I recently attended a very large professional conference. In a rush to make it everywhere and yet feed myself, I was running to get breakfast before the sessions and spilled the majority of this much-desired coffee all over my shirt. Here I was, standing with an impressive, unmistakable, impossible-to-hide giant stain of dark liquid spreading across the front of my solid blue shirt and sleeve with nothing to hide it.

It was a full-scale, front-row-worthy disaster, the kind of stain strangers notice before you notice them. The kind of stain that screams “I spilled my whole cup of coffee,” either due to sheer inexperience or incompetence of handling coffee and conference attendance at this point in my life. My first thought was immediate and familiar:

“What an idiot. Now everyone will see this. I can’t even handle my coffee or present clean and professional. What will they think?”

This was followed by the realization of a complete lack of time to deal with it. My choices were to either proceed to the conference sessions I paid for with a full-on stain and focus on my goals of professional development while managing stares, or try to return to the hotel room to change, hiding my clear incompetency of handling coffee cups and missing out on the learning that I came for.

That internal voice was a blend of many voices over the years and my physician training and career. The blended judgments of supervisors, colleagues, patients, and co-workers toward myself and others that I would be exposed to; the shaming, discarding, and dismissal as defective objects when someone was imperfect, human, or made some sort of mistake that was judged as incompetence rather than humanity.

Shame is defectiveness, something so defective that it deserves to be tossed aside or punished or excluded. Judging self and others as defective is so intrinsic in medical culture (starting in training and continued in practice) contributing to physician burnout, trauma, and overall toxicity of our field, costing us our mental and physical health and opportunities.

I had a choice to make: Hide, run to the hotel room missing out on an educational opportunity, or own my “stain” with everyone who came my way that morning and whatever judgments they may make toward me. So I let the thought linger briefly and walked toward the conference activities, with a giant coffee stain announcing my humanity to the world and owning my “incompetence” in handling coffee cups.

As I moved through the morning in my stained shirt, it dawned on me: This is what real life and medicine is actually like. Not the idealistic version we are led to believe, but the real, messy, unpredictable, deeply human version with mistakes or actions that may leave “stains” we can’t hide. The stain itself is a point of subjective judgment. Some may judge my hygiene and question my “professionalism” based on stained attire and reduce my value or professionalism. Others may relate to it or use it as a connection point or even offer assistance or shared experience.

What some see as mistakes and incompetence may just be human experience that in medicine we are led to believe is defectiveness and an invitation for judgment, gossip, harm, and punishment.

What are the visible “stains” in medicine?

The range of visible “stains” can range from medical or treatment mistakes, scathing online reviews, board complaints and lawsuits, job loss, mental and physical health struggles, crying after a patient case, relationship breakups and divorces, backlog of charts, running late, or chipped nail polish and coffee-stained shirts.

Fortunately, in many places, the judgments are shifting to a more accepting human response. We are moving from “What kind of a psychiatrist are they if they can’t keep their marriage intact?” or “He clearly wasn’t functioning because of his divorce” to “They made a mistake,” “We are all human,” or “We all get complaints; let’s focus on what we can learn here.”

As I walked around with the coffee stain, a passing woman came up and offered me a Tide Pen. I thanked her for the gesture and care. The stain was clearly too giant even for Tide to clean up at this point. We both laughed, and it was a very funny and validating connection. As I thought further, it dawned on me that in medicine when we make a mistake or face a public “stain,” we often are faced with one of three responses from colleagues and people around us:

1. The judgers

These are the people who act as though they’ve never spilled a drop in their lives. They are perfect, never made a mistake, never missed a guideline or had complications or setbacks. They dole out judgment and punishment from their idealistic pedestal, define us based on the “stain” as good or bad, worthy or unworthy, discarding us the instant we are “bad” in their judgmental opinion.

The fact is, no one is perfect and every position of power is temporary. Their perfection is a performance at a cost in other areas of their lives they keep hidden or completely ignorant of. Their criticism is a shield. Their ego is fragile, built on a moral idealistic pedestal with no empathy, compassion, or humanity.

2. The distancers

They look away. They pretend not to see. Not from cruelty or judgment, but from discomfort. They might be uncomfortable with our mistake, stain, or imperfection. It reminds them of their own humanity, or they may not want to be associated with someone so human or “disorganized” or messy. Human imperfection makes them afraid, uncomfortable, and they don’t want to see themselves or their vulnerability in us. Avoidance and ignorance is their defense, leaving us feeling abandoned and alone once our “defect” is public.

3. The connectors

They’re the ones who say, “Oh, I’ve done that too.” The ones who remind us we are not alone. The ones who offer the metaphorical Tide Pen, the ones who offer help, validation, their own past experiences to guide us and motivate us through a setback. They remind us that we are human, this is a temporary experience, how we can learn and grow from this, and don’t leave us alone in shame or discard us. They connect, they validate, they accept, they scaffold us. They know humans are not perfect and for humans to overcome adversity, we need peers. They accept us as human: imperfect, deserving of connection and acceptance and a supportive hand.

The stain does not define us

Medicine trains us to believe that perfection is required, mistakes are moral failures, judgment is inevitable, and so is abandonment and rejection by peers when we make mistakes and that being human is unacceptable and defective.

But the truth is this: Your stain (your mistake, your misstep, your moment) does not define you. How you carry it does. And how others respond reveals who they are, not who you are.

The attending who humiliates a resident for a mistake is not teaching excellence. The colleague who gossips about another physician’s divorce or board complaint is not protecting patient care.

But the physician who admits their mistake and turns it into a teaching moment? The senior colleague who admits their own mistakes and shares it with learners and younger colleagues? The mentor who says, “I’ve been exactly where you are”? The colleague who says “We all made mistakes, focus on the learning”? The colleagues who connect, validate, scaffold, and support? Those are the ones who change the medical culture, shifting us from shame to acceptance and growth.

We are human first

As I walked toward my room, almost forgetting the stain, I wondered: What if we treated ourselves and our colleagues with the compassion we offer patients every day? What if complaints were framed as information and learning points and problem-solving, not indictments? What if we focused more on sharing our mistakes without fear of judgment and punishment? What if physicians could admit humanity without fear? What if our vulnerability was not a liability among our colleagues and patients?

What if a coffee stain didn’t mean I was a disheveled unprofessional physician who cannot manage her coffee and the stain was just that: a coffee spilled?

Imagine if we all, every day, intentionally move away from judging ourselves and others to acceptance and change. Away from shame and defectiveness, toward acceptance, change, and growth. Acceptance of our humanity instead of a dark punitive dungeon of shame; acceptance that we will all at some point have a visible stain.

And when someone else “spills their coffee” (literally or metaphorically) we can be one who responds with connection, not judgment. Because medicine doesn’t need more perfect physicians that never existed. Real doctors are people who have spilled their share of coffee, learnt, laughed, and shared their setbacks. Medicine needs more acceptance, growth, and peer support to sustain our profession, teach the next generation of doctors, and provide the best care our patients deserve.

Maryna Mammoliti is a psychiatrist.