The F-word: Think It, Just Don’t Say It

It might seem strange that I’d feel the need to advise fellow professionals to watch their language like this. We’re all respectable adults, yes? But you’d be amazed to hear the way some people talk…and words matter. Rightly or wrongly, people judge you by the ones you use.

I’m, therefore, here to advise you: Try to remove that nasty little 4-letter F-bomb from your repertoire. Under most circumstances, the word “fair” won’t help you. Even if it’s modified with things like “un-.”

I recall an episode from early-ish residency. We had a two-tier system for covering call, where junior and senior residents split responsibilities, and it was time for me to take over XR. I was unpleasantly surprised to enter the reading room and find that the now-departed senior had left a massive stack of films (yes, we were still using those) on the counter. They’d accumulated over a course of hours on her watch, but she’d left without looking at any of them.

I felt the need to tell the attending who’d just arrived for reading-out that this was not my mess…mostly because I didn’t want him to think I was slacking. Part of me also wanted him to know that she’d shirked her responsibilities. (It wasn’t the first time she’d demonstrated a crummy attitude in such regard, and had more than once left other residents in the lurch…evidently thus far without repercussions.)

The attending didn’t much seem to care, dismissively saying, “She’s old, and she’s tired.” I was disappointed by this…but I don’t consider it evidence that I’m an evil, vindictive individual. I’ve previously referenced in this column that humans are hard-wired to seek justice; some articles covering the matter refer to the “revenge center” of the brain. Functional MRI actually found circuits involving the amygdala and the dorsolateral prefrontal cortex, activated when subjects experience or just witness acts of unfairness.

So we’re physically set up to recognize and react to unfairness. Why not point it out when we see it? Especially if we feel we’re the ones being treated unfairly?

Because it wouldn’t change anything. At least, not in ways we’d want.

“Fair” is an entirely subjective concept. In an awful lot of circumstances, my “fair” isn’t going to be the same as yours, because we’ve had different lifetimes to form the concepts for ourselves. If I say that something you’ve done, or are passively benefitting from, is not “fair,” it’s almost certain that you’ll disagree.

Suppose you recognize that my accusation has merit. It might make you feel guilty or otherwise uncomfortable. You might have a cornered feeling: I’ve expressed a valid point that you unjustly have X or did Y, and you don’t have a reasonable retort to defend what you’ve got. Either you relinquish it (but you don’t want to), or you keep it, exposed as willfully benefitting from unfairness. You’re probably going to resent my putting you in this position…and might decide to make me pay for it later on.

Or you truly believe that I’m wrong about the unfairness. Maybe you try explaining to me why that is, maybe not. Either way, there are two people bashing their contrasting senses of what’s fair against each other. Nobody’s going to change their mind. One or both parties might be so unable to imagine the other’s perspective that they’ll believe the argument of “fairness” to be disingenuous, a manipulative path to ulterior motives.

Then, of course, either or both might simply resent the conflicting opinion: Who are you to tell me what’s fair here? How are your values any better than mine?

Griping about fairness can also do the complainer other disfavors. Even if they manage to do it without sounding whiny, it makes them look weak. They are essentially saying that they want something, but can’t get it for themselves. Even appealing to a higher authority to get it for them, they aren’t supporting their case with evidence or other logical points—they are depending on the magic word “fair” to get their way.

Such authorities, and indeed others interacting with a frequent “fair”-er, quickly develop fairness-fatigue. “Life’s not fair” isn’t just a parental parry against squabbling siblings, it’s actually helpful advice (which, at that age, tends to fall on deaf ears). But, later on, some folks might just learn the lesson: Avoid the F-word whenever possible.

Getting back to that situation with the stack of neglected X-rays, I know I didn’t say anything to the attending about fairness. Even if I‘d bothered to track down and confront the senior resident, I wouldn’t have used the word with her, either. It was a couple of decades ago, but even then I’d lived long enough to know that it wouldn’t have helped my case. Indeed, it probably would have taken me down a notch in their eyes.

Better, instead, to support your side of things by showing your audience what they need to conclude for themselves what is fair. Persuasion has been nicknamed the art of “letting others have it your way,” and that’s a more effective route. Babbling about what you think is fair won’t help and might actually hurt your case. But if you can present your facts in a way so the other side assembles them to arrive at their own sense of “fairness” that meshes with yours…you can win without even fighting.

Follow Editorial Board member Eric Postal M.D., on Twitter, @EricPostal_MD.