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  1. Ian D Wacogne, Edition Editor
  1. General Paediatrics, Birmingham Childrens Hospital, Birmingham B4 6NH, UK
  1. Correspondence to Dr Ian D Wacogne, General Paediatrics, Birmingham Childrens Hospital, Birmingham B4 6NH, UK; ianwacogne{at}

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‘The unexamined life is not worth living.’ Now, full disclosure, I have to declare that it was not my brilliant memory, but a search engine which told me that this was Plato, recalling the words of Socrates (at his trial for impiety and corrupting youth, which are interesting ideas, but a couple of threads of thought that I won’t be following here). I’m presuming that you mostly live examined lives. It’s one of the duties outlined by our professional bodies. It’s also one of the reasons you’ve opened this journal, or clicked to access this page. The desire to know more, understand better, and improve ourselves is key to our professional development, for the service we provide to children. The trouble with this is acknowledging when we’ve been less than we should have been.

In this edition, in this month’s Editor’s Choice, Hannah Jacob, Anna Baverstock and Camilla Kingdon tackle an issue of profound importance: recognising and addressing rude, undermining and bullying behaviour ( see page 331 ). This was a paper that I handled as editor, but in honesty I didn’t need to do much at all. In fact, if you bear in mind how much I dislike exclamation marks in papers, you’ll see, as I did on reading it again just now, how lightly I touched it. There are at least two that I would not ordinarily have let into the journal… But it seemed particularly important to me for this argument and exhortation to have the voices of the authors particularly clearly. I don’t know, and haven’t asked because I don’t need to know, if these authors have been bullied, but it is clear that they’ve witnessed these poor behaviours and their thoughts about how to manage them in the workplace are really important.

There is something else that I don’t know, and this I definitely have not asked. Have these authors ever found themselves as the rude person, or harasser, or bully? It’s an extremely challenging question to ask, and I’d argue that it is one that we need to ask ourselves. I can only answer for me, and if I’m honest, I think I probably have. More than once. In fact, when I look back on the times in my career when I’ve felt most upset with myself, both with patients and with colleagues, the way that I’d describe it is that it is when I have failed to be kind that I am most distressed. Fleur Adcock’s brilliantly concise poem ‘Things’ describes this hot flush of shame and is absolutely worth a few minutes of your time. Of course, this does the old trick of making the issue about me, but in self examination I do need to talk about myself. Now, any student of team factors will tell you that nearly no one goes to work intending to do a bad job, and I’d argue that few go to work intending to be rude or to bully.

This issue is hammered home in one of their references, which was a combination of absolutely shocking and completely obvious, and likely as true today as it was when it was published 5 years ago. Riskin et al showed in a well designed randomised trial that simple rudeness made a team perform worse (Riskin A, et al. The impact of rudeness on medical team performance: a randomized trial. Pediatrics 2015;136:487–95). And we know that when teams perform less well, patients come to harm.

So, here’s a transparently self-directed mid-wintery message. After quite a year, when many of us have been subjected to rather a lot of stress, and have any number of excuses for short temper, snappiness, and general incivility. Take a breath, pause, and ask yourself (Ian): ‘Could I be kinder?’


  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.