIN: I'm sorry, John, I was going to add something to that.

DONVAN: Manoj Jain, Dr. Manoj Jain, and for people just joining us, Dr. Manoj Jain is a doctor who years ago wrote about the need to apologize and has actually had to do so and is glad he did. Go ahead.

JAIN: So in fact there was a study done at the University of Michigan, and in 2001 they started a program for disclosure of medical errors. And they looked at six years before and six years after the program was started, and what they found was that their litigation expenses had gone down from $3 million to $1 million.

And also the claims had gone down by 50 percent. So the disclosing of medical errors to patients had worked out very well for the University of Michigan. Other studies did not pan out in the same way, but none of the studies that I've looked at found that litigation went up with some type of a disclosure plan.

DONVAN: Which would suggest that there's no downside to apologizing, and maybe there's an upside. Let's go to Lilian in Bernie, Texas. Hi Lilian, you're on TALK OF THE NATION.

LILIAN: Hi, how are you doing?

DONVAN: We're good, thanks.

LILIAN: Good. I have been a nurse for a long time, and in the beginning, we had the same - you know, we were told you never apologize. And I was involved at one point with a doc who - and I was in attendance, and he gave an incorrect dose for a medication to a young child, and the child, of course, overreacted, and there was - it was very difficult.

But the child was OK in the end, and the doctor asked that I come with him, and he talked to the family and was very up front and said that he'd made an error. He even had where he had calculated the dosage and showed that it was a mathematical error that he made and didn't realize it, you know. And the family was very, very distraught, and actually it was a family that was known to be not very friendly to the medical staff.

But they ended up understanding and accepting the apology, and...

DONVAN: Wow.

LILIAN: ...nothing - there was - nothing came of it from the family. But interestingly enough, later, the doc was really vilified by the attorneys for the hospital, saying that, you know, he shouldn't have done that. He put everybody at risk. He should have just said it was a bad reaction to the medication, which, of course, would not have been the truth.

DONVAN: Right.

LILIAN: And it was - later on, the ethicist pulled him aside and said I wish doctors didn't worry so much about being sued and worried more about going to hell. And I - that was a little over the top, but I...

DONVAN: Yeah, kind of (unintelligible) thanks very much, Lilian, for that story.

LILIAN: Yeah.

DONVAN: I want to ask Guy Winch, a psychologist, in this conversation. Guy, we've been talking about people in professional situations resisting making an apology because of the legal concern. Without the legal concern, do you think that by and large people are inclined to be willing to apologize when they make a mistake regardless of that, you know, putting aside that situation, or are people resistant? Are we - as humans, do we - are we good with apologizing, or do we find it difficult?

WINCH: I think we're good with the most basic thing that we learn when we're three years old. When we're three years old or four years old, we're told you do something wrong, you say I'm sorry, and you will automatically be forgiven. And we carry that level of sophistication with us as adults. And so many of us feel that I'm sorry is sufficient, and the problem is that it's not sufficient.

And I would wager that even in the medical field, if the change now is that doctors are going to apologize more, then the expectations will rise, and they will have to become better at the actual apology. Right now it could be that a very basic apology will work. But as our expectations rise from them when they make mistakes, they'll have to get a little bit better at it.

DONVAN: And Jennifer Robbennolt, I know that you're a law professor. Do you practice? Do you have clients who might be in a situation where they turn to you and say, should I apologize or not?

ROBBENNOLT: I do not.

DONVAN: If you did?

(LAUGHTER)

DONVAN: So we can make it hypothetical.

ROBBENNOLT: Yeah.

DONVAN: What would be your instinct? Would you say go ahead and apologize, or would you say be very, very careful about this?

ROBBENNOLT: My instinct would be that in light of what we know about the - both the personal and the legal benefits of apologizing, it would be a conversation I would definitely have with my client, about whether or not that client would like to make an apology.

I think there are a couple of things as a counselor that I would want to raise with them. One is to make sure that the client is sort of willing and able to make a good apology. On the one hand, there's an instinct. Often a lot of doctors will say I want to apologize, but, you know, someone is telling me not to.

