I’ve been following this conversation started by the Grammar Girl:
“I was a guest on a podcast where kids asked two people questions to decide who was the fake and who was the real expert.
The host said that early on, the kids thought the fake was the expert every time because the actors answered every question confidently, and the experts would hedge or even sometimes say, ‘I don’t know.’
They eventually told the fakes to be less confident so the kids would have a chance of picking the expert sometimes.”
The Grammar Girl’s post was making a point specifically about ChatGPT, but the sentiment can be applied more generally, and in our case to the field of lactation and other perinatal care providers.
Some of my favorite comments on the Grammar Girl’s post include:
Never trust an expert who isn’t willing to admit that they don’t know.
Experts know that there are sometimes variables or gray areas, thus they don’t answer in terms of absolutes.
That makes me think of how an intelligent person (possibly an expert in something) is still curious and open minded enough to not always be sure of everything.
Those who are experts, look before they leap, stop before they comment, ask for help and do their research. Saying ‘I do not know’ is a strength.
It reminds me of the quote: ‘The enemy of knowledge is not ignorance, it is the illusion of knowledge.’
Individuals on the perinatal care team can get stuck in a rut where humility is absent, and this can become dangerous for their patients.
Debra Bingham of PQI, in a recent newsletter, reminds us of physiologic humility.
“Perinatal health professionals work tirelessly to provide the best care they can. Unfortunately, sometimes we get stuck performing “strong but wrong” routines. For example, we have centuries of evidence to tell us that physiologic birth practices are key to having the best outcomes. Yet, too often we do not practice what I like to call physiologic humility. Humility that the physiology of a woman’s body before, during, and after giving birth is complex and typically works well on its own. Thus, we should proceed with physiologic humility because there are so many limitations in our knowledge of the complex physiologic processes related to birth …
As perinatal health professionals it is our responsibility to do everything possible to ensure that women in our care get to experience Mother’s Day. Especially this month, may we all continue to keep that in mind and as a top priority.”
In all fields of care, cultural humility must also be maintained. As defined by the National Association of County & City Health Officials (NACCHO), cultural humility (CH) is “a lifelong process of self-reflection, used to better understand the multi-dimensional identities of clients in order to establish and maintain respectful, healthy, and productive relationships.” NACCHO’s Shifting the Care Paradigm Fact Sheet describes how lactation care providers can partner with families and their community to understand individual patients’ cultural background, experience and personal challenges, and specific goals.
In the U.S., perinatal care is often siloed; however, this trend seems to be evolving as care becomes more collaborative. Collaboration requires all care providers to exercise a level of humility, offering their expertise while respecting and hearing out other members of the care team. Most importantly though, care team members must work together to respect their patient’s wishes and facilitate informed decision making.
“Absolute certainty leaves little room for shared decision-making,” the author of Humility and the practice of medicine: tasting humble pie points out.
The author later concludes that “the cultivation of humility is often painful and requires a high level of self-awareness and reflective practice.”
A challenge indeed, but worth the effort. Consider “taking a bite” of “humble pie.” [Chochinov, 2010]