An effective apology involves a delicate balance between tact, tone and timing. In high-stakes settings, when jobs and reputations are on the line, it can be even harder. The significance of an apology can vary in different settings and professions.

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This is TALK OF THE NATION. I’m John Donvan in Washington. Neal Conan is away. I was heading out to do an errand a while back and I decided to drive, and as I approached my car, which was parked in the street, I walked up from behind and, drat, I spot the rear taillight has been smashed, somebody obviously trying to park behind me had bumped into it and cracked it open.

And of course now there’s nobody parked behind me, that space is empty. So whoever did this is long gone. And I’m really annoyed as I head to the driver’s side door to get in until I notice a note had been left. I am sorry I damaged your car, it reads. My phone number is da-da-da-da-da-da-da. Wow, it can still happen, fessing up to a mistake, saying I’m sorry.

And you know what? I forgave whoever did this instantly, and I didn’t even call the number. It’s true, apologies can be hard to pull off in any setting to friends or to spouses or to people whose taillights you might wreck. Some of us can do it, though. But there is one setting where saying I’m sorry can really get you into trouble, and that’s when you’ve made a mistake at work.

Say you’re doctor, say you’re sorry, and you could get sued. But some doctors and people in other professions are now beginning to push back against the no-apology reflex with some good reasons, and we’re going to get into those reasons. And we want to hear your story on this. Did you ever owe a patient or a client or a customer an apology? And did you carry through? Our number is 800-989-8255. Our email address is And you can join the conversation at our website. Go to, and click on TALK OF THE NATION.

Later on in the program, the gut-wrenching science behind hot peppers. But first Dr. Manoj Jain, who wrote a recent Washington Post article that was titled “Medical Errors are Hard for Doctors to Admit, But It’s Wise to Apologize to Patients.” He is an infectious disease specialist in Memphis and a Washington Post contributor and joins us from member station WKNO there in Memphis. Welcome back to TALK OF THE NATION, Dr. Jain.

MANOJ JAIN: Thank you very much, John.

DONVAN: So what was your error? What was the medical error that you were writing about?

JAIN: So, you know, some years ago, I was called at about 3 A.M. in the morning by the nurse at the hospital, and she told me my patient was having a fever of 103 and writhing in pain. And as I often get a little bit of a history, and I ordered some antibiotics and some Tylenol. I gave the patient Levaquin and Vancomycin.

And then about two hours later, at 5 A.M., the nurse called me now, and she was frantic. She was quite concerned because now the patient was having welts and was wheezing and had developed a tremendous rash. And I asked her: Just read me the note that I had just written. And in the note was a note that I had written saying allergies to Levaquin, the very antibiotic that I had ordered.

DONVAN: So you had totally made a mistake, and it was totally your fault.

JAIN: It was totally my fault.

DONVAN: So what did you do?

JAIN: And, you know, when that happens, I had this deep sense of embarrassment, guilt and fear all at the same time. I was embarrassed because of the very fact that I had made an error. I’m a doctor. I’m a professional. I want to do the right things for my patient. But I had made an error.

I was guilty because I had caused harm, suffering, which was avoidable to my patient. And then also I had fear. I was feared about litigation, a lawsuit that could happen from this whole thing.

DONVAN: And in terms of action – so that’s what happened inside you. In terms of action, what did you do?

JAIN: So at – then I went to the hospital at that very moment. I saw the patient, and she was in a terrible situation. I ordered the appropriate medications, and then I apologized to her. I told her that I had made an error, and at that time I didn’t know very much about medical errors disclosure. And I just fessed up to making the error.

Now we know that we need to not just say that we’ve made an error, we need to take responsibility, we need to apologize, but we also need to tell the patient what we will do in order to not have this happen again.

DONVAN: I’m interested that you just said now we know, which means you’re talking about there was a time when that wasn’t the standard practice. So I’m curious, back when this occurred, it sounds like several years back, and you did apologize, did your colleagues know that you had done that, that you’d admitted the mistake and apologized? And if so, what did they say?

JAIN: Sure, so I wrote about this in the local paper, and some of my colleagues said why admit to the mistake? You know, you know, it just happened, it’s something that happens in our day-to-day life as doctors. But I had a deep sense in me – and I think many doctors do – that when something like this happens that you feel guilty, and you want to share that with the patient and be open to them.

And when I started talking about this, I found that there was a great deal of literature and also policy changes that were happening in order to have doctors disclose medical errors.

DONVAN: What’s the case – I’m not saying that you shouldn’t disclose, but I want to know what’s the argument being made that you should, other than a sort of it’s the right thing to be honest.

JAIN: I think one aspect of why we should do it is because it enhances doctor-patient relationship. You see, the doctor-patient relationship is based on trust. And if we can enhance that trust by having the patient become aware of an error that may have happened, you know, at a later point the patient may find out that there was an error. And what if they realize that you as a doctor didn’t tell you about that error? That would be horrible for the patient.

DONVAN: So she forgave you, this patient?

JAIN: She did. You know, she was very understanding. And, you know, I presented the situation, and I was quite empathetic about, you know, the situation as well. And patients very often understand that doctors are doing their best in very difficult circumstances.

I had a case of – a conversation with a surgeon when I told him about my situation, he told me how he at one point had left a sponge in a patient’s chest after doing surgery. And at that time…

DONVAN: That just sounds like a nightmare if you’re a doctor.

JAIN: That’s a horrible situation. And then the surgeon went up to the family, discussed the situation, told them honestly what had happened, and he offered to have another surgeon take over the case and obviously waived all the medical charges. The family elected to have that same surgeon do the surgery again.

DONVAN: So he said you don’t have to ever deal with me again because I’ve caused you harm, and they said, no, we still want you because you’ve apologized?

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JAIN: And you’ve apologized, and they did not file a lawsuit.

DONVAN: We’re also asking our listeners to call in, people who have been in a professional situation. It doesn’t have to be medicine, but it can be medicine, where you didn’t do what you were supposed to do, and it caused harm, and you were faced with the question of whether to, number one, admit and, number two, apologize. And those two things are not exactly the same thing.