Dr. Sunita Sah

speaker

332 appearances 4 recordings 4 series first heard Jan 2025 last heard 6 Feb

Dr. Sunita Sah’s voice in public audio — every appearance, attributed to the second.

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Recordings per month over the last 12 months — 1 in all, peaking in Feb 2026 with 1.

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Armchair Expert with Dax Shepard · Sunita Sah (on defiance) · 22 Jan 2025 podcast

And she was like, oh, we just want to make sure you don't have a pulmonary embolism. PE is a blood clot in the lungs. And it has a specific type of pain. And I worked for six months in respiratory medicine, which you call pulmonary here. And this type of pain when you have an embolism in the lung is what we call pleuritic chest pain. It's a sharp pain.

It catches your breath when you breathe in and breathe out. And I didn't have that type of pain. I didn't want to have this CT scan she was talking about because it's on average, 70 times the amount of radiation of an X-ray. And even though it's still small, why have ionizing radiation, which can cause cancer many years into the future, why take the risk, right? If it's unnecessary. Yeah.

So I had the knowledge in that situation and I should have said no. And yet I just couldn't say no. And so I was then wheeled into the room with a CT scan and the technician and I couldn't even say no then. I would just ask questions in this polite way like, oh, it's not a lot of radiation, is it?

Even though I knew because I wanted them to pick up on my discomfort and say, oh, do you not want this?

And that didn't happen.

So I ended up having this CT scan. Why couldn't I just say no in that situation? It was safe for me to say no. It would have been effective. And yet something held me back. The only reason I had it was because the doctor told me to. So here's the doctor in a safe situation. She's even smiling. I can't say no. And I'm a doctor myself.

So what would I have done in this situation with George Floyd with a police officer wearing a gun? That's how difficult this is. It's terrifying when you think about it. And there was a survey of 1,700 crew members of commercial airlines. About half of them did not feel comfortable to speak up when they saw an error. Yeah.

So there's this psychological process that I call insinuation anxiety disorder. that I uncovered in my experiments. But the actual experience, I experienced it when I was having the CT scan. I knew this feeling for years and years. The name for it only came after I started doing research in it.

And insinuation anxiety is this aversive emotional state that we have when we believe that not complying with someone else will be a signal of distrust to that person. So it basically insinuates that the other person is incompetent, biased, corrupt and trustworthy in some way. And you don't want to give them that signal. And so the co-pilots telling the pilots, you haven't observed this.

You're doing something wrong here. Like, I don't think we should do that. It's really difficult.

And I see it in experiments in the hospital as well in surveys. Nurses can't speak up when they see a colleague making an error for the same reason. Wow.

How can you? Even with physicians in this particular survey, it was less than 1% whether you had a supervisory role of the physician or not. Less than 1% could actually tell them if it was something about the physician's incompetence. You don't want that. You want your co-pilots to speak up.

You want supervising physicians and nurses working with physicians to speak up if they see something going wrong. Because these life and death situations are huge. But even when it's not life and death, and sometimes you don't know, like as the rookie cops, right, they probably didn't know this was going to turn out to be an unfolding murder or life and death type of situation. Yeah.

But you don't want to end up in those situations because you're so wired to go along with it. You're so socialized to say, OK, I'm going to obey.

The Oxford English Dictionary definition of defiance is to challenge the power of someone else boldly and openly. And I shouldn't really disagree with that having been brought up in English. It's the best. I do. I think it's way too narrow.

And I think a better definition of defiance, considering everything that we've spoken about, is that to defy is simply to act in accordance with your own true values, your core values, when there is pressure to do otherwise.

And also values can involve other people too. Speaking up when you see somebody causing harm to someone else is really a communal act in a way. So redefining, reframing defiance from this negative connotation to being a proactive positive force in society. Because if you think about it, every single act of consent and dissent and compliance, that creates the society that we live in.

So if you're socialized to comply from a young age, if you're rewarded for being compliant, and I know I was, you probably were. I don't know if you were.

That's fascinating. So for many of us... Yeah, yeah.

That was encouraged, right?

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