Interactions between team members can have a big impact on performance and outcomes. Disrespect and hostility can create a threatening environment and hinder collaboration and productivity. In a medical setting, it could literally be a life-or-death situation.

The Civility Saves Lives movement aims to raise awareness about the importance of behaviour and promote a culture of civility. By showing respect and support towards each-other, teams can enhance their performance, deliver better outcomes, and provide a healthier and kinder path towards personal growth.

In this episode, Dr Chris Turner, co-founder of the Civility Saves Lives movement, demonstrates how we can create an environment where civility is valued, information is freely shared, and everyone feels empowered to contribute. By taking the time to show respect – and to address disrespect without offering judgement – we can make a positive difference in the workplace and improve outcomes for teams and patients.

Listen to this episode to

• Understand the importance of civility and its role in improving team performance and patient outcomes.
• Learn about the effects of incivility on individuals and their ability to think and perform under high-pressure situations.
• Find out about the origins of the Civility Saves Lives movement, and its impact on behaviour in healthcare.

Episode highlights

• [00:01:32] Meeting Chris
• [00:02:21] Civility Saves Lives
• [00:10:50] The minimum unit of performance is the team
• [00:13:32] Setting an environment for people to speak
• [00:16:25] What happens when we're scared of being wrong
• [00:23:40] How hostile behaviour impacts teams
• [00:25:45] How rudeness affects trust
• [00:27:22] We don't go to work to be unpleasant
• [00:31:21] Knowing that someone's got you
• [00:35:15] How to give feedback
• [00:49:44] Curiosity's role when giving difficult feedback
• [00:55:08] How to avoid the drama triangle
• [00:59:09] Understanding cultural context
• [01:01:52] Accepting uninvited criticism
• [01:04:23] How to take difficult feedback
• [01:06:15] The act of saying sorry
• [01:09:39] Chris' top tips

About the guest

Chris is a consultant in emergency medicine at the University Hospital of Coventry and Warwickshire. He co-founded Civility Saves Lives with Joe Farmer, a grassroots organisation dedicated to raising awareness of the impact of behaviour on performance.

LinkedIn | Twitter | Website

Resources

• THRIVE Weekly Planner
• How to Escape the Drama Triangle and Stop Rescuing People – Episode 75, with Annie Hanekom
• How to Have Crucial Conversations – Episode 85, with Dr Ed Pooley
• Download the episode’s workbook and CPD form. You can use them for reflection and to submit for your appraisal.
• When Rudeness in Teams Turns Deadly – Chris’ talk at TEDxExeter
• The Decline in Task Performance After Witnessing Rudeness is Moderated by Emotional Empathy - A Pilot Study, by Gadi Gilam
• Zero Degrees of Empathy: A New Theory of Human Cruelty and Kindness, by Simon Baron-Cohen
• Medical Student Perceptions and Experiences of Incivility: a Qualitative Study, by Louise Griffin and Anna Baverstock
• Promoting Professionalism by Sharing a Cup of Coffee
• The 15 Commitments of Conscious Leadership: A New Paradigm for Sustainable Success, by Jim Dethmer, Diana Chapman, and Kaley Klemp
• Radical Candor: Fully Revised and Updated Edition: How to Get What You Want by Saying What You Mean, by Kim Scott

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Connect with Rachel

Have any questions? Contact Rachel through these platforms:

• LinkedIn: @Dr-Rachel-Morris
• Twitter: @DrRachelMorris
• Email: hello@youarenotafrog.com

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What is the true cost of a hostile work environment?

In a high stakes job, like medicine.

It could be the patient's life.

If you work in an environment where you don't feel safe to call out a

potential mistake, or even ask a question, this can be incredibly

stressful and potentially dangerous.

And what if you witnessed someone being rude or disrespectful?

Is it your responsibility to deal with it, or is there a chance you could make

life harder for the people involved?

In this episode, I sat down with Dr.

Chris Turner, a consultants in emergency medicine and the co-founder

of the Civility Saves Lives movement.

He discovered how important it is to create a space where it's

okay to challenge or ask questions without risking humiliation.

if you've ever worked for a difficult boss or you've seen someone

mistreated and haven't known what to do, this conversation will give

you some practical strategies.

As well as things to think about.

And if you're a leader under pressure, you'll learn how to foster a more

psychologically safe environment where challenge is welcome.

If you're in a high stress, high stakes, still blank medicine, and you're feeling

stressed or overwhelmed, burning out or getting out are not your only options.

I'm Dr.

Rachel Morris, and welcome to You Are Not a Frog.

My name's Chris Turner.

I'm a consultant in emergency medicine at university, also

as a Coventry in Warwickshire.

And a few years ago I co-founded Civility Saves Lives, which is a

grassroots organization dedicated to raising awareness of the impact of

behavior on performance at individual team and organizational level.

We do it primarily within healthcare, but it's kind of spidered out.

We do it in other places as well.

Thank you so much for coming on.

I've wanted to have you on for a long time, and I know this has taken quite

a long time to set up, hasn't it?

This interview, because a, a friend of mine who's also an ED consultant's been

saying to me for ages, you've got to get Chris Turner on your podcast because his

work has been totally transformational.

So, um, for those people that don't know what the Civility Saves Lives movement

is, what, what is it and how did it start?

Okay, so firstly I should probably say it's not my work.

The vast majority of this is other people's work, which we brought

together and, um, kind of packaged.

I mean, I, I introduced some of my own work in it, but, um, Civility Saves

Lives is really, it's really all about discussing with people how behavior

matters, how their behavior matters, and actually about understanding the impact

that other people's behavior has on us.

And it came about because there was a guy called Joe Farmer who

worked with us and he was an F1.

And we very rarely have F1s in the emergency department.

And for some reason we had F1s for a few months.

A few months after he left, he sent me an email, said, Chris,

can I come and talk to you?

And I've gotta say, I mean maybe this speaks of my personal paranoia, but

I thought, Oh, I wonder some, I did something bad when we worked together and

I wonder if you have now got the courage up to come and talk to me about it.

Either way, you know, whatever it is, I'm gonna have to speak to you.

So I arranged to see him.

And we went and we went along to one of the coffee places in the hospital

and I said, so how are you doing?

And what's up?

And he said, well, I have to do, I have to do a project, I

have to do a talk on something.

Um, and I thought, who does the weirdest stuff that I know of?

And thought Chris Turner.

He's interested in odd stuff.

Yeah.

Yeah.

So I'd be worrying about this nicely.

He just thought I was a weirdo.

Um, and so we sat down and started talking about, I'm very used to people

regarding the things that I'm interested in as being a little bit left field.

And we got to talking about stuff and we, we talked early on about sort

of behavior and then we talked about a whole bunch of different things.

And then he told me a story.

And the story was of him and his registrar, him and his registrar

going to theater one night.

So it was a surgical specialty registrar.

And they had to go to theater 'cause it was an emergency.

And Joe knew this reg really well and she was apparently

fantastic and really just on it.

And they go to theater and they're there with a consultant that

he doesn't, Joe doesn't know.

