Ignaz Semmelweis

Tone Matters

13 January 2020

There is more to the story of Dr. Ignaz Semmelweis than merely learning that people will discount the possibility that they are, in fact, responsible for things that happen because they believe themselves to be above reproach. Another important part of the story is how Dr. Semmelweis responded to criticism.

To put things mildly and diplomatically, Dr. Semmelweis did not respond well. Among other things, he began to write “open letters” calling out those who opposed him. Here’s a sample of the language that he used:

‘I know that since 1847 thousands of women and children have died, who would be alive had I not remained silent…. In this massacre you, Herr Professor, have participated. Murder must cease!…’

​Semmelweis Ignaz​, Zwei offene Briefe an Dr. J. Spaeth, Professor der Geburtshilfe an der k. k. Josefs-Akademie in Wien, und an Hofrath Dr. F. W. Scanzoni, Professor der Geburtshilfe zu Würzburg (2012), https://www.gutenberg.org/cache/epub/40261/pg40261-images.html.

and:

Your teaching, Herr Hofrath, is based on the dead bodies of lying-in women slaughtered through ignorance…. If, sir, without having refuted my doctrine you continue to teach your students and midwives that puerperal fever is an ordinary epidemic disease, I proclaim you before God and the world to be an assassin, and the history of puerperal fever would not do you an injustice were it, on the grounds that you were the first to set yourself in opposition to my life-saving discovery, to immortalise you as a medical Nero.

​Id.​, (excerpts and translations from SD Elek, ​Semmelweis commemoration. Semmelweis and the oath of Hippocrates.​, 59 Proc R Soc Med 346, 351 (1966), https://www.ncbi.nlm.nih.gov/pubmed/5327978.)
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What I must admit here is that he is not entirely incorrect. The results of his handwashing techniques seemed to have completely turned the tide at the hospitals that practiced them. However, his tone, as evidenced in his calling those who opposed him “medical Neros,” “murderers,” and “assassins,” was so wholly unhelpful that it left one in doubt as to whether he actually increased resistance to his correct ideas merely because people refused to like him.

Writing online is one of the most difficult things that we do. We write like we speak — with tone. Unfortunately, we also read as we speak — that is, using the tone we think we might be used to express the words we are reading. The result can be disastrous. Something I write with a sarcastic tone in my head can be interpreted using a wholly straightforward tone when read by my recipient. Likewise, something intended to be taken as written by someone else can be misinterpreted as sarcastic, condescending, or otherwise insulting when I am reading it.

This is an especially important lesson when dealing with policy compliance issues. These matters tend to have people dealing with high levels of emotion. When services have been suspended, or a threat of suspension (or worse) is in play, people on both sides of that divide tend to become very emotional. Everyone seems (on occasion, at least) to immediately feel like the “other side” is just out to belittle them at best and take their jobs away at worst.

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At moments like these, it is vitally important for professionals to walk away before hitting “Send” on that message. Time needs to be taken for reflection, and an editing process needs to happen that will result in the tone of the message being reviewed for levelheadedness and accuracy. While it is perhaps true that business correspondence, in general, is no place for vitriol, sarcasm, or hyperbole, this is especially true when it comes to writing messages touching upon policy compliance. So, wait 10 minutes (or an hour) and consider asking someone else to review the message for tone and clarity.

Whether you are a policy compliance agent or dealing with the policy compliance people at your service provider, it’s always worth remembering that the person on the other side of the message is still human. They want to be treated with just as much respect as you desire to receive from them. Thus, we must take the time to write clearly, dispassionately, and succinctly.

Mickey Chandler
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