PROFILE IN COURAGE MOMENTS


I was medical director at a hospital back when medical directors/physicians in management were relatively new.  There were two Catholic hospitals in town, each with a medical director, and at the time there was a loose arrangement of the two hospitals with one overall medical director, my boss.

I went to a meeting one day at the other hospital about the roll out of an integrated medical delivery system, which I assumed wouldn’t involve me too much, but would start integrating practitioners in both hospitals and add a third hospital in a rural city to the network.

That night, I failed to show a major Profile in Courage moment: to stand up for what is right when one has absolutely nothing to gain and a great deal to lose.  My boss, whom I respected and liked, was passed over for the job of medical director, for which she was perfectly qualified, in favor of a family practitioner who was an EEG tech when I was a resident. I didn’t speak up against this outrage.  I can still remember hearing the name of the new network medical director. No, I didn’t stand up to the elderly nun, an institution in the hospital and community, to say, “Sister, this is wrong. Unless you reconsider, I am resigning.”

Yeah, I was making good money, but my wife and I could have swung it had I quit. Maybe I was so stunned that the doctor chosen didn’t have the qualifications. Maybe I was afraid.  But I certainly failed to speak up, that is quite clear, and I should have.  I might not have changed the decision, and I might have been fired had I not resigned, but the chance to do the first and risk the second was a risk I should have taken.  My boss resigned, the family practitioner had a very uncomfortable first meeting with me and was gone from his job within a year.

I subsequently worked under a new senior medical director, part of the executive team (I was never allowed into that sphere) before I had enough and finally left for graduate school, two years later.

My failure to speak up remains a big regret, and I can date it, because there was a total lunar eclipse that night, and I still remember standing outside looking at it and wondering why I hadn’t said something.

Profile in Courage moments may be more minor, but they are clearly speaking out against injustice when staying silent is easier and safer.  At one medical conference, the organizer commented on work that had been done on lymphapheresis for multiple sclerosis.  He quoted a study I happened to know quite well.  Not sure what I was doing, I suddenly found myself standing up.

“I disagree with you, sir.”  That turned everybody’s gaze on the 31 year-old nobody well back in the room.  “I was one of the physicians involved in the study, and while as an academic I want publications on my resume, I asked to be removed from this one, because I thought the study was poorly designed, biased, the data incorrect, and the conclusions unwarranted.”  Shaking, as I do when I speak passionately in public, I sat down amid a lot of murmuring.  The organizer mumbled a few words, and I simply shook my head no.

I can think of another time when I suddenly stood up, which I knew enhanced my words, the shaking, and the passionate comments.  The chief of staff at the hospital had lambasted me in front of the Medical Executive Committee, saying that I was examining patients, and I had no business doing so.

“I was called by the nursing staff because the patient was admitted to cardiology, and no doctor the nurses called wanted to accept the patient.” (Yes, those sorts of things happened.)  “I examined the patient, wrote some covering orders, then called an internist I knew who took over the patient’s care.”  At this point, I was winding up, so I let go with one more.

“I have also taken over the care of a Parkinson’s patient whose family fired the doctor, so he just quit, which is unethical behavior.  It is incumbent upon the physician to transfer the care, and this one just walked away.”

If I remember correctly, I walked out of the room down the hall and outside and cried for a few minutes.  One of the better things I learned—too late in life but better late than not at all—was how to cry.

Like perfect squelches, words one says that are absolutely perfect in time, place, and content, Profiles in Courage are one—two—three—five in a lifetime events. I can date every one of the four perfect squelches in my life. I blew my big Profile in Courage moment.

We need more Profile in Courage moments in Washington.  We need elected representatives to speak out against a president who doesn’t belong in office.  Many are apparently saying this in private.  Mr. Flake did a decent job, but he limited his Profile in Courage moment.  He could have done what few politicians are willing to do: quit his party and caucus with the other, stay in office, and let the voters decide whether he was adequately representing them. Mr. Flake would have rocked the country in doing so. While he would have taken a huge amount of heat, maybe a recall election, he would have earned the respect of millions, including me.

We need someone in the halls of power to speak up and say the emperor has no clothes (the visualization of which is abhorrent), that Congress is co-equal and will act accordingly, with both sides of the aisle having a say in legislation, even if one side is outvoted.  We need someone to say that much as they like the chance to put through a conservative agenda, that to do so without addressing the dysfunction in the Executive Branch is wrong, and Congress can and must do something about it.

The irony to me is that before #metoo many Profile in Courage moments I’ve seen have come from Iranian women who don white every Wednesday to protest the forced hijab.  For years, many have removed the cover altogether and shown videos of themselves walking without it.  These women are very courageous.  Many are insulted. Some have acid thrown in their faces.  Others are beaten, arrested, even killed.  They are putting their lives on the line for something they believe in, and if the running of the United States of America is less important than whether an Iranian woman should cover her hair, then we would do well to open immigration to those women, should any actually want to come here, in hopes they might light a fire under our lawmakers.

We now have American women speaking out against sexual abuse, which has involved my own alma mater, which really hurts.  Many of these women never spoke up, but when the time came, they took their Profile in Courage moment and ran with it. Some won elected office.

In these days of Roy Moore, Michelle Bachmann, clean air is unhealthy, more guns makes us safer, $1000 savings in taxes allows one to buy a car, adding $1.5 trillion to the debt is a good thing, grabbing them by the pussy does not disqualify one from becoming President, taking off the clothes of a 14 year-old girl doesn’t disqualify one for the US Senate, each of us needs to be on the lookout for a Profile in Courage moment.

It’s fine to shake, to sweat, to speak passionately.  Don’t be afraid to pause.  Mr. Obama often paused when he spoke.  He did it for effect, but he also did it to think about what he was going to say next.  We need a lot of thinking these days.

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