And the consultant says to the reg, This is your operation on you go.

And she started operating.

Then pretty quickly it became clear that the consultant was sort of asking

question, question, question, and it they became slightly more intrusive, slightly

more nippy, slightly more hostile.

And Joe said that what he watched was somebody who he knew to be a wonderful

gifted clinician, turned from that version of herself into somebody who could barely

speak and barely make a cut without looking like she couldn't do anything.

And eventually the consultant took over the operation.

And we were just talking about it, but I had just read some work by Christine

Porath and a little bit of work by Amir Erez about what happens to us

when we're put into that situation.

And it was a proper light bulb moment for me because it was that realization that

it's not just me that this happens to.

I always thought of it as a personal feeling that I couldn't cope with this

sort of, um, undermining and abuse that sometimes exists within the workplace.

And I thought that I should be stronger.

Maybe I'm just too soft to work around here.

And that realization that this was actually a human reaction, it wasn't

because I wasn't enough, it was because this is how humans react in that situation

and the vast, vast majority of us do.

And so we thought we'd give a talk.

We'll give a talk on this.

And we, very early on we decided to give it a name, which is pretty

damn grandiose, if you don't mind me saying so, you know, I mean it.

Why did we think that our, our one talk needed a brand,

but we decided that it did.

Maybe just a tagline.

Very early on, we went with Civility Saves Lives, and then we discarded it

because it didn't feel punchy enough.

And then we went with Don't be a.

And after Don't be a, you can add any primary or secondary

sexual characteristic.

You can add any euphemism, you can add anything you like,

and that feels more punchy.

The problem with that is that nobody goes to work to be a dick.

And what we'd have ended up doing is having this talk that was basically

the equivalent of pointing a finger at people and saying, don't be

a, don't be a, when most of us don't see us in that mode anyway.

And I had at that time recently met Adrian Plunkett, who Adrian and Emma

started Learning From Excellence.

And Adrian and I had been talking about Prosociality and how to

get people on board with things and the power of aspiration.

And eventually Joe and I circled all the way back around to Civility Saves Lives.

And we decided to call it that.

And we got a lot of criticism for it in the first place because people said

nobody will know what civility means.

They don't understand that as a word, but it is actually the academic word.

It's the word that people use in the papers.

And that felt important that we weren't just telling people to be nice what

we were doing, saying that there are certain behaviors which genuinely

make a difference to outcomes.

And that was how it came about.

And you know, we sort of, we went and gave a, we gave a talk each, and then

we both got invited back to give other talks and other talks and other talks,

and it gained its own little momentum.

And then eventually I got asked to do, uh, I got invited to do TEDx

NHS, which was, uh, which was great.

Well, it's such an interesting story 'cause, 'cause on the face of it,

and by the way, side note, I love that branding, Civility Saves Lives.

It's, I'm all for, I'm all for a good brand.

And what I love about it is like, everybody can be civil.

Okay?

Even the biggest clunker in the world can be civil.

They can manage it, you know?

So if you'd saved niceness saves lives, that that doesn't really

work, 'cause not everyone can be nice, but everyone can, can be civil.

Like if the, if the king came up to you today, you would be able to be

civil no matter what state of mind you are in, probably, hopefully.

Uh, so everyone can aspire to that.

And then the saved lives is that this really, really matters.

So I think it's a totally brilliant branding.

I, my question is, what was it about Civility Saves Lives that

was just so astonishing for people?

I think it was that we were, we were saying that something that we do

all day every day, which is interact with other people, was fundamental

to the quality of care that we were able to give in healthcare.

Because for most of us, we go through an exam process to gain credibility, and

that exam process is always about us.

You know, I, I go, I've done many, many exams and it's always

been about me knowing stuff.

It's never been about me getting the best outta the people around me.

Even in os when I interact with other people, it's about me knowing stuff.

The oskies tend to be command and control because they're testing my

ability to know things .When actually, once you become part of the team, and

if you can't do everything yourself, then the minimum unit of performance

is not the individual, it's the team.

I, so if I'm running a example, often uses this.

If I'm running a trauma team, I could be the best trauma team leader in the world.

And I'm not, I mean that's probably Caroline Lecher and Vir Virgo who are to

the people that I work with who are just absolutely fantastic trauma team leaders.

But I could be it.

And if I went in that room and I was the best trauma team leader in the

world ever, if nobody else was there to help me do it, that would be a

catastrophically bad trauma team.

And it's a wee bit like having the best tires in the world and

claiming you've got the best car because you need everything else and

everything needs to work together.

So the minimum unit of performance when you have to work with

other people becomes a team.

And that's quite a challenging thought.

I find it an immensely challenging thought.

By the way, it's a Michael West comment and that that's where that comes from.

And I think once people started to consider this idea that we are measured

on personal mastery and exams, that's us knowing the answer to everything, but we

get our results in in team situations.

So our results are dependent upon team mastery, once you start talking

about that, people go, Oh, maybe I could be even better if I thought

a little bit more about this.

And for what it's worth, the the most important thing when we are

working in teams in complicated and complex situations appears

to be information sharing.

How much information are we choosing to share with each other?

And if you think about it, that makes a ton of sense.

Because if I'm the trauma team leader, literally everybody in the

room knows stuff that I don't know.

They've all got stuff going on in their heads that I don't

know, some of it's relevant.

If they don't feel able to tell me that stuff that's relevant, then if

I don't know it, I can't take it into account when I'm making a decision.

And therefore my decisions are likely to be not quite as

good as they could have been.

So it's a lot about being civil means that someone in your team is able

to share the information that they need to with you without thinking

that they're gonna be penalized.

Or is there something, have I got that slightly slightly

No, no, no.

That, that's, that's a large part of it.

Making sure that people in your team feel that their

contribution is welcome and valued.

And when they say something that you don't agree with, as a leader,

not denigrating them for it.

One of the first people that I ever learned this stuff from was

a guy called Magnus Harrison.

And Magnus is the medical director across Leeds Trusts.

But when Meg, when I first met Meg, I was a higher specialist trainee,

and he was the clinical director for emergency medicine at Stoke.

And Stoke was an amazing place.

Totally overwhelmed many, many years before other places were

overwhelmed, but utterly aspirational.

And the consultants there were absolutely fantastic.

And Meg used to say this thing when a trauma came in, and I learned it from, and

it's this just before the trauma came in.

And you say, okay guys, same rules as always.

If you think that I'm doing something wrong or you think I've

missed something, please tell me.

If I don't acknowledge, you, keep telling me till I do acknowledge you, I need

to know you are my check and balance.

I am your check and balance.

And if you tell me something I don't agree with, that's absolutely fine,

but I still need to know about it.

And what he was doing was setting up the environment for people to be able

to speak, and he's actually giving them the responsibility as well.

And I really like it.

And I picked up, and I've used it myself for many, many years.

And it has undoubtedly saved my bacon on a number of occasions and

actually saved patients' lives as well.

That ability for people to speak up.

