A Different Perspective

Hi again, Christine here. I have another confession to make. I am a recovering apologizer. Don’t know what that is? Sorry, I always assume… Oops. Thanks for listening. Let me try that again.

Apologizers are those people that are always saying sorry to you. For me, it got so bad that if you looked at me wrong, some variation of “I’m sorry” came out. Work colleagues, friends, family, significant others – it drove them crazy. I frequently heard: “What do you have to be sorry for?” I would mumble something about sympathy for what they were dealing with, not really meaning it. If I had to guess, I think this stemmed from not wanting to be a burden or create problems. I didn’t think about it. It was just me.

Then I did my fellowship. Suddenly, I was on the receiving end of the apologies. As soon as I heard “I’m sorry”, I looked for fault in what had been done before and reasons I shouldn’t have been called, searching for the answer to the question I had been asked so many times: “What do you have to apologize for?


Noticing this, I started paying a little more attention to my feelings when I said “I’m sorry”. When I actually needed to apologize (because I had done something wrong), I felt a little ashamed, but also relieved after being forgiven. But, comparing this to most of my apologies, my feelings were quite different.  When I apologized just to say, well, something, I felt myself physically tense up and become defensive as I spoke: as my mind said I’m sorry as a way to ward off any attack, my body was preparing for the attack… just in case!

At work, this tended to happen in three main situations: when I couldn’t give someone (usually a patient) what they wanted, when calling a specialist for a consult, and when patients have been waiting for a long time to be seen. I felt like I needed to say something in these situations, to justify my contributions, but then I began to wonder – why am I putting this added pressure on myself? I didn’t like how I felt when I said “I’m sorry” so these didn’t seem like the right words to use. I wondered what else I could use?

My default response to any problem is to do research. There is a lot of psychology behind all this and all of it is available on the internet somewhere. I’ve put some links at this end of the blog but what I discovered was:

  1. Constant apologizing puts both people in the conversation in a negative frame of mind.
  2. Apologizing puts you in a subservient position in the relationship. Doing it constantly causes the other person to lose respect for you.
  3. Women tend to adopt this behaviour more readily than men.

It turns out my apologizer behaviour had been negatively affecting my personal and professional interactions, whilst simultaneously making myself feel bad. I realized something needed to change, but how?

In contrast to apologizing, saying “thank you” affects people this way:

  1. It makes the recipient feel positive as we all like to feel we are helping others.
  2. You appear to be a warmer person and are likely to have a better interaction.
  3. Saying thank you makes you feel better because you practicing gratitude, recognizing you are being assisted and supported.

So let me go back to those situations in the Emergency Department and try to deal with them one by one:

Dissatisfied Patients:

Firstly, I now recognize that I can express empathy for the frustration that the patient (and sometimes I) feel without using the words “I’m sorry”. Instead, creating a plan for going forward puts the patient and I on the same page. For example,

“I can tell it’s frustrating to you that you can’t get this MRI today, so I’m going to get you scheduled for an appointment with a primary care physician who can order it and follow-up on the results.”

Much of the time, these people have been going around in limbo and are in my ED because they don’t know what else to do, so they respond positively to having their feelings validated and a plan worked out.

Calling for a Consult:

While I hear all the time that women apologize more than men, almost every person who calls a consult in my ED apologizes when the specialist calls back. I remind my learners all the time: you are calling someone who is on call – it is their job to call you back. phone-315140_1280If they don’t call you back in a timely fashion, you would be upset and the specialist would have to apologize to you. I think we apologize in this situation because we are taking up the specialist’s time and attention, two precious resources, and we want to be worthy of using them. Instead though, I have taken to saying “thank you for calling me back” as I try to flip around all those interpersonal problems I discovered in my research. Now, instead of starting the conversation with one person on the defensive and the other looking for fault, when I say “thanks for calling me back,” we start with two people feeling a little more positive towards each other and on the same side, which is always going to be better for patient care.

Patients who have been Waiting:

The third situation is probably the toughest for me. Much of the time, I didn’t do anything to cause the patient to wait to be seen; there are just a lot of people in the ED and I am moving as fast as I can. In my research, I found a study that suggests apologizing for things that are obviously not your fault that have affected the person, like the weather or traffic, can increase the recipient’s trust in you. I want to apologize, but about half of the time, hearing “I’m sorry” seems to put patients on the attack, creating a difficult interaction, while the other half of the time, I see the patient deflate from their prepared attack and start to work with me. Despite the possible benefits in this situation, I know how negative I feel when I apologize when I didn’t do anything wrong. Instead of “I’m sorry,” I do a combination of what I do in the other two situations:

“Thank you for patience. I know how frustrating waiting to be seen is. How can I help you now?”

These changes have served me well and I have made similar changes in the rest of my life. Most of my apologies are when I think I have been a burden on someone and I hate that feeling. Substituting “thank you” much of the time, as the cartoon artist Yao Xiao demonstrated in a fantastic piece in late 2015 (10), means I am overall more positive towards myself since I’m less often seeking reassurance and approval from others about the choices I have made.tulips-2152979_1920

Oh… and when I do need to apologize, my words are more genuine and sincere.

Thanks for reading this. I hope you got something out of it, and if you’re interested in knowing more, check out the links below.




  1. http://www.chicagonow.com/conversations-soapbox/2016/05/the-psychology-of-thank-you-vs-im-sorry/
  2. https://www.ncbi.nlm.nih.gov/pubmed/20855900
  3. https://www.fastcompany.com/3032112/sorry-not-sorry-why-women-need-to-stop-apologizing-for-everything
  4. http://www.unlimitedloveinstitute.org/downloads/12%20Altruism,%20Happiness%20and%20Health%20IJBM%202005.pdf
  5. http://journals.sagepub.com/doi/abs/10.1111/1467-9280.14461
  6. http://citeseerx.ist.psu.edu/viewdoc/download?doi=
  7. https://greatergood.berkeley.edu/pdfs/GratitudePDFs/2Wood-GratitudeWell-BeingReview.pdf
  8. https://www.ncbi.nlm.nih.gov/pubmed/25111881
  9. https://www.hbs.edu/faculty/Publication%20Files/Brooks%20Dai%20Schweitzer%202013_d2f61dc9-ec1b-485d-a815-2cf25746de50.pdf
  10. https://www.boredpanda.com/stop-saying-sorry-say-thank-you-comic-yao-xiao/?utm_source=google&utm_medium=organic&utm_campaign=organic
  11. http://journals.sagepub.com/doi/abs/10.2466/pr0.1967.20.3.687?journalCode=prxa

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