Recognizing how labels shape narratives in prehospital medicine

EMS leaders must be conscious and intentional in applying labeling lenses to patients and providers


As I was walking into a meeting with some people I’d never met before, a friend whispered in my ear, “Just so you know, she’s religious.” I presume that my friend was either looking out for me – so that I didn’t commit a social mistake – or looking out for her – hoping that I’d be less likely to say something offensive. I’m not sure, as I didn’t have time to ask what he was hoping for.

The problem with my friend’s well-intentioned heads up is that it created a perceptual filter through which I viewed this person. I instantly considered how I should communicate so that I was not offensive or inappropriate to my view, creating in my head a story about what a religious person would like or not like.

The labels we use are a mixed bag. In some ways, they can be helpful. The term “abused child” was not part of the popular lexicon until pediatric psychiatrist C. Henry Kempe published an article in The Journal of the American Medical Association titled, “The Battered Child-Syndrome.” Even though there were countless acts throughout history that could be described as child abuse, without the label, children’s broken bones were treated and they were sent back into the abusive situation without intervention. With the label applied, we diagnose, treat and protect children from psychological abuse, physical abuse, sexual abuse and neglect.

Remember; good medics, conservatives, liberals, religious people and animal lovers are much more than their labels. (AP Photo/Julie Jacobson)
Remember; good medics, conservatives, liberals, religious people and animal lovers are much more than their labels. (AP Photo/Julie Jacobson)

On the other hand, labeling a patient as “the femur in room 3” has a depersonalizing effect that often results in a poor patient experience. Nicknaming one of your bodybuilding medics “muscle head” might cause people to imagine he is not very intelligent, even if he is.

Labels color the lens of leadership

As leaders, we need to be careful when we have the impulse to label someone. That goes for any label. Imagine being involved in a rollover car crash where you’re knocked unconscious. As you start to wake up, picture the face of one of your “bad medics” looking down at you. Chances are the “bad medic” label will stick to that person like super glue for the rest of their career. That feeling you have when imagining their face looking down at you is probably the same feeling you have when they clock in late or when the charge nurse from the local hospital calls to complain. Everything you hear, see, or think about them is filtered through the lens of their label.

Switch scenarios and imagine the face of one of your best medics. When the charge nurse from the trauma center calls to complain about this medic, it’s likely that your first thought is something like, “This is a nurse problem, not a medic problem.” When the “good medic” comes in late, you’re more likely to presume that they had a good reason for being late. It’s human nature.

Filling in a story about a person based on a label is natural and automatic. The opportunity is to notice the narrative you make up and to avoid believing it. It’s a setup for problems if you treat someone as if the narrative you made up about them based on their label is true. Think about someone who is labeled a “drug-seeker.” What image comes instantly to mind? What narrative do you have about drug-seekers? Is drug-seeking an illness? Does it usually relate to addiction? Are drug-seekers weak willed? Will drug-seekers try to manipulate you to get what they want? Notice how easy it is to answer these questions.

Now let me ask you something personal. Have you ever taken a Tylenol or an antacid? If so, you sought that medication, that drug. Which make you a drug-seeker. I’m one too. Some of you are thinking, OK you got me. Others are thinking, not that kind of drug-seeker, I mean the addict. Whatever you think, the label becomes a filter that colors your perception.

Be conscious, intentional about labeling

One strategy is to become aware of our natural tendency to use labels and to be conscious, intentional and helpful with our labeling of others. Remember; good medics, conservatives, liberals, religious people and animal lovers are much more than their labels.

What labels do you claim in the world? Which ones could accurately be applied to you? There are several labels that accurately apply to me including dad, vegetarian, balding, author, former paramedic, associate professor, Buddhist, fat, Californian, registered Green Party member, liberal, meditator, martial artist, husband, committee chair, conference speaker, former boss, friend, student, mentor, Jewish, consultant, leader, employee, Dead Head, team member, reader, Caucasian, improvement guide, spiritual, facilitator, award winner, American and more. Chances are, you can pick any one of these and make up a narrative about me. I would not recommend trying to make up a narrative with all of them, it could cause hallucinations.

The reality is, there is only one of these labels that I’m comfortable putting out there. Only one where the default common story that people will make up about me aligns with who I really am. That’s student. What label most accurately identifies you?

[Read: What EMS leaders need to know about unconscious bias]

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