Journal of Sacred Work

A stiff apology is a second insult…. The injured party does not want
to be compensated because he has been wronged; he wants to be healed
because he has been hurt.   -G.K. Chesterton


   A patient with an especially acute migraine headache lies writhing in pain in her hospital bed. She pushed the call button half an hour ago and the nurse has still not arrived with her scheduled pain medication. Finally, the nurse charges through the door. "I’m sorry I’m late," she says with irritation, "but you have to understand that we’re short-staffed tonight."
   The "I’m sorry, but…" apology is no apology at all. As Chesterton says, most people injured by a mistake feel hurt and want to be healed. They seek healing from the disrespect implied by the hurt. Excuses compound the hurt.
   So what could the nurse have said that would be more caring and healing?… 

   The
fact-based example above is especially problematic. It may be true that
the hospital floor was short-staffed on the night the delay occurred,
but what purpose does it serve to lay that excuse on a suffering
patient? What can sick patients do about short staffing other than to
worry even more about their care?
   What if you were the patient in this situation and the nurse said, instead, "I’m so sorry you had to wait. I’m here now, what can I do for you?" Even better, "What a hard thing it must have been to wait so long. Here is your medication."
   Loving apologies empathize with the person wronged. They don’t offer legal defenses to patients who aren’t even threatening lawsuits.
   As a lawyer and long time hospital CEO, I can tell you that the medical establishment has become overly anxious about whether to apologize at all for mistakes. Most patients are not laying in wait hoping to file lawsuits, they are lying in pain looking for sympathy. It turns out that honest apologies are wise business practices as well.
   As reporter Lindsay Tanner wrote in a recent AP story: "The hospitals in the University of Michigan Health System have been
encouraging doctors since 2002 to apologize for mistakes. The system’s
annual attorney fees have since dropped from $3 million to $1 million,
and malpractice lawsuits and notices of intent to sue have fallen from
262 filed in 2001 to about 130 per year, said Rick Boothman, a former
trial attorney who launched the practice there."
   This is not to suggest that doctors and nurses need to say, "boy, I sure did screw up. You ought to sue me and this hospital." It’s to say that sympathetic identification with the pain of the person who feels wronged is the right thing to do. In any case, to say, at least, "I’m so sorry for all your discomfort" is hardly an admission of legal liability.
   Kimberly Johnson may have said it best and most succinctly, "Never ruin an apology with an excuse."  It’s such beautiful wisdom.
   The real basis for a loving apology lies not in the law but in love. When we recognize that the other has been hurt and feels disrespected by something we’ve done, we discover we don’t need to offer excuses. We need to be present to the pain of the other.
   I discovered early in my career in hospital administration that the more I tried to defend my hospital to angry patients, the angrier I got. On the other hand, when I would say, with sympathy, something like, "What a shame you’ve had to go through such difficulty," I would almost always notice an immediate softening in the attitude of the other.
   Love calls us to identify with what another person needs from us, not what we need from them. There will always be time for explanations if that is what is needed. First, a wronged person needs to feel heard. The "I’m sorry, but…" opening can sound very much like "I’m sorry, but I’m not sorry."
   The truth is, most caregivers need to learn the art of apologizing. It’s natural for the nurse on the understaffed floor to try and avoid responsibility for something she feels is not her fault. The object of her complaint about staffing needs to be her supervisor, not her patient.
   Loving apologies call for courage as well as caring. The surprise is how effective unqualified apologies can be. When offered in a caring way – a true apology can be a way to absorb a patient anger rather than to push it back – and in so doing to begin dissolving that anger. Apologies can heal. They can shine the light of love into the lonely corners of perceived injustice.

Spiritual Practice: The next time you feel you’ve offended someone, try the unqualified apology – with friends  and family as well as with co-workers, bosses and patients. Think about it from the standpoint of what the other person is feeling. Sincere concern for the other will help you find the right words to use.

-Erie Chapman