Author's Notes Chapter 4
Notes for Chapter 4
In this chapter, we learn more about Judith and meet Ted for the first time.
Judith seizes an opportunity to assert her newfound independence and authority, but quickly discovers that confidence is easier to claim than to sustain. Her attempt falters—she realizes she is not yet the person she imagined, nor as self-assured as Ted once was.
Meanwhile, Ted’s decline—already foreshadowed—continues to accelerate. Yet with that loss comes an opening: a doorway into another kind of understanding. There is a quiet, practical wisdom that can accumulate with age, and Ted has chosen to use what remains of his energy to share it.
After the previous Monday morning session, Maya—the seemingly ever-present student—catches him as he leaves his office.
Tutorial 1: “When Trust Breaks”
The Conversation
Ted was preparing to leave when he noticed a student lingering outside his office. The young woman had been shadowing Kim in clinic that morning.
“Dr. Hughes? Do you have a moment?” she asked, hesitating. “I saw what happened between Dr. Green and Mrs. Wood today. I’m trying to understand…”
Ted gestured for her to come in. “You’re Maya, aren’t you?”
“Yes. Maya Peachy.”
“What are you trying to understand, Maya?”
And so begins a conversation that becomes a masterclass in the emotional complexity of medicine—where listening is not merely a skill but a moral act.
They discuss the interaction between Kim and Mrs. Wood, dissecting not the clinical decisions themselves but the human exchange—how grief, exhaustion, and system pressures distort communication. Through their dialogue, Ted exposes the tension between professional duty and human limitation, between empathy and self-preservation.
Maya learns that good communication isn’t simply about what we say, but when we have the emotional resources to say it well. Ted reminds her that explanation can sometimes sound like justification, and justification can feel like dismissal.
By the end of the tutorial, Ted has offered her something rare: not certainty, but honesty.
“Medicine is irreducibly complicated,” he tells her. “We teach technical excellence because it’s measurable. But what we must also teach is emotional courage—and that requires facing our own failures, limitations, and humanity.”
Judith’s Arc
In contrast, Judith’s own chapter continues to trace her evolution as a leader and advocate for women confronting bullying and sexism in medicine. Her strength and vulnerability mirror the same themes Ted explores—trust, failure, and the courage to keep trying.
For a deeper exploration of these ideas, see Chapter Three of Trustworthiness: The Missing Link in Medical Ethics (available through amazon.com.au).
For a more extended discussion in an earlier form, refer to Chapter One of Trust and Betrayal: Morality and the Emotions in Surgery (also available through amazon.com.au)