Because one of the things I realized when I came to England, and I, and I work in

Coventry, one of the things I realized when I came to England is that my accent

sounds quite hostile to a lot of people.

Particularly I'm a wee that stressed.

I, I sound like Groundskeeper Willie.

And, um, people listen to me speaking and sometimes, I mean, I'm feeling

nothing but love and pride and they think I sound like I want to stab them.

And became acutely aware of just how much I had to moderate my language,

change how I present myself and not get too Scottish excitable.

It's interesting, isn't it?

How even you know, one would think that in an emergency situation with a patient

who is sort of dying before your eyes, that people would genuinely not care

about the ramifications, about speaking up, about telling someone something.

But you are saying that actually even in those situations where it

is a life or death situation, how they think it's going to be received

makes all the difference still.

yeah, completely.

Because this is about image management.

I mean, that's what Amy Edmondson would talk about here.

She, she was talking, she'd be telling you about image management.

We're always image managing.

We want to be seen as good and competent by the boss.

We don't want the boss to be telling us that we're muppets.

And it actually changes what people think about in those situations.

Um, in a, in a different sphere.

But within my n h s job, one of the things that happens when new junior doctors

rotate into the department is that when they come and see me, the things that

are most important to them are that they get the right diagnosis and they

don't look like a fool in front of me.

It's really important.

We're always worried about looking like fools in front of folk.

And actually, they're so obsessed with this, that for the first few weeks

when new medical staff rotate into the department, they come and give me

a history, they'll give me a really fantastic history, and then I'll say

to 'em, okay, so you've told me about this pain and what's going on, all this,

all this stuff that's going on for 'em, and how awful this pains is for them.

What have you given them for analgesia?

And if not.

They've not, because what's worrying them when they go and see the patient is, is

getting it right, getting it right for me.

And one of my jobs is then to make it okay to not quite get it right, but also

to make it really important that we get it right for the patient and getting it

right for patients involves what's their main problem at this moment in time?

What can we do to turn off, in this case pain, and how are we going to progress

things going forward so that the patient understands what's going on and feels like

an informed participant in their own care.

that's really interesting.

We, we focus as a human species on what is going to not make us look foolish, make

us look okay, get people to accept us, and that includes status and it includes not

being wrong and not looking like an idiot.

And that is often trumps everything else.

And it trumps the outcomes for other people.

It trumps perhaps what our other behaviors is, are in other spheres of stuff.

And I'm really interested in how that then interferes with our performance

because as well as, like you said, focusing on the wrong things.

Were like, we're not giving the patients analgesia when they needed to.

But that surgical registrar that you told me right about right at the beginning,

she literally couldn't think straight.

And then, you know, fumbling, all thumbs, et cetera, et cetera.

What happens to your brain when you are in that state?

Why is it that we perform so badly when we do have those worries?

This, what I'm about to say is a kind of combination of different

theories that people have around this.

It's how I understand it, and I can guarantee you that if you got

into discussion about this with a neuroscientist, that they might go,

That's a gross oversimplification, or he is on completely the wrong route.

But the way that I see it is this.

When somebody treats us in an uncivil way, something that feels

disrespectful, may not be intended, but it feels that way to us, that is

the thin end of the wedge of threat.

It's the very beginning of us going, Oh, oh, you think it's

okay to treat me like this?

How else might you treat me?

And when that happens, we, we don't think of it as threat.

We are just aware of the discomfort of the interaction.

So it's not, I'm not saying, Hey, I feel really threatened here.

That's not what I get.

I get some much more subtle emotion.

And what then happens is two things.

The first is that we begin to redistribute blood from our brain

to our body so that our, our brains are literally getting less oxygen.

But the other thing is what's happening inside our brains.

And there, there seems to be some kind of obligation that whenever

you discuss stuff like this, you have to mention the amygdala.

Um, so I'm gonna randomly mention the amygdala, I think it sounds like science.

Um, but what, the guys who look at this talk about is that instead of

at the amygdala are our cognitive abilities being directed towards logic

and understanding, they get diverted elsewhere towards, how do I need to behave

to avoid this threat that's incoming.

What that does is it squeezes down our bandwidth and it makes us literally

less smart than we would've been.

It probably also has, on an evolutionary level, saved our lives, because we are

now in a position where we're going, I'm getting out the way of this, whatever

this is, I'm getting out the way of it, and if we can't get out the way of

it, our brain keeps sending more and more resources in the direction of, you

know, you need to get away from this.

But if you're stuck in theater and you're in a social situation,

that is un inescapable, then what happens is you get driven further and

further and further down that route.

And eventually we know that human beings can go into a freeze state

where they're literally just standing there unable to respond.

And you know, people might not, not think that really happens, but I've

seen it happen to people in the past.

Um, and even if you've not had it to you in real life, you've probably

had it in a dream, in a nightmare.

Those nightmares where we are rooted to the spot, that's

freeze, and it's horrible.

And that's, but that's the, the far end of this when there's real overt threat there.

The bit of this I'm interested in is that thin end of the wedge.

It's the perception of incivility and what it does to us and why

we over perceive incivility.

But we absolutely believe that we've got it right.

I mean, we believe with a high degree of certainty that when somebody else

has treated us in a disrespectful way, that that was their intent and we're

completely wrong most of the time.

Yeah.

When, when someone's short with us, it's because, oh, I've done something wrong.

Rather than they are just knackered, they're just tired and they're just

hungry, or something's distracted them and they're annoyed about something else.

You know, we, we automatic.

'cause I guess that's safer, isn't it?

If you're talking in, in terms of survival, it's just safer

to assume everyone's out to get you, then you can avoid it.

But that doesn't work in, in the sort of society that we end up

existing in now, because we end up seeing threat all over the place.

Keeps you safe but not particularly happy and um, and rooted to the spot.

That sort of fight, fight or freeze thing that happens.

And that was really interesting to hear you talk about that.

'cause I do talk about the makesit all the time and I've never quite

understood why we get less empathetic.

I understood that you make black and white decisions 'cause your

blood is directed from the brain.

But your explanation of actually, when I'm under threat, it's much better

for my brain to be thinking about how to survive that threat and how to get

myself outta the situation than empathy towards the other person, perhaps.

That makes huge amount sense to me.

Yeah, empathy is so hard to access when you're under threat because

everything is about survival.

Really interesting.

When I first came across your work, actually, it was in the context of

civility, saves lives, and if you are, say in the emergency department and you

are in a recess room, there's a recess going on over there and you are working

over here, but over there, someone's being uncivil, and it's not even to you, but

it's to that team over there that affects your performance over here perform.

Is that right?

Yep, absolutely.

Because we recognize that there's hostile behavior going on near us.

We might need to get out the way of it.

Uh, and what the work on this shows is that if you witness incivility between

other people, on average, there's about a 20% reduction in your cognitive ability.

That's probably dependent on a whole bunch of things.

It's a really interesting piece of work done by a guy called Gadi Gilam.

Gadi Gilam looked at the impact of witnessing incivility, but depending on

where you sit on the empathy spectrum.

So that's the Simon Baron Cohen work.

