In a new book from Oxford University Press, The Elephant in the Room, Rutgers sociologist Eviatar Zerubavel explains more broadly what I've been noticing for quite some time in medicine, something I've called the anechoic effect. Why is it that folks can behave like such miscreants and everyone turns a blind eye?
Turns out there is a real science, and tons of data, behind the mechanism for this phenomenon of "conspiracies of silence." I plan to read the whole book, having just read reviews and excerpts so far. But I want to bring it, in the meantime, to the blog readership's attention.
In the book notes, the author (or his editor) notes that, unlike the parable of the Emperor's New Clothes, "the denial of social realities--whether incest, alcoholism, corruption, or even genocide--is no fairy tale." Further, "the longer we ignore 'elephants,' the larger they loom in our minds, as each avoidance triggers an even greater spiral of denial."
In a useful explanation of his approach to selective memory, presented to the University of Virginia several months ago, Zerubavel talks about the "sociology of attention," in which the intensely social activities of remember things, "telling on" one's colleagues, and whistle-blowing (another, even more fraught form of "telling on") all become susceptible to "denial and oblivion."
Do things like this happen in healthcare? Let us know what you think.
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