The September 27th issue of the New England Journal of Medicine features a short article by Dr. Katherine Treadway that lucidly describes the way medical students and residents learn to detach themselves from the human meaning of the life and death events they are involved with in becoming physicians. Treadway explains in a compassionate manner that if students did not distance themselves from the dead person (“cadaver”) they dissect in anatomy class they might faint rather than learn. Likewise with surgery and the effort to resuscitate people who have experienced cardiac arrest.
The novelist George Eliot described this phenomenon in an unforgettable manner: "If we had a keen vision of all that is ordinary in human life, it would be like hearing the grass grow or the squirrel's heart beat, and we should die of that roar which is the other side of silence. "
The same dynamic applies to health organizations. Insurance companies talk about “covered lives.” Policy analysts discuss “consumers” (i.e. – patients) and “providers” (i.e. – caretakers). These terms serve an important purpose -- they capture a component of reality that might be overlooked or underemphasized. But the detachment that allows efficient functioning can deprive those in organizations of a textured appreciation of what their work, whether in medical records, a billing office, building services or the executive suite, means to real living people. With too little detachment we are overcome by the roar on the other side of silence. But with too much detachment health work becomes sterile, and those we serve know our hearts are not in what we do.
A key function of organizational ethics is to help organizations get the balance right – not too little detachment but not too much. Organizations that aspire to excellence must risk listening to the dangerous roar.
The novelist George Eliot described this phenomenon in an unforgettable manner: "If we had a keen vision of all that is ordinary in human life, it would be like hearing the grass grow or the squirrel's heart beat, and we should die of that roar which is the other side of silence. "
The same dynamic applies to health organizations. Insurance companies talk about “covered lives.” Policy analysts discuss “consumers” (i.e. – patients) and “providers” (i.e. – caretakers). These terms serve an important purpose -- they capture a component of reality that might be overlooked or underemphasized. But the detachment that allows efficient functioning can deprive those in organizations of a textured appreciation of what their work, whether in medical records, a billing office, building services or the executive suite, means to real living people. With too little detachment we are overcome by the roar on the other side of silence. But with too much detachment health work becomes sterile, and those we serve know our hearts are not in what we do.
A key function of organizational ethics is to help organizations get the balance right – not too little detachment but not too much. Organizations that aspire to excellence must risk listening to the dangerous roar.
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