But at the same time, there's a lot of psychological resistance to admitting that one has made a mistake. That's true for all of us. So there's a conversation to be had with the client about whether the client is willing to make the kind of apology that is likely to be effective.

And then there are - you know, the risks, the legal risks are going to vary with the circumstances. Interestingly, in circumstances where it's clear that an error has been made, that's the place where an apology is most likely to be effective and also the least risky, right? Because the evidence is already clear.

DONVAN: OK.

ROBBENNOLT: Sometimes - and this happens a lot in medical cases - it's not at all clear what has happened to lead to an adverse outcome. And in those cases I would tell my client that you need to...

DONVAN: Make sure it was really your fault.

ROBBENNOLT: Well, yeah, but you need to express sympathy. You need to have the empathy piece of the apology.

DONVAN: Right.

ROBBENNOLT: But then you need to investigate and to assure the patient that that investigation is going to happen, and then get back with the patient to talk about what that investigation revealed and then, if appropriate, offer an apology.

DONVAN: All right.

ROBBENNOLT: Because a lot of patients really want that assurance that something is going to happen to make the kind of error not happen again in the future.

DONVAN: All right. Thanks, Jennifer. You are listening to TALK OF THE NATION on NPR News.

Let's bring in Carmen in Niceville, Florida. Did I pronounce Niceville, or is that Niceville, Carmen?

CARMEN: Nope, it's Niceville.

DONVAN: I like that. OK. What's your story?

CARMEN: Well, my story is I have been a tax preparer for a number of years, and there was a situation where I forgot to have some people sign their paperwork and didn't realize for about a day and had to call them and say, you know, I forgot to have you sign this document. It's going to delay your return. And it was pretty tough to pick up the phone and make that call. Just people with money, you know, they sometimes react...

DONVAN: But you did it.

CARMEN: And I did it. I took a deep breath and I called and said, hey, this was my mistake, please come back in and sign. And they were good about it, and I was grateful for that. I really was.

DONVAN: All right, Carmen. Thank you. It's really interesting that all of these stories turn out to be kind of good stories so far. Let's go to Monica in Asheville, North Carolina. Hi, Monica. You're on TALK OF THE NATION.

MONICA: Hi. Thanks for the call. This is so relevant. Had I had the kind of doctors that are speaking today on the phone, I wouldn't be a survivor of lots and lots of medical mistakes. Thank God I've had three doctors like the doctors who are speaking today, who are, you know, human. They admitted. They apologized. They even showed me the errors other people had made. I forgave the ones who made mistakes. I'm writing a book about it. I'm changing the names to protect(ph) the guilty.

But to me, it seems to me in America we don't want to take responsibility for our actions. And it - apologizing comes hard for everyone. I mean look at the Republicans, for God's sake. They don't apologize, and they say...

DONVAN: Now, now, we're trying to be even-headed here. But move forward, move forward.

MONICA: I know, I know. But you know, let's look at doctors as professionals, but also as humans. They can make mistakes. And when they try to hide mistakes, like in my case, you lose trust. And if I had not had the three doctors who are extremely kind and like the ones who are speaking today, I would never trust again because of the way I was treated.

One doctor, for instance, told me that he knew what was best for me, gave me an anesthesia that wasn't appropriate, and I went through cesarean section without anesthesia. Now, the anesthesiologist apologized. The doctor who made that mistake never did.

And so rather than get angry, I just decided that it was best to forgive them anyway and write about them, but change the name to maybe make it a lesson for other doctors. And I'm really happy to hear that doctors and you guys are having this conversation. It's really heartening.

DONVAN: All right. Monica, thank you. And you're going to wrap up the - this discussion for us because I'm afraid we're out of time, but you hit on a very, very good and forward-looking note. You've been on both sides of this equation. I want to thank you for your call. I also want to thank Dr. Manoj Jain, who is an infectious disease physician and a writer; Jennifer Robbennolt, who is a professor of law and psychology at the University of Illinois; and Guy Winch, a psychologist and author of "Emotional First Aid: Practical Strategies for Treating Failure, Rejection, Guilt, and Other Everyday Psychological Injuries." My thanks to all of them. Transcript provided by NPR, Copyright NPR.