It started with a muttered comment in the hallway.
I’d just finished a complicated case when a colleague, passing by, quipped to another, “Careful — he’s got a temper.” It was said lightly, almost as banter, but it landed hard. My mind flashed to other moments, other labels: “difficult,” “abrasive,” “too intense.”
For years I carried the quiet shame of that reputation — not because I was prone to uncontrolled outbursts, but because I didn’t yet understand what my anger really meant.
Medicine has its share of legends about the surgeon who throws instruments or the consultant who shouts down the hall. We tell those stories with a mix of awe and disapproval, reinforcing the idea that physician anger is always a problem of personality. The “rageaholic” myth endures — a cautionary tale whispered in residency and cemented in staff meetings.
But here’s what I’ve learned, after decades in ORs, clinics, and now in coaching physicians: the vast majority of what gets labeled “anger” in doctors isn’t about volatility at all. It’s about values.
Most physician anger is situational. It flares when something core is threatened: the safety of a patient, the dignity of a colleague, the integrity of care. It’s frustration at delays that put a sick patient at risk, or disbelief when an insurance denial blocks a necessary treatment. It’s the pressure of doing the right thing while fighting a system that often seems designed to stop you.
The trouble is, medicine doesn’t leave much room for that distinction. The label “angry” sticks faster than the story behind it. And once it sticks, it can distort how others see you — and how you see yourself.
When I work with physicians now, I draw not only on my surgical career but also on my training as a Fellow of the National Anger Management Association. We start by separating the expression of anger from its origin. Sometimes, yes, the expression is counterproductive. But the origin? More often than not, it’s legitimate. Understanding that changes the conversation from “How do I get rid of my anger?” to “How do I listen to it without letting it run the show?”
One practical tool I share is the Pause, Name, Choose method:
Pause: Create the smallest possible gap before reacting. This could be one deep breath, a count to five, or even leaning back in your chair.
Name: Identify what’s really going on. Am I feeling disrespected? Helpless? Overwhelmed? Neuroscience tells us that the act of labeling an emotion activates the prefrontal cortex — the brain’s center for reasoning and self-control. In other words, name it to tame it.
Choose: Decide how to respond in a way that protects both the principle and the relationship.
Another is to remember that anger is often a secondary emotion, and rides on top of something more vulnerable. Exhaustion, fear, grief, or moral distress can all wear anger’s mask. Naming those deeper emotions not only defuses the immediate charge but can also guide you toward a more constructive next step.
The myth of the rageaholic keeps us from seeing anger for what it is: information. It tells us that a line has been crossed or that something important is at stake. When we treat it only as a flaw, we lose the chance to address what’s actually wrong — and to model for our teams that strong emotions, handled well, are part of being human.
That day in the hallway, I didn’t correct my colleague. I let the moment pass. But if it happened now, I might say: “I’m not angry. I’m committed. And sometimes that comes out strong.” Because the truth is, passion in medicine can be mistaken for rage, and the difference is worth naming.
Patrick Darnley Hudson, MD, FACS, BCC, is a retired plastic and hand surgeon, psychotherapist, and board-certified coach. A Fellow of the American College of Surgeons and of the National Anger Management Association, he holds advanced degrees in counseling, medical ethics, and liberal arts. He specializes in helping physicians navigate the pressures of modern medicine through Coaching for Physicians. Dr. Hudson is the author of several books. His latest is In Search of Meaning: Frankl, Yalom, and the Inner Life of Physicians (Coaching for Physicians Series).
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