Healthcare CommunicationHealthcare WellbeingMedical EducationSMACCHealthcare wellbeing and Medical Error

Healthcare Wellbeing and Medical Error- Breaking the silence: Sara Gray

Sara Gray works in the Intensive Care Unit and sometimes connects with patients. This was especially true for a lady who was in her unit intubated due to pneumonia. When this patient experienced a failed extubation, a tricky re-intubation and subsequent tracheostomy, Sara was kicking herself. She says we have all been there…

Have you ever dropped your phone? What was the internal dialogue in your head at the time? Sara calls this out inner voice.

She used to think that our inner voice did not matter to high level medical performance or resuscitation skills. That was until the evidence changed her mind. The inner voice is powerful. A negative inner voice can increase anxiety, raise the heart rate, and use up valuable cognitive processing power.

So, when running a complicated situation, your inner voice matters! For Sara, the critical soundtrack of the inner voice was constant. Her question was – how do I change this?

This led Sara to the concept of self-compassion.

She explores how she trained the inner dialogue, which is a skill to learn and practice. Self-compassion has been shown to reduce the heart rate, reduce sympathetic surges, reduce stress induced immune responses and in practical terms make your hands shake less when is high stress environments in the ICU. Sara expands on the benefits. She suggests that once you are a competent clinician with good theoretical and procedural skills, it can be hard to take it to the next level. However, serious psychological skills are all part of excellent bedside resuscitation.

When reflecting on her experiences in her practice, Sara highlights how medicine views calling for help as an act of weakness. In a profession where tiny mistakes lead to life and death consequences, staying silent can lead to shame and isolation. This in turn manifests as burnout, depression, addiction, and suicide. Everyone in healthcare is at risk. It is the price of a culture of silence. The answer to reverse this includes self-compassion. Self-compassion is not a light switch – rather it is something you must work at and practice. Sara tells a story that everyone in healthcare will relate to and walks you through examples of useful resources to assess and work on self-compassion.

After this talk learn to listen to your inner voice, practice self-compassion and use skills and empathy to take care of yourself and your community. Self-compassion can make work performance and life better.

We hope you enjoyed Healthcare Wellbeing and Medical Error- Breaking the silence by Sara Gray. For more like this, head to our podcast page. #CodaPodcast


Resources to consider:

1. This is Dr Kristin Neff’s website, complete with a self-compassion quiz, and then exercises and resources for those who fail the quiz! She also has a book if you prefer that format.

2. Pema Chodron. Fail, fail again, fail better. A short, and lovely commencement address with excellent advice for failing better.

3. Angela Lee Duckworth. Grit. A marvellous book about the essence of perseverance. Or if you don’t like books, consider her TED talk at

4. Brene Brown. The Gifts of Imperfection. A book about failure, and acceptance of failure. Again, if books aren’t your thing, she has a hugely popular TED talk about vulnerability: and a website/online learning community:

Sara Gray

Sara Gray works in Toronto at St. Michael Hospital. She divides her work between Emergency Medicine, Critical Care, wellness programs, public speaking and professional coaching. But her real life revolves around her family, soccer, books, puzzles, sports, travel, friends, cocktails and food. Probably in that order.