Behind the Mask of Shame Part 1 - The Background

In this inaugural episode of a multi-part series on shame in surgery, Stephen Thornton, a surgery resident and Behind the Knife fellow, explores the pervasive yet invisible emotional burden of shame within surgical training and practice. Drawing from personal experiences, including the suicide of a mentor, Thornton introduces listeners to Dr. Will Bynum and Professor Luna Dolezal—leading shame researchers whose work through the Shame in Medicine Project and the Shame Lab reveals shame as a deeply embedded, distributed emotion across individual, relational, organizational, and societal levels. The conversation unpacks shame not as a moral failing, but as a complex, evolutionarily rooted human experience that, when acknowledged and constructively engaged, can foster connection, growth, and systemic change. The episode emphasizes that shame is not inherently destructive; rather, its harm arises from secrecy, stigma, and unexamined institutional norms that perpetuate silence and isolation. The discussion highlights how shame manifests in healthcare through perfectionism, hierarchical power dynamics, public criticism, and even physical environments that exclude or humiliate patients and providers. The hosts introduce 'shame competence'—a framework for recognizing, responding to, and transforming shame through awareness, empathy, and systemic redesign. They stress that shame is not something to be eradicated, but a lens through which to humanize medicine, improve well-being, and build more compassionate, resilient teams. The episode concludes with a call to action: normalize conversations about shame, practice self-compassion, and begin transforming healthcare cultures from the inside out.