Life In The Hospital

Controlling The Epidemic Of Outrage

Outrage is one of those human emotions that when used sparingly is useful to separate the most egregious violations of social norms from the constant background of minor social violations. This applies to whether you are working in a hospital or anywhere else. But in excess, outrage can be lethal to workplace culture. We live in an era when outrage surrounds us, whether it be Twitter-tantrums, toxic comments posted to news articles on-line, or angry pundits on TV news commentary shows. We have become saturated with outrage.

Outrage will burn you out

I recently listened to a podcast by a radiologist who had embraced the F.I.R.E. movement (Financial Independence, Retire Early). The radiologist had become burned out less than 10 years into his practice and viewed work purely as a means to retirement; in fact, he did not like his job and wanted to retire as soon as possible, preferably before age 45. After listening to him, I don’t think it was his job that he did not like, I think it was his life that he did not like. He said that he was able to tolerate continuing to work by stopping listening to commentaries on TV and stopping reading news feeds on-line. I think it was the constant barrage of TV and on-line outrage that had been making him unhappy and contributed to him being burned out.

Outrage is contagious

Outrage provokes a response in us when someone fans the fires of our opinions into a conflagration of anger and incredulousness. So what happens when you are told something that sets you into a fit of outrage? You tell it to your buddy sitting next to you in a bar. Or you re-tweet it to your Twitter followers. Or you send a link to a website to your family members. 15 years ago, the contagion of outrage spread slowly since you would have to wait until the next evening when you’d be meeting with your friend at the bar. Today, a pandemic of outrage can occur almost instantaneously via email and Twitter. It is said that 1 person infected with measles will then infect 9 non-immunized people on average. Today, one person infected with outrage can then infect a thousand people within an hour.

Outrage is addictive

We get rewarded for being an outrager. When we post something outrageous on a blog, we get more website visits. When we tweet something outrageous, we get more re-tweets and then other people tweet back equally outrageous tweets and pretty soon we are in a vicious Twitter cycle of  perpetual outrage, a growing vortex of fury burning through the internet. When a commentator says something outrageous on TV, he or she get more viewers. The attention feedback that we get for generating outrage has operantly conditioned us to generate more outrage. If you are listening to a news channel on cable TV, you will likely start daydreaming when the host is talking about a new fruitcake recipe but as soon as they bring on a far-right or far-left news pundit, you will snap back to attention. Outrage makes us feel alive.

Outrage is exhausting

Our emotions need balance, like Yin and Yang. If we spend too much time being outraged, then our emotions become out of balance. It takes a lot of psychological energy to be outraged and if you spend all of that energy being outraged, there’s little left over for all of the good things in life, like your profession or your family. Moreover, if you get all worked up being outraged all day, you can’t fall asleep that night and you end up being chronically sleep-deprived.

Outrage is poisonous

Sometimes, outrage can be unifying, to bring together a group of people for a common goal for the good. For example, when a community comes together after a particularly heinous crime. Or when a football team gets fired up to perform better after a particularly flagrant foul by the other team. But outrage can also be dividing. For example when it comes to politics and religion – both of which can intersect in hospital practice. And when outrage divides us, it can poison team-building efforts and derail interspecialty collaboration.

Outrage is distracting

When we become angry, our minds focus on that which made us angry and we can lose sight of our other tasks. This can foster mistakes and errors in judgment. Working while outraged is like driving while intoxicated.

Professional outragers versus amateur outragers

There are two types of professional outragers. There are those who get paid to be as outraged as possible – the radio political commentators whose voices’ raise as they incredulously mock people of the opposite political party. Then there are those who are paid to enable outrage in others – the TV news commentators who bring people with different opinions about a news item on their show and catalyze them into a shouting match on live TV. These are people whose job it is to be outraged or to create outrage and if they don’t, they lose their job.

Amateur outragers are different – they don’t get paid to be outraged or create outrage, they just do it because they enjoy it. These are the internet trolls who post demeaning comments on blogs and internet chat rooms. The are usually anonymous and for them outrage is a hobby rather than a career.

Fortunately, there are ways to lessen outrage in our hospitals and our workplaces.

  1. No tweeting on the job.
  2. Use work computers for work and not for surfing posted comments on websites.
  3. Keep waiting area and employee lounge televisions on cooking-related channels and home improvement channels; not on news channels
  4. Keep political campaign advertising out of the building
  5. Wait 10 minutes before responding to a “hate email” from someone who is enraged about something
  6. As leaders in the workplace, we need to ration our own outrage so that we set an example for the rest of the employees

I personally do not like being outraged and I have adapted my lifestyle to minimize outrage. I am not on Twitter. I read the local morning newspaper and then do not look at news shows or internet news feeds for the rest of the day. I avoid reading internet articles that encourage viewers to post comments. I flag “hate emails” to come back to later in the day or on the following day, after my emotions (and the email’s author’s emotions) have settled down. I don’t put our hospital’s amateur outragers on hospital committees. I don’t listen to news shows on the radio in the car. And maybe most importantly, I created this blog as a way of cleansing my soul when faced with events that could fester and ferment into outrage if I didn’t reflect on them and analyze them.

Save your outrage for the stuff that really matters and then use your outrage sparingly.

November 3, 2019


By James Allen, MD

I am a Professor Emeritus of Internal Medicine at the Ohio State University and former Medical Director of Ohio State University East Hospital