The intrusion

Early in my tenure as one of three Chief Residents, we had settled into our office, a generous and inviting space that we shared, complete with a coffee maker and comfy chairs and a coat rack. The coat rack was old and worn, but it had character, and stories. It previously resided in the waiting room of the Internal Medicine Clinic, for decades, and was set for the dump pile, but it was completely functional. While worn, it was beautiful wood, and it was claimed for the Chiefs’ office by our immediate predecessors. We three loved it.

We came into work one Monday morning, early in our academic year, and found our entire office to be rearranged, re-furnished, and devoid of our coat rack. I was furious. Our space, our residents’ space, our warm, inviting, comfortable gathering space, had been invaded and marred. We now had “upscale” furniture and we looked like an office out of “Mad Men” (before it existed) or some other corporate organization. This was entirely and absurdly out of place inside the walls of a County hospital that served the most disenfranchised patients in the Twin Cities. Further, it was an entirely masculine feel, and my female partner and I were insulted.

She and I went on an immediate quest to find our coat rack. We wandered into every logical storage area we could think of, being deeply familiar with the secret hiding spots inside this expansive campus inside of which we had already spent three intense years.

Finally, finally, we found it: inside a call room for the dialysis unit ICU. How ironic. I marched back the long distance to our office (probably the equivalent of at least a quarter mile), hoisting our coat rack, with my Chief Resident partner Joan’s help, high and proud and fury-driven.

We were met at our office door by the faculty member who had orchestrated the forced redecoration of our office. I proudly re-set the coat rack in its rightful place, and my partners began the task of resetting these absurdly large desks in our original, preferred, arrangement. All the while he sputtered with his own fury about image and perception and shoulds and looks and “curb appeal.”

Calmly, but firmly, I approached him, well within his personal bubble. I called him by his first name, which I had never done. I was physically shaking.

“Tom,” I said, “this is OUR office now. You are more than welcome to visit. You are never welcome to intrude.”

Personal Moral Injury involves a cascade of intrusions just like this.

Disinterested parties assuming they know what’s best for you, for your patients, for The Organization, then inflicting their Better Way with no conversation, no allowance for an exchange of ideas, no partnership. Professional investment in the organization on the part of the medical staff and nurses then starts to erode until only rubble remains.

We kept our office, our way, for that entire year. And the coat rack remained for some years to come, because its story became known far and wide.

Grassroots is how we impact change. Power from within each of us, then banded together, with a singular common goal: the well-being of our patients and of our partners.

Jenie