It shows that people sit on a spectrum of empathy, and at one

end, those wonderful, warm people that most of us like to be around.

And down the other end, there's the cold fish.

And it's no real surprise that if you're at that warm, empathic end,

people seem to be significantly more impacted by witnessing incivility.

Not directed at them, just witnessing incivility.

And that's, I think it's really important in healthcare because what sort of

people do we want to work in healthcare?

And what sort of people are attracted to working in healthcare?

It's usually empathic people.

What that means is we have cultures where we accept people treating each

other in an uncivil fashion, then it's probably gonna have more of an

impact than that 20% I talked about.

'cause that was across everybody.

But we are probably selecting out people who are the top end

of the empathy spectrum to work within the context of healthcare.

One of the key things that we have to do, that we would like from the

patients and relatives when they come into our organizations is trust.

And there's a parallel here with what happens in banks.

Now, you want to trust your bank, you want to trust your healthcare provider.

If you go into a bank, if you've chosen to go into a bank and it's your bank,

80% of people are already Nhat promoters.

They have decided that they believe in this bank on witnessing a single

uncivil interaction between two members of staff, no matter whether or not it's

felt to be warranted, then the percentage of people who are Nhat promoters of

that bank goes from 80% down to 20%.

We really don't like it when the people around us are treating

each other in a negative way.

And I think that's important in healthcare as well because certainly when I was at

the very early stages of my career and as a medical student, um, humiliation in

front of patients was utterly normalized.

It was completely acceptable and utterly normalized.

And we allowed some pretty hideous behaviors at senior levels.

And I know that people might say this, nothing's changed, but.

Grief.

It's an awful lot better than it was.

Um, because some of the things that that happened were beyond the pale.

And I was speaking to somebody about this, um, just a couple of weeks ago,

and he was describing how when a certain surgeon walked onto the ward, and I

knew who the surgeon was, as soon as he started this story, which I think is

quite funny, uh, when a certain surgeon walked onto the ward, he used to hide

in the stationary cupboard until he had gone, 'cause the guy was so scary,

so odious, so difficult to deal with.

And do you know what?

I think the interesting thing there is I'll bet that if he knew the impact that

his behavior had on the performance of his teams, this guy would've been horrified.

I'll bet that he chose to behave that way because he thought that got

the best outta people around him.

And it's very easy to slip into this mode of looking at these guys and going,

oh my God, that they're just, they're, they're just utterly awful human beings

and they know it, and they're having this terrible impact on the people are in them.

My experience of this is a lot of these guys have no idea that's how they're seen.

None whatsoever.

And they are continuing to behave in the ways that they had role

modeled to them when they were, when they were medical students.

And additionally, a lot of them are extremely judgmental.

So they look at a situation and they make a negative judgment about the

people involved in that situation and decide that they're lazy or stupid or

don't care when actually in healthcare, these things are almost never true.

I am really interested that you brought that up.

'cause I was just thinking, you know, what about that surgeon who

was asking that registrar the, the nitpicky questions are getting at her?

You know, do people go to work to be assholes?

I don't think they do, but they end up being that, and why do they do that?

Because it's been modeled to them.

But surely, you know, surely, you know, it's been modeled to you.

You knew that that didn't get the best out of you and how much you hated it.

But we can just continue to perpetuate that and to to do it to other people.

Well, I knew it didn't get the best outta me, but I didn't know if it got

the best out of other people or not.

It wasn't until somebody had done their research and I felt in a position to,

to go, Oh, it's not just me and it.

And I think it's one of the strongest messages that, that we

get out there is, you know, it's not just you, it's everybody.

And it's not okay because you've got a whole team that's a whole

team whose performance is dropping off, some of it precipitously.

And the consequence of that is that patients are getting a raw deal.

And actually, you know, as a leader, I'm getting a raw deal.

I'm getting worse, less out my team than I could have got out my team.

And one of the issues here is, is the curse of knowledge.

Once you know that this stuff matters, you can't unknow it.

And it's so blindingly obvious.

Because not only is there science that supports it, but there's

our own feelings that support it.

It's so blindingly obvious once you know that behavior matters,

that it's hard to unknow it.

But actually, there's loads of people out there who, who have had the

sort of leadership that we've just been describing, role modeled to us.

And I, I'm all always thinking about whenever somebody says I'm

going to go and crack the whip, you show me somebody in healthcare who

needs to be stimulated any further.

Most of the people who are working in healthcare are overstimulated.

And overstimulated.

People don't perform as well as people who are in the kind of golden zone.

That's the whole Ys Dodson stuff.

You push people too far, you are arousing too much.

Their performance drops off.

People don't need further arousal.

What they need is somebody to reduce their stress levels so that

they can start thinking again.

But it is a kind of natural human thing when we think someone's

not performing to, to kind of.

get more emotional, more hacked off with them to show them that we're disappointed.

But none of it helps unless they're super, super understimulated.

But I don't think that exists in healthcare.

I mean, I work in a place that's like some kind of hell version of Vegas.

You know, the lights are on 24 7, we have no windows, half the clocks don't work,

and there's people screaming and shouting and fighting and in pain, and there's a

smell of blood and other bodily fluids, and it's horrifically overstimulating.

And one of the things that helps to people to perform in that setting is trying

to make them feel a little bit safer.

Trying to make them feel seen, trying to let them know they're important,

reducing the number of things that they have to do, not expanding upon it, and

making them know that you've got them, you've got them if something goes wrong.

And, the, the, the more experienced I get, the more senior I get, the more I

see that the idea that I've got them if something goes wrong, is actually key.

Um, Shirley my wife talks about a guy called Charlie Hendrickse.

Now I've never met Charlie Hendrickse, but my God, that man

has loomed large in my married life.

Um, and Charlie Hendrickse, who may hear about this through this podcast, I

think it'd be rather lovely if he did, but when she was a house officer, he

sat her down and he was the registrar.

And he said, if you're worried, I want to be worried.

If you phone me in the middle of the night, I may be groggy, I may be a

bit grumpy, but I will always come.

And when I come, I will never be angry that you have called me.

And that gave her a kind of safety net that allowed her to,

to call him when she needed to.

And she talks about how amazing it was that you would just

stand at the end of the bed.

You know those really sage people who stand at the end of the bed and sort

of stare at the patients for a few minutes and they go, they've got this.

You go, how could you know that?

And then they turn out to be right?

He was one of those guys.

And I like that.

I like that idea that, you know, you set people up to be able to ask you,

you set people up to make the job as safe as possible and you know,

compare and contrast the people who leave and say, I don't want you

to call me and feel free to cope.

Where's the safety there?

Really, really difficult.

And I mean, to me that is just the, the best leadership you could possibly

have in these high stress environments.

People that say, I've got your back.

Call me anytime.

And yeah, I, I mean, when I think back to the consultants I worked

with, and there was one particular one who was completely odious and

everybody, or he was rude to everybody.

He was really not a nice person.

But I think he genuinely cared about his patients, and I think he just

genuinely didn't know how to behave.

