Healthy respect
When I set out to observe life inside a major urban hospital for a year, I expected to find heartbreaking, inspirational and possibly alarming medical stories. I anticipated insurance entanglements, technological marvels and cultural conundrums.
I didn't expect, however, to find classes to correct bad behavior. The classes -- at Brooklyn's Maimonides Medical Center in New York -- were designed to enforce the hospital's Code of Mutual Respect, and part of a national trend to help people in the medical field rediscover the value of that old-fashioned virtue called common courtesy.
Among the provisions that these doctors and nurses needed to be reminded of were not to use racial or ethnic slurs, or language that was profane or sexually explicit. Also, to refrain from intimidating behavior, "including but not limited to using foul language or shouting, physical throwing of objects."
Slurs? Throwing things? Was this a hospital or a reform school, I asked one physician, a department chief. He shrugged and told me that such behavior was far more common than I might imagine.
"I've worked in lots of hospitals where surgeons have thrown instruments; they get scissors that don't cut, they fling it across the room," he said. "I was at a hospital where the resident accused the attending surgeon of breaking her wrist."
Broken wrists may be extreme, but the way hospital workers treat one another sets the tone for how they treat patients and their families, who are often frightened and fragile. The simplest form of human communication -- a harsh or caring tone, abrupt or attentive behavior -- can be healing or destructive. So in the past few years, hospitals around the country have begun writing codes similar to the one at Maimonides, to promote respectful behavior all around.
During my year at the hospital, real cases illustrated the relationship between respect and result. In one case I heard about, a patient had been prepped for a knee operation. The operating team had followed the universal protocol called "preventing wrong site, wrong procedure and wrong person surgery." Yet just before the procedure began, someone asked, "How come the knee being prepped isn't marked with a 'yes?' "
Who had dared to speak? It was a medical student, the lowest-ranking person in the room, who had noticed the "yes" was on the other knee.
A physician who was there said, "There has to be enough respect so a medical student can raise his hand and say, 'You're operating on the wrong knee.' "
