Rule 276 - Never point or shake your finger at a patient

If you do that, please stop it. If you don't know if you do it, ask a friend. If you don't have a friend, make one.

This rule comes from Dr. Clifton Meador’s A Little Book of Doctors’ Rules, a book I received early in med school. What follows is an examination of Dr. Meador’s 276th rule: Never point or shake your finger at a patient. If you do, please stop it. If you don’t know if you do it, ask a friend. If you don’t have a friend, make one.

If you like this post and want to support me - click the little heart (either at the bottom or top of this article), leave a comment, and/or subscribe for free if you have yet to subscribe!

_______

Why no finger-wagging? Well…the short answer is you’ll come off like this guy.

This is Principal Vernon from the classic John Hughes film The Breakfast Club. If you haven’t seen it, I cannot recommend it enough. Just wait to watch it until after reading this essay…

Here’s a quick synopsis – Molly Ringwald, Emilio Estevez, and others attend Saturday detention which is overseen by Paul Gleason as “Principal Richard Vernon.” It’s a coming-of-age tale where an unlikely band of teenagers find camaraderie with one another and rebel against their domineering principal.

When I first read this rule, I thought of Vernon – a picture of finger-pointing and chest-puffing. He does this throughout the film and is a character I want to use to flush out Rule 276. So…let’s dive in!

Lessons from the Big Screen

Here’s a question for you: shouldn’t we root for Vernon?

Vernon is the clear antagonist in the film. We, the viewers, root for the teenagers to rebel against his authority and outsmart him at every turn. Yet, if you take a step back, isn’t it obvious that we should root for Vernon instead of against him?

It’s his job to instill discipline in these kids, and discipline isn’t a bad thing at all. Discipline is the “thing” that is essential for someone to set and reach goals. It is a necessary quality to better yourself. These are good and noble pursuits. For example, he assigns a 1000-word essay at the beginning of the movie where the kids must describe “who they think they are.” You could argue he’s trying to get them to think about their future, who they want to be, and who they could be. This is something worthwhile and helpful, especially for those maturing into adulthood.

However, as the film progresses Vernon’s finger-wagging and chest-puffing increase and his words ring more and more hollow. This is evidenced by this famous scene with Judd Nelson. If you watch this clip, just know there’s some language.

Watching that clip, you get a confusing picture of Vernon, “the authority figure.” He acts as if he doesn’t care and doesn’t want to be there. He doesn’t accept any responsibility (blaming Emilio Estevez for the door stop fiasco) and berates Anthony Michael Hall, calling him “peewee.” Yet, he takes the time at the end of the clip to drop some wisdom on Judd Nelson, saying that he should spend more time on himself and less time trying to “impress others.” Which is objectively good advice.

But do we buy it? No. Not because Vernon is wrong, but because his actions don’t match his words. He domineers, lording over his students like an ineffectual warden. He wears bravado like a faux fur coat. His attitude and weak attempt at a “tough guy” persona eat away at any attempt to mentor his students. As a result, there’s no heft or meaning behind his words. His message, even if it aims to counsel, falls on deaf ears. This is because finger-wagging seeks to dominate, not communicate. It soils any attempt at guiding, consulting, or communicating. Therefore, he fails at his role.

By the end of the film the kids find a sense of belonging, and in a way start to form the answer to Vernon’s essay question at the beginning of the film. Not because of Vernon’s antics, but in spite of them.

“From” and “With”

Do we root against him because he is “the authority,” or due to how he wields his authority?

It’s both…but in the context of this rule and the movie, Vernon is ineffective more so because of how he uses his authority, so I am going to focus on that.

Vernon’s fatal flaw as a character is that he continually speaks from his position of authority, not with it.  In other words, he uses his position of authority to support his authority – which creates shaky ground from which to speak and act. It is both unconvincing to the students and lazy on his part. His actions seem to say, “I’m the principal so you have to listen to me because I’m the principal.” This doesn’t breed confidence but instead breeds insecurity because he’s nothing to stand on but his title. So… Vernon turns to pointing fingers and talking tough.

Now I’m not saying that positions of authority aren’t important that shouldn’t be taken seriously - quite the contrary. They are extremely important. These positions serve as important distinctions; they are privileges. It is not Vernon’s right to be a principal, it is his privilege, and privileges can be rescinded. This means that his position of authority is something that must be continually earned.

“From” vs “With”

This then begs the question:

What does it mean to continually earn authority?

It means that you speak and act WITH authority… not from authority.

How do you make the transition from “from” to “with”?

First, your actions must align with your words. Put simply - do what you say and say what you do. This is something Vernon fails to do. Why would you take advice about maturing from someone who acts immaturely?

Second, you don’t use your authority to support your authority. Failing to do so eventually creates a lack of confidence and insecurity; a void that Vernon chooses to fill with finger-pointing and authoritarian tough talk. Not the best choice because he’s, rightfully, not taken seriously.

Instead, fill that void with experience, knowledge, and virtue. Jumping back now to the world of medicine, experience is gained through reps and time (one of the reasons residency exists after medical school). Knowledge is earned through rigorous studying both in school and outside of it. Studying and learning never stop throughout your career. Virtue is gained through moral reasoning and introspection. These are the things that will build a solid foundation from which to work, erasing the urge to shake fingers and establishing sound patient relationships built on respect and the mutual goal of improved health.

Speak with authority, not from it

To conclude, a white coat and the title of “Doctor” is a privilege. It’s something that is earned through years of hard work. This special title doesn’t grant you the knowledge, the experience, the virtues…it’s the other way around. Therefore, you must continually earn it by striving to hone your craft - to improve. And you can’t improve from a place of insecurity.

Insecurity and self-doubt create a void that’s easily filled with the false sense of security finger-pointing provides. But finger-pointing and its ilk create a barrier between you and your patient. No matter how hard you may try, as long as your fingers are drawn you won’t be able to reach your patient in any meaningful way. So holster those fingers and instead speak with an authority built on your virtues, knowledge, and experience. It’s an initial step towards building trust and a strong relationship with your patients.

_______

Thank you for reading this post and supporting my work! Thanks to the great John Hughes for making a tremendous film. And as always thanks to Dr. Meador for the guidance.

If you enjoyed reading this post and want to help support me and this blog - consider sharing with your friends and family, leaving a comment, or hitting that like button! Thanks and see you next Wednesday…

- Tyler