However, I think about the, it makes me feel really scared, the thought that

anyone would go and give him some feedback about his behavior because I think they

would just get eaten for breakfast.

But if I was that person behaving, odious, I would a hundred percent

want someone's give me the feedback so that I could change it.

Um, I guess side, that's probably why I think the Civility Saves Lives

thing is so amazing because it's not about criticizing you as a person.

'cause how you are making me feel.

It's about saying, no, actually, if you make me feel like this,

then the behavior goes bad and then the patient outcomes are worse.

So you're, you're looking back constantly to the patients.

But how, how do we give this feedback to these.

People who, like you said, there are a few psychopaths around, but most people don't

go to work to give people a hard time.

Most people have had a hard time themselves and they're

just passing on the joy.

But yeah, how do we give feedback so that actually lands?

So, we have to take a step away from the feedback before

we get on to giving feedback.

The feedback needs to matter to the person that you're talking to.

I, I could give you some feedback just now, Rachel, about your behavior and if,

if you don't give a damn about how you're seen, you're not gonna give a damn about

the feedback, it's not important to you.

So I see part of the Civility Saves Lives stuff as being an arc.

The first bit is making the argument that behavior matters.

And just put out there for people to think about for themselves.

I'm genuinely not trying to persuade anybody that behavior matters.

What I'm doing is I'm, when I talk about this stuff, I'm just

wanting people to have a wee think.

They decide for themselves if this is important.

I think most people end up deciding that it's important on their terms.

Um, and there will be some who don't, and that's okay because that's people.

But the first bit is to get people into the head space that behavior matters.

And then when it comes to feeding back to people, so what we know is

just getting people on board with the idea that behavior matters.

Plenty people are insightful enough to change, to choose to change.

So the Anna Baverstock work in maternity units in Somerset, where

they took the percentage of people who believed that behavior mattered,

over the course of a year in multiple sessions, they took the percentage

of people who believed that behavior mattered from 60% to a hundred percent.

In the same time, the percentage of people who said that they had seen

uncivil behaviors in the preceding two to four weeks went from 70% to 50%.

Now, I thought it would've gone up.

I thought it would've gone up because I thought we'd have

had this availability bias.

We'd, we heard about incivility and we're gonna see it all over the shop.

That's not what happened.

And one of the explanations I have in my head for this is that there are people

who are insightful enough to go, Yeah I'm not gonna behave like that next

time and I'm just gonna bite my tongue.

So we catch a few people there.

In fact, we catch a lot of people there.

And then we get the people who haven't got on board with this, or

actually I think who mostly don't see themselves as being uncivil.

And you know, none of us see ourselves perfectly all the time.

You know, you and I will have interactions with this week with

people and those other people will walk away feeling quite damaged by that.

And we won't have a clue.

We just will not have a clue.

And the more it happens, the more it's normalized, the more that's just

the way that Rachel or Chris interact with people and it becomes just us.

And then you get this really dangerous statement in the workplace where

people go, oh, you know, that's just Chris, but no one's told me.

And I don't know how I'm coming across.

So then we need to get into how you have these conversations.

And it's interesting the, the way that you set that conversation up

was you telling somebody who had been uncivil to you about how you felt.

And that is a phenomenally high level feedback skill,

like really, really difficult.

And the reason that it's really difficult is say it's me and you, and I speak to

you, and I leave you feeling like crap, especially if I'm the boss, if you have

to come and give me feedback back, we know that the person in your position

believes that I deliberately did it.

That means if you come and give me feedback, what you're saying

is, Chris, so you know how you tried to hurt me the other day.

Well, it worked, please don't do it again.

That's empowering your aggressor.

You have to be an idiot to want to do that because, or, or just a masochist.

So we don't have those conversations.

Because actually much as we want to have that degree of personal mastery, we want

to be able to go and say, yeah, this is how it is to somebody, actually, we're

the wrong person to do it, because when we do go into those conversations, we

carry a lot of emotional baggage with us.

And that emotional baggage arouses us, closes our bandwidth, stops us being the

best version of ourselves, and it means that we often get into confrontational

interactions, or we are so meek and mitigating that the other person hasn't

a clue what we're trying to say to them.

So the best evidence on this, and this makes a bit more messy,

but it's much more effective.

The best evidence on this is the right person to have the conversation

is not you, it is somebody else.

Preferably a peer of mine who then comes and has the conversation with me.

And I'm going to talk a little bit for the next minute or two about

what that conversation looks like.

And the conversation looks like this.

It's a conversation that has three overarching meta principles.

The first one is this, and it's really counterintuitive.

The person having the conversation is going to care about the

person they're speaking to.

Because people who are damaging others in interactions are often

quite damaged and hurting themselves.

Also, if they don't know, This is gonna be a difficult thing to hear.

So we are gonna care about them in that conversation.

The second thing we're gonna do is we are going to have the conversation

with zero judgment about intent.

We literally don't know the intent of the person who is speaking.

And the third bit is we are going to deliver the professional privilege of

a package of information, of knowing how we are perceived or that person

is perceived, which is a really long way of saying, telling, telling

someone how somebody else felt.

And the way that we teach people to do this, it is three step technique.

It has those three overarching things in the first place, but the

three step technique goes like this.

Check in, raise the flag, land the information.

And the check-in is like this.

I'm, I'm gonna usually hear Rachel, but you don't need to say anything okay?

So, the situation is now that Rachel has been involved in something

and Rachel's, someone's pretty devastated at the other end of it.

Uh, Rachel's blithely going on through life as Rachel does, um, boiling

frogs and doing all the rest of it.

And I'm gonna go and speak to you.

And I, and I come and speak to you and it would be as soon as is practical,

but also at the right time for you.

And the conversation, the first bit is check in and I say, Rachel, how are you?

No, really, how are you?

And I pause and I wait.

And you might well say you're fine, or you might as happened

to me the last time I did this.

Um, you might then speak for eight minutes without stopping,

'cause you are not all right.

And very occasionally, and this is really rare, very occasionally, the

person you're speaking to is so not all right, that you don't go any

further with the conversation, just say to them, listen, I think you

need to go and speak to your line manager, your GP, occupational health.

'cause you're not in a good place.

And very, very occasionally, I I will say, and I'm gonna have a word

with your, with your line manager.

'cause I, I'm worried for you.

But that's rare.

That's really rare.

The, the vast majority of people are a bit hacked off.

There's a lot of crap going on and you know, they tell you a bit about that.

The second bit is raising the flag.

And it would go like this.

It'd go so Rachel, what happened with Sam yesterday in the department?

Now I'm raising a flag.

It's pretty clear something happened with Sam.

And you might say, oh, you know what?

I made this joke.

And I realize afterwards it could have sounded, it could have sounded

racist, but I don't think she heard.

And I can say, Hey, she heard.

At which point, we know a lot of people move into what's

called service restoration mode, where they go, Chris, thanks.

Do you mind if I leave now I need to go and speak to her.

Because people don't wanna be that person.

Not everybody does that, but a lot of people do.

But most people will go, yeah I spoke with Sam, normal conversation.

