A resident explains why it’s important in medicine to resist the urge to rush to judgment | Opinion

“Whoever wrote this note clearly has no idea what’s going on here,” said a member of the team.

“Yeah, none of this makes any sense. This person seems incompetent,” echoed another.

I was working with a team that had been taking care of this patient for several weeks. By then, we were all thoroughly familiar with the patient’s prolonged, complicated clinical course.

The note, however, had been written over the weekend by someone who was relatively new to the case. At a glance, the author did seem lost.

Medicine is unforgiving when it comes to judgment. Every thought process, recommendation, or decision must be thoroughly documented and signed by the author, and made available for everyone else involved to read. Since all notes are reviewed in hindsight, it is easy to judge them.

There is nothing inherently wrong with this. Everyone, regardless of the line of work, must face the risks and the responsibilities that come with not performing well. But we are often too quick to blame blunders on a colleague’s character or intent.

A few weeks earlier, one of my colleagues told me that someone senior to me was upset that I had not properly taken care of a certain task. The senior person claimed to be concerned about me, using the words lazy and inattentive.

Few things in medical training feel worse than knowing that someone above you thinks you are incompetent. This is a strict hierarchy where your seniors’ opinions can determine your future.

Then I calmed down and realized that this was all a miscommunication. The task could not be completed that day because the office that handles it was closed. I had forgotten to relay that information, leading to an assumption that I did not even try.

I quickly sent an email to help clarify the situation, and ultimately, no harm was done.

But that experience has stayed with me because it revealed how quick we can be to judge others even without fully knowing the circumstances.

In social psychology, this tendency is called the fundamental attribution error. It refers to our tendency to conclude other people behave as they do because of their abilities or their intent, while we rationalize our own behaviors or outcomes based on situations outside our control.

This asymmetry occurs because we know our own circumstances much better than we know others’. I know why I was not able to complete that task, but my senior did not. The author of that note may have had a number of reasons for having made errors, but the team did not know them. We may never know them.

However, what is clear is that the next time we observe an error, we have to resist the tendency to equate it to a flaw.

Even if someone makes a mistake that is obvious in your eyes, it does not automatically make them incompetent. Even if someone fails to deliver something you regard as simple, it does not make them lazy. It could easily be that what you see is not the whole picture.

Sure enough, the next note that was written had improved dramatically, and in a few days, the team had little recollection that the initial conversation had ever taken place. No one was incompetent, after all, only misunderstood.

Jason Han is a cardiac surgery resident at a Philadelphia hospital.