"When I was a junior medical student, I was offered the chance to watch a critical, lifesaving procedure in a cardiac catheterization lab. The patient, a middle aged man, had a heart attack that morning, and the cardiology team had rushed him to the cath lab to try to place a stent and save his life. Medical teams typically rely on strict hierarchies to function efficiently under pressure, and I was at the bottom of the hierarchy that day."
"A few minutes in, I noticed one of the sterile wires the team was using had slipped and become contaminated. I assumed the team would see it, but it quickly became clear that because of where I stood - at the very bottom of the hierarchy - I was the only one with the right vantage point to see what happened. I thought about speaking up, but I had been told explicitly to stay quiet."
An observational account describes a junior medical student's experience in a cardiac catheterization lab where a sterile wire became contaminated and the student, despite explicit instructions to remain silent, spoke up. The team replaced the wire and continued the lifesaving procedure. The account emphasizes the impact of hierarchy on psychological safety and the potential value of individuals at any level noticing crucial details. The account also advises leading through small, strategic actions without formal authority, proposing experiments to test ideas rather than pushing sweeping reforms, understanding leadership constraints before challenging systems, and mastering one's role while learning system-wide operations.
Read at Psychology Today
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