Yeah, not nothing.

Nothing happened in it because it was a normal conversation

for the person I'm talking to.

So I've checked in, I've raised the flag, and now I'm gonna land the information.

Really, really carefully constructed and very simple, and it goes like this.

So Rachel, after you spoke with Sam yesterday, Sam was really upset and I

know you'd want to know that is it from my perspective, that's a full stop.

Now, what will happen then is the other person will speak.

They always speak.

They want to uh, they want to say what happened from their perspective.

They want the chance to talk.

That's all cool.

The important thing has been done.

This person now has that piece of information that they can choose

what they want to do with it.

Because if you don't know, how can you choose to behave

differently the next time?

And that sounds soft, doesn't it?

Is it, what I've just described sounds kinda soft, but it's built on work by a

guy called Gerry Hickson in Vanderbilt, uh, Vanderbilt's in Nashville, and I.

A few years ago before Covid and you know, before we used things like

Zoom and Teams and Riverside to have conversations with people, um, we used

to go to see people or phone them up.

And I had an entire summer holiday designed around a one hour meeting with

Gerry Hickson in Nashville, in Vanderbilt.

And I'm not a good man to be married to.

I think that's pretty obvious from that statement.

Um, however, that being said, you know, there was also a, a family wedding

going on down there, so, you know, everybody got something out of it.

Um, and I know what I got out 'cause I got an hour, an hour with Gerry Hickson

and it was utterly, utterly worth it.

We sat down and he talked, so they, he, they're the pioneers of this.

And he discussed some of the data.

At that point they had 37,000 of their equivalent of that

cup of coffee conversation.

After a single cup of coffee conversation, only 2000 people went

on to behave the same way again.

And that 2000 had another cup of coffee conversation.

But this time, with the 360 describing from the people were in, what it was

like to work with them, because I guess a few of those guys goes, ah, I

was just one person being a snowflake.

But then they got the 360, which the organizations paid for,

and then they were down to 267.

Those 267 were the very first level at which HR or the line manager got involved.

The rest of this was done at a peer-to-peer level.

I think that's absolutely incredible.

This idea that by packaging the information in a way that people can

hear, people just choose to change if they think changing is worthwhile.

So many questions.

Chris.

That is a complete revelation to me.

Um, just that Gerry Hickson's work, was that specifically in

healthcare or was that across lots of different organizations?

His 37,000.

Were all doctors, often regarded as being the most difficult

group of people to change?

Yeah, totally.

that, that third thing of your three steps land the information, the, the very

short thing, Sam was upset and I knew you'd want to know, and then you just

stop so you don't tell 'em anything else.

Or if they then start asking, well, why, what did I do?

I don't, can you then give more information?

Well it depends what you know.

Um, so, after you spoke with Sam yesterday, Sam was really upset

and I know you'd want to know.

They might well want to understand that, and I get that.

The important thing is that Sam was upset because we know that

upset people don't perform so well.

And what might happen there, what, what sometimes happens is that people

will ask lots of questions to try and understand it a bit better, and they will

sometimes go, that's a lot of rubbish.

So go fine, but Sam was still upset.

And you furnish people with the knowledge of somebody else's

emotion, and it's not really my place to explain why they were upset.

Arguably, if this person wants to know, then that the, the right place, the

best place to have a conversation with someone where they're saying sorry for it.

Now, I know that occasionally people don't say sorry, but the

vast, vast majority of people do.

Because we really don't like hurting our fellow person.

That is there, there aren't many people out there who are, who

are genuinely sadistic like that.

In fact, you that you can measure the percent of people who abuse power.

Um, and it's about 4% of people.

Two to 4% of people state that they do things 'cause they have the power

to do them, so they might as well.

But that's pretty sort of psychopathic, sociopathic, uh,

position to take on things.

Okay, so you've given them feedback and go Sam was upset, I knew you'd want to know.

What happens to that person goes, oh my gosh, they were upset.

Ugh.

How do I, and you don't know exactly why they're upset and you'd be, um,

uh, we use this concept of being over the net which is when you make

assumptions about what the other person's thinking, you've, you know,

you know, you don't necessarily know.

You can assume, well, it might have been 'cause of this, but

you don't necessarily know.

But what's the person that's you are talking to, the person that's done the

upsetting doesn't know and they don't really have the skills to find out.

'Cause it's actually, it's, I think it's quite an advanced skill to go to

someone and go, and this is something I'm trying to really learn at the

moment go, can I just check in?

'cause I noticed that when I said this, you responded in, in, in, in a, in a way

that I was quite surprised that, can I just check what was going on for you?

And the story in my head is, I might have done this, but can I, you know,

again, that takes quite a lot of courage and, and a bit of skill to do that.

And we are really rubbish at reading other people's facial expressions.

Totally.

So it becomes about, and I'm keeping this pretty high level, it becomes about

curiosity, not trying to guess what the other person's feeling, asking them.

So, many, many years ago, I was having literally one of the worst

days of my life as I'm one of the worst week, weeks, months of my life.

It was awful.

I was clinging on by my fingertips.

And I arrived at work and something really crappy happened on my way to work,

which put me in an even worse place.

And I arrived at work and we were doing long shifts, 11, 12 hours.

And on my own for that period of time with a queue of doctors

coming to ask me questions.

And with the way it works for us is I stand here and facing me as

the senior nurse in the department, and we both have a computer screen.

And we talk to each other over our computer screens.

And the day was brutal.

It was a weekend, it was a Saturday, it was a brutal day.

And we were getting seven o'clock and the nursing shift was changing over.

And my colleague, my nursing colleague, um, said, can I have a word?

And I said, Okay, yep, fine.

Let's have have words, see what's going on.

And he got me around the corner and he said to me, do you know, I've gotta

tell you, this has been one of the worst shifts I've ever done, and it's

been one of the worst shifts I've ever done because I've had to stand here

and watching you with that smug look on your face the entire bloody day.

And I want you to know how crap it was for me.

And it was literally all I could do to not cry.

And we are just rubbish at working of what's going on in somebody else's life.

We are so bad at it.

And when we take judgment into it, when we decide that we know how

somebody else is feeling, we're just wrong lots and lots of the time.

And if he had stopped and paused or if I'd chosen to share at the beginning of

the shift, if we'd stopped and paused and checked in with each other, we might well

have had a much better day, but we didn't.

And that at the end of the day, his assumption was I was just being smug

about stuff, which it is a weird accusation 'cause I'm not sure how often

I feel smug, but it's not very often.

So interesting.

So, so just getting curious.

So, so if, if someone needs the skills to find out what they've done, just

literally going up to someone going, I can, you just fill me and I, you

know, I, I, I, I think I may have upset you, I'm, I'm curious, did I,

and what was the cause and what, what, what's going on in just being curious?

did I do?

Yeah.

What did I

Just asking what did I do?

I, and not having the conversation to prove that you didn't do

it because they got upset.

They, they, they own that emotion.

it's a case of being curious to understand how they experienced it.

Do you need Sam's consent to go and have that conversation with,

with the person that upset her?

