The Price of Silence
Practical Prescription: A Call to Action
As a young clinician, I was appointed to sit on a hospital committee dedicated to chemotherapy safety for pediatric patients. I prepared for my very first meeting as a brand new committee member, a proposal for a simple change in practice that would drastically reduce the chance of a specific chemotherapy error. This specific error had never happened in our particular hospital to my knowledge, but it was a well-documented error across medical literature - and it would cause severe neurological damage or death for the patient if it were to ever happen. I was aware that our hospital had never implemented the standard recommended safeguard to prevent this error, so I went into the meeting with a well-researched and widely acceptable recommendation backed by international guidelines. This recommendation required a simple operational change, and I was confident that everyone on the committee would agree.
Boy, was I ever wrong.
The committee leadership not only told me this change was not needed, “because this error would never happen here,” - they actually ridiculed me for bringing this to the committee. They appeared insulted that I would possibly question the current procedures that had worked for decades. Nothing like this “would ever happen here.”They cited cost barriers, operational barriers, and many other “reasons” to not implement my recommended change. They rationalized their way out of doing the right thing. And then they actually laughed at me.
I’m well-versed in dealing with professional disagreements among medical teams I’ve been a part of over the years; it’s normal for healthcare professionals to have healthy disagreements during discussions about a diagnosis or treatment approach, because everyone has a unique perspective and has the patient’s best interest in mind. I’ve never taken it personally when a physician didn’t accept my recommendation.
But that day, I was devastated. I could not believe that a committee dedicated to the safety of children - seasoned medical providers - would ridicule me for bringing their attention to such an important subject. This was literally life or death, here. And what seemed like a common sense approach had been turned into a completely different narrative by those in power.
It felt like I was being told to disregard all truth and reason, and the facts I saw with my own eyes - in the spirit of not questioning the powers that be. I felt completely gaslit.
I went back to my director, appropriately up my chain of command, and reported the events that unfolded. The solution that was offered? Document it. Write down the date and the recommendation you made, along with the committee’s decision. And then? Pray that the error never happens.
I did what I was told. I followed the rules. I played nice around those committee members who I interacted with regularly. I was new here, after all, and I wanted to do a good job. I kept my head down and took good care of my patients. I occasionally mentioned my ongoing concern with some of my colleagues who bore witness to the ridicule I had experienced, and who were also in disbelief. But we continued on in our jobs, because “nothing like this would ever happen here.” For the most part, I stayed quiet and complied.
You can probably guess where this story is going.
About 2 years after that first meeting, during a routine chemotherapy-related procedure, it happened. The potential error I had called out years before, the one that “would never happen here,” the one that was too expensive to consider safeguards for, happened. By the grace of God, at the very last second, an attending physician questioned the chemo that was being handed to him to administer during the procedure. He hesitated, with the wrong chemo literally in his hands, and in that moment the error was recognized. Somehow the thing that would never happen here had made it past all the safety checks and balances that were part of our standard operating procedures, and it was seconds away from being given in a way that would cause absolute devastation.
The price of silence and ultimate compliance had nearly cost everything.
Guess what happened next? Policies changed overnight. That recommendation I had brought to the committee years before immediately went into place. Suddenly there were no barriers. Because this child’s LIFE had nearly been compromised over an avoidable error that had narrowly escaped the certain devastation it would have caused. The system we had in place had not kept this child safe, and all of a sudden no one was willing to be on the wrong side of history. Everyone agreed that something had to change.
The thing that would never happen here? It happened. And it’s happening now in our country.
I am being told once again what my eyes did not actually see, this time by our government. I am told to comply, to be silent, and to not question the powers that be. I’m told that “nothing like this will ever happen here,” in our beloved United States of America.
And this time… I am not staying silent. My eyes have seen what they have seen. I will not be gaslit again. Because once again, actual people’s lives depend on it.
Here’s the thing. I don’t think you would be okay sitting around that hospital committee table either, waiting until the thing that “would never happen” to happen in your community, to your friends, or to your family. I don’t think you’re okay with just praying that the harmful situation never takes place but then never making changes to a broken system. (And I truly hope you’re not the committee members who are sitting around laughing at the people who are concerned about the current system.)
I believe you and I care about that kid with cancer who is trusting the system to deliver the correct chemotherapy, the one that won’t kill them.
I also believe you and I care about the lives of people in our country, who are trusting the system not to kill them.
I believe some of you are staying silent because you’re just trying to, “protect your peace,” or stay on good terms with those around you. You might mean no harm by staying silent, you’re just trying to keep doing your job and “not getting distracted.” Some of you are even using your faith as an excuse to remain silent.
But we cannot afford the price of silence any longer. It is time to speak up.
Friends, we are living through more than a chemotherapy error nightmare. We are living through consolidated power that dehumanizes and ridicules anyone who questions it. We are watching as a masked army terrorizes cities, killing bystanders, separating families. We are seeing the denying of due process rights for immigrants, ICE agents entering homes without a warrant, and subjecting detained immigrants to all types of abuse. We are seeing people who have followed the rules be punished for doing exactly what they were told. We are seeing US citizens being murdered by ICE (with video evidence you can watch with your own eyes, instead of waiting for your government to tell you what you see). And then we are being gaslit and lied to regularly by the powers that be, telling us what to believe about what we just watched. Telling us that what we know to be true, isn’t actually true.
You don’t have to change your political affiliation, your conservative views, or your faith beliefs. You can want true immigration reform and for the actual “worst of the worst” to be handled accordingly. It’s does not need to be either/or. You can want all those things AND speak up to say that what is happening right now in America is not okay.
Are you willing to stand up and say that the system has to change? We need each voice, rising together… including yours.
A practical prescription: This week, the U.S. Senate will vote to give MORE funding to ICE. Call or write your elected officials to tell them to oppose any bill that maintains ICE funding. There must be major reform to this lawless broken system.
You can download the app “5 Calls” which provides talking points on important issues, and a direct link to your specific elected officials.
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You can go to https://www.senate.gov/senators/senators-contact.htm to find your senators and their contact information.
Then make the actual call. Write the email.
If you voted for this administration? Your voice is needed now more than ever, to tell your elected officials that this abuse of power and dehumanization is NOT what you had in mind.
And if you “aren’t political” or didn’t even vote? You’re still affected by politics that determine polices in our country, that affect people…including you.
Let’s not wait until the “thing that will never happen here…” actually happens.
We truly cannot afford the price of silence any longer.
Dr. Peek