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If you are an emergency room physician, death and the fear of failure are constant companions. A countdown timer starts when a patient arrives with a fatal wound or condition. If that timer reaches zero, the patient will die. If it is prevented from reaching zero, the patient will survive and live to fight another day.
It is literally a race against the clock, and the role of the ER physician is to battle that timer directly through medical interventions that either solve the problem or keep the patient alive long enough for a trauma surgeon, interventional cardiologist or other specialist to solve the issue that is killing them.
As you might imagine, when the ER staff wins that fight and saves a life, it is a fantastic feeling, but when they fail and lose a patient, it is devastating. Worse yet is when they lose a patient who could have been saved because they either made an error or did not have the required resources to save the person. Every ER Doctor has memories of the patients that they lost. In fact, a requirement for a long and healthy career in emergency medicine is the ability to find peace with this notion.
I recently had the opportunity to spend time with Dr. Dan Dworkis, an ER physician, Professor at the USC Keck School of Medicine, Medical Director of the Mission Critical Teams Institute, Podcast host and the author of The Emergency Mind. Dan has spent his career working in emergency rooms. In fact, not just emergency rooms but a busy trauma center in Los Angeles.
As you might imagine, Dan has seen it all and, as a result, carries the stories and memories that come with working at a hospital that is frequented by children who have been shot, traumatic car accidents and people with life-threatening injuries and illnesses.
Dan has spent a big part of his career studying how we make decisions under stress, how to operate in high-stress environments and how to create a culture of continuous improvement. Not surprisingly, I learned a lot from Dan. But, by far, the most profound thing I learned from Dan was a unique way to approach failure and, in the process, open ourselves up to growth and learning.
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The ritual: Learning by embracing loss
As you can imagine, trauma physicians see quite a bit of death. No matter how good a doctor you are, you will lose patients, and some of those people certainly could have been saved with different skills or different resources. It would be easy to simply block yourself off from these feelings, to harden your heart, and to put these bad experiences into a mental box that you lock away. While this might not be great for your mental health, it is certainly a seemingly easier thing than confronting these memories and feelings. Yet, Dan actually advocates doing the complete opposite, leaning into the failure and attacking it directly.
When a patient dies, there is an awkward moment immediately afterward where the team that treated the patient must transition away from that fight and move on to another. Despite just a few minutes before waging a war to save their life, the team must move on from this person. Machines must be turned off, tubes and wires removed, and each team member must emotionally reset and get back to work.
It would be easy at that point to block the feelings and doubts that arise, place them in a box and move on to the next task while hoping never to think about those feelings again. But that is not what Dan does or advocates. Instead, he engages in a ritual that he was taught as a young doctor, which is to gather the team at the bedside of the patient, place a hand on the deceased patient, and utter the following phrase: “Thank you for teaching me. I am sorry that all I could do for you today was learn.”
This seemingly simple act and brief statement is more than just a ritual to clear the mind before moving on. Instead, it is a deeply profound approach to situations where we cannot succeed and lays a strong foundation for learning and growth.
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Embracing failure
The first significant thing that this ritual does is acknowledge and embrace failure. Rather than moving on and pretending that something profoundly negative didn’t just happen, this ritual looks failure square in the eye and leans into the discomfort of the situation. It embraces failure and immediately triggers the learning process.
The first step to growth is the recognition and admission that what we currently do or know is not sufficient. To learn from others, we have to accept our own shortcomings, and this practice opens the door to that and to discovering something better. If we do not admit to our shortcomings, we cannot improve, and this is precisely the point of this ritual.
Simply look at the phrase, “Thank you for teaching me. I am sorry that all I could do for you today was learn.” By its nature, it says I failed you today, and I wish I had more to give. It doesn’t say, “It’s too bad you died,” or “Wow, rough break you got.” It says, “I am sorry.” It embraces that the team didn’t have enough to save the person (and to be fair, no one may have been able to save them), but simply that acknowledgment doesn’t go far enough. Rather, it says I “learned from you.” It implicitly says, “I will be better next time” and “I am growing and improving my skills.” It is active, not passive, and immediately takes the first step toward learning.
Conclusion
A profound lesson extends far beyond the medical field and this single ritual to all of us. Whether you are an entrepreneur, a business leader, or even a parent, creating a culture of learning from mistakes and continuous improvement is critical to getting better. We should never run from our errors or try to hide them. We should embrace our failures and view them as perfect opportunities to grow. By establishing a process that immediately addresses our failures or shortcomings, we also immediately focus our attention on how we can improve, where we have deficiencies and perhaps most importantly, we immediately begin the process of learning and growth.