Okay, so that's a really interesting question.

'cause a lot of the time, once people have talked about it, they don't want

some, once they talk, they've kind of got it off their chest and they go,

I don't want to tell it to anyone.

The way that we advise is that there is a commitment to having the conversation.

As soon as we are having first conversation, there is a commitment

to tell the supposed perpetrator, because otherwise how can they know?

So yeah, there's a commitment to having the conversation.

How can they know?

How can they change?

Now, as you were saying this, by the way, I just think this is absolutely brilliant.

I can see how this would be so helpful, but in my mind I'm having

a, a small reaction because we teach people a lot about the drama

triangle and about getting outta rescuer, victim, persecuted mentality.

There's a bit that I love at the moment, um, called the 15 Commitments of Conscious

Leadership, all about being a conscious leader, being self-aware, um, and not

reacting, not being in your amygdala zone, but actually sort of being above the line.

And there's also books about called Radical Candor and all

this thing about you going to have these conversations with people.

And I slightly worry with this, that you'll get lots of people in rescue

mode going, oh, no, don't worry.

You don't need to go there.

I'll go and have a word with them.

Don't worry.

You, you don't need to.

And, and a lot of the stuff we talk about is empowering people to have

those conversations themselves.

But it makes absolute perfect sense that it's so hard to have a conversation

when you've been upset about something.

So maybe it's that, that upset power balance thing.

But how do you avoid getting into the rescuer victim role

when you are doing this?

I'll go and have that conversation on your, it's not really on your, it's,

I was about to say on your behalf, but you're not having it on their behalf, are

you're having it on everybody's behalf,

Yes.

Yeah.

Okay.

I think, I think it helps to step away from Karpman for, for understanding the

relationships that are going on here.

You're not a rescuer, you're not a victim.

You're a messenger, you're, you are giving somebody a piece of information that they

have a professional right to know, and you're handing it to them because then

that knowledge could literally result in other people having their lives saved.

Because if we go through life leaving trails of devastation behind us and

the people that we work with, then the consequence is that our patients

get worse care and we are there to provide the best care that we can.

So in my head, this is not about the drama triangle.

This is a different relationship and it's a, it's a more adult adult relationship's.

And it's not about rescuing, it's about informing in the most kind,

compassionate way that we can because it is not easy to hear this kind of stuff.

None of us enjoys hearing that we left other people distressed.

We don't like that in the fir.

Well, very few of us enjoy that.

But particularly if we know that that means that our patients are getting

less good care, that's even worse.

So compassionate delivery of a package of information that people have a

professional right to know about.

And I love that 'cause you've reframed it from what you're not doing.

You're not going and rescuing the victim who's been hurt.

You've noticed the behavior.

And it's Notre, it's not really about anymore.

It's not about the victim of the behavior anymore.

It's about the person that did that behavior.

It's about telling them, giving them feedback about the behavior so

that they can change for the future and keep everybody safe, right?

and it's also something else.

It's that there may have been no intention, none whatsoever.

In fact, sometimes the person didn't even do the behavior that the

other person's taking offense at.

It didn't happen that way.

But this is all about how we experience life as human beings.

And we don't all experience it the same way.

And we get stuff wrong.

And we think, we think that we've, we have the, the full

truth, but of course we don't.

It doesn't matter.

On one level, this is the level that it doesn't matter on.

If we have an interaction, I'm left feeling less at the end of that

interaction, the consequences that my performance is dropping off.

We don't want that in our, in our teams.

And there's a just an infinite amount of subtlety to, to this once you get into

it because it's actually about knowing the individuals that we work with and

knowing what's the right way to interact with one person or another or another.

And yeah, sure, we should be civil to each other, but there are still

different words and different behaviors that trigger different people.

And you know, one of the things I learned coming to England is that there is, there

is language that I would use in Scotland amongst my mates that you guys, you guys

are so soft, you're horrified by it,

Oh yeah.

You must never anything directly, Chris.

Well, yeah, no, I mean, there, there are words that you can, there's a

word that I have learned is apparently a dreadful word that begins with

C, and it's a very small word.

And apparently it's a really bad word in England, in the groups that

I function with, uh, or some of them in Scotland, it means person.

Literally that's what it means.

And if anybody doesn't believe me, you can look this up.

So if you were to go and look up online, if any C, and you all

know what the word is, if every C says it, does any C mean it?

And there are these brilliant clips of Scottish people chatting

on the news or phoning into shows using this word to mean person.

One of them's, one of them's on the national news, and it's

not until people phone and go, you do know what he just said.

And, and there's, they're literally devoid of malice when they're using the word.

And some of this is about understanding the cultural context of what's

acceptable, what's not acceptable, and bending and flexing to be, to be

appropriate in, in a different culture.

And you know, also letting culture evolve and change.

And it's not about forcing everybody to be exactly the same way, but also

understand, understand that some of the things you might say or do

might cause distress and offense.

And that's not my purpose in my use of language most of the time.

Yes, yes.

You choose, choose your battles and all that.

I mean, there, there's, there's a few things that, that strike

me as, as why this is so helpful.

Firstly, is that what you are when you are raising that, just to let you know,

Yeah, what happened because Sam was upset.

I thought you'd like to know.

I think a lot of the time we don't give the feedback well 'cause we don't

wanna upset the person, but because we don't, we don't know what, we'll

then say, what advice would we give?

You know, and this is how I think you should change, or this

is what you should do instead.

But if you don't have to do that, then great.

All you're doing is saying, actually that happened.

Thought I'd thought I'd flagged that up for you.

So that makes it much, much easier.

Like, and literally anybody can tell someone that they've upset somebody, that

they've noticed somebody else was upset.

You don't need to be skilled.

You could just go and say, that happened.

I don't know, you know, you go find out why yourself, but I'm just saying it did.

One of the things that.

We know about this, and this is uncomfortable, is that as leaders

we generally are more accepting of criticism If we invite it.

Uh, uninvited criticism or uninvited challenge is difficult.

Invited challenge.

We feel like we have a degree of control over it.

And that's back to that thing that Magnus taught me to say in trauma

about, you know, if you think I've missed something or you think I've

got something wrong, please tell me.

I was talking a few weeks ago to a surgeon who, he admitted this in a, in

a group of folk, and, and you know what?

It's, it's uncomfortable what he admitted, and I would entirely resonate

with it, and it's, it's this, he said, I really like people to call

me by my first name in theater.

And everyone calls each other by a first name.

And I like it when my team call me by my first name.

I really dislike it when somebody comes in who's not being part of that

team and isn't part of that group who comes in and uses my first name.

And it's very clear that's not right, okay?

And yet it is the human condition that we don't enjoy somebody

assuming they can do that.

I don't enjoy it.

If I'm running trauma and somebody comes in and assumes they can come

in and criticize what I'm doing.

You know, it's like, who the hell are you?

Out.

You know, get him a room.

Um, because actually I find that destabilizing.

And I suppose part of that is me trying to control my own environment so

that I'm not overstimulated by it and that I'm able to perform at my best.

And somebody else coming in and challenging around that can be difficult

if I've not been in control of that.

And, you know, maybe that makes me, maybe that makes me a wee bit small.

I don't know.

but that's my experience of it.

think that makes you human, Chris, because if, if I may call you Chris or Dr.

Turner.

Yeah.

Yeah.

No, uh, emergency medicine, very flat hierarchy, you know.

I, I think that is just a human condition, isn't it?

Because nobody likes, well, criticism gets our backs up, whether it's well intended,

whether it's right or not, because again, it's just that threat thing, isn't it?

So if it's uninvited, it just catches you unawares.

For a start.

If it's un, if it's invited, then you, you could brace yourself for it.

And you know, and you know that it's got good intentions behind it as well.

So there's, it's completely different kettle of fish.

Um, but what if you are that person?

Because it's, it's really hard, you know, I'm sure everyone listening

to this podcast is not only thinking about people that they need to go

give feedback to about their behavior, but thinking, oh my goodness,

and then I know I am that person.

And the problem is when we get that feedback that we want, because there's

no way I want everyone to go through life going, well, that's just Rachel.

I want people to come.

So I'm not that, that's just Rachel.

I'm thinking of some people that probably would just go, that's just

Rachel, mainly my close family.

Anyway, um, you want, you want that feedback, but when it comes,

it can be really devastating.

And then I'll m does flare up.

So how do we manage ourselves?

How do we, how do we not not be that person that responds really

badly, but we are the person who is inviting criticism and, and,

and dealing with it when it comes?

So we're going to have a response.

We're humans.

We're gonna have a response.

Of course, you're gonna have a response.

You didn't wanna hurt people.

You've been told you've hurt someone.

So we're gonna be disappointed in ourselves.

The point is that us having our own reaction about our self worth,

this is not somebody else telling us that we've been bad, the the

transaction totally different.

This is an internal monologue, an internal understanding.

And I've had it done to me twice.

Twice in the last 10 years.

I've had feedback delivered to me in something resembling

the way I've just described.

And on both occasions, I had precisely zero knowledge that I had hurt somebody.

And on both occasions it gave me the opportunity to go and speak

with that person and to resolve it.

And on both occasions I ended up having very good working

relationships with those people.

And one of the things we know about people who say, sorry, and the act of saying

sorry, is that lots of folk hate it.

They're, they're just at test saying, sorry.

But the truth is that if we screw up with somebody before we screw up with somebody,

they see us at say a level five in terms of how much they like or respect us, we

screw up with them, we go down to three.

And these, by the way, I'm just giving numbers 'cause people will

be listening to this as a podcast.

These are made up numbers.

All right.

This is the illusion of, of science.

This is truthiness.

I'm just, I'm just putting this out there because it makes more sense.

So we started as a five.

We were a dick, we're down to a three.

Somebody tells us that we've screwed it up, we go and say, sorry, now

we're not a five, now we're a seven.

We rise in people's estimation.

The act of saying, sorry, it's hugely powerful, hugely pro-social.

It sees others, it recognizes flaws in ourselves and it says we can be

better, and people really like it.

And I am not suggesting for one second that people go out and screw up so

that they can say sorry and be seen in a better light by other people

because that'd be highly manipulative.

But when we do screw up, you go and say sorry, people think you're an even better

human being, and I'm done with that.

That's a, that's a pretty big payoff, um, for a small act of contrition.

Yeah.

And I can definitely think of times in, in my career where, yeah, I did muck up

and I thought I'd completely mucked it up.

I'd like lost my temper or something like that.

And I went to that person.

I apologized and they were like my best mate afterwards.

It was amazing.

It's, it's amazing the effect it has on the relationship.

It's, it's, it's, it's weird,

Yes, it?

is indeed.

Weird.

It's weird,

did that happen?

You know,

like, how are we, like, I was really awful to that person and

now like they Yeah, it is, it is.

It, it is really uncanny.

but the other thing I have noticed is, and this happens to me recently and we,

I'm quite upset on this podcast about these stories of guilt and shame and

I ought to, and I'm such a bad person.

I thought I'd upset someone recently and I was really beating myself up

about it and I noticed it that they reacted slightly offhand with me

and, and I was like, I, I thought I can't go and I can't speak to them.

What if I, what if they tell me I, you know, what if they really come

back with criticism, et cetera?

But I did, and I went to speak to them and I had upset them.

I had, and they, they said, yes, you did, and they told me and I apologized

and it was like, it was like a drain clean had gone down the drain and just

the relationship was much, much better.

But the thing, the reason I'm telling this story is the story I was making

up in my head about how awful it would be if I actually had done

that thing I thought I had done was actually much worse than receiving the

criticism that I actually had done it.

Does that make sense?

The shame I felt before we actually, it was in the open, was much,

much worse than the shame when I actually knew and I could apologize.

A hundred percent that.

We still fear it though.

We do.

It's, it's hard.

It's my, it's my quest to be able to do this without, without telling

myself all those awful shame stories.

'Cause we all muck up, don't we?

Particularly when, when you work in environments where literally

people are dying and, and life turns on, you know, split decisions

and all that sort of stuff.

So, Chris, with all of this, what if you had to distill this advice into three

top tips for people, what would they be?

I would say be kind to yourself.

You're gonna screw up.

Everyone screws up.

Own it when you do.

Find the people who let you own it without weaponizing it.

And when other people screw up, let them own it, but don't judge them on it.

Support them through it because nobody wants to screw up.

And the final thing I would, I would ask people to think about is just

really quickly, what's your theme tune?

What music do you want people to hear when you walk in the door?

Choose your music.

And then decide how you need to behave.

If you want people to hear that music when you walk through the door.

I love that.

Do you mind me asking, what's your theme tune?

Uh, mine's really embarrassing 'cause the people who wrote it

are a bit of a pair of clunkers.

Um, which means I, I now can't tell you because I'll get, nah, Right Said Fred.

Deeply Dippy.

I love it.

For a minute.

I was thinking it's, I'm too sexy for my shirt.

No, no, no, no.

Definitely Deeply Dippy.

Yes, I'm very, very, very, very sure.

We now know you are next.

The next time you do like a TEDx talk, we now know what's

gonna be playing as you walk on.

So, so, so, so helpful.

Thank you so much for being on the podcast.

If people wanna find more about, you know, the Civility Saves Lives

or get in contact with you or anything, how, how can they do that?

civilitysaveslives.com is the website.

Um, and if you write to us there, everybody gets answered,

usually reasonably quickly, but everybody gets answered.

And then one of us has a chat with folk.

It's usually me if people wanna talk about this stuff.

Um, so you see us get us there and yeah.

And we're on Twitter at, at civility Saves.

thank you.

So we'll put all those links in the show notes, including links

to the TED Talks as well, in case people wanna wanna watch those.

And thank you so much for your time and I think we're gonna have to get

you back at some point, if that's all right, to talk about this more because

I'm sure we'll have much more, many, many more, more questions with people.

So thank you so much for being on

Thank you Rachel.

Thanks for listening.

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