[Originally posted to my personal blog, reposted here with edits.]
Introduction
You could call it heroic responsibility, maybe,” Harry Potter said. “Not like the usual sort. It means that whatever happens, no matter what, it’s always your fault. Even if you tell Professor McGonagall, she’s not responsible for what happens, you are. Following the school rules isn’t an excuse, someone else being in charge isn’t an excuse, even trying your best isn’t an excuse. There just aren’t any excuses, you’ve got to get the job done no matter what.” Harry’s face tightened. “That’s why I say you’re not thinking responsibly, Hermione. Thinking that your job is done when you tell Professor McGonagall—that isn’t heroine thinking. Like Hannah being beat up is okay then, because it isn’t your fault anymore. Being a heroine means your job isn’t finished until you’ve done whatever it takes to protect the other girls, permanently.” In Harry’s voice was a touch of the steel he had acquired since the day Fawkes had been on his shoulder. “You can’t think as if just following the rules means you’ve done your duty. –HPMOR, chapter 75.
Something Impossible
Bold attempts aren't enough, roads can't be paved with intentions...You probably don’t even got what it takes,But you better try anyway, for everyone's sakeAnd you won’t find the answer until you escape from theLabyrinth of your conventions.Its time to just shut up, and do the impossible.Can’t walk away...Gotta break off those shackles, and shake off those chainsGotta make something impossible happen today...
The Well-Functioning Gear
I feel like maybe the hospital is an emergent system that has the property of patient-healing, but I’d be surprised if any one part of it does.Suppose I see an unusual result on my patient. I don’t know what it means, so I mention it to a specialist. The specialist, who doesn’t know anything about the patient beyond what I’ve told him, says to order a technetium scan. He has no idea what a technetium scan is or how it is performed, except that it’s the proper thing to do in this situation. A nurse is called to bring the patient to the scanner, but has no idea why. The scanning technician, who has only a vague idea why the scan is being done, does the scan and spits out a number, which ends up with me. I bring it to the specialist, who gives me a diagnosis and tells me to ask another specialist what the right medicine for that is. I ask the other specialist – who has only the sketchiest idea of the events leading up to the diagnosis – about the correct medicine, and she gives me a name and tells me to ask the pharmacist how to dose it. The pharmacist – who has only the vague outline of an idea who the patient is, what test he got, or what the diagnosis is – doses the medication. Then a nurse, who has no idea about any of this, gives the medication to the patient. Somehow, the system works and the patient improves.Part of being an intern is adjusting to all of this, losing some of your delusions of heroism, getting used to the fact that you’re not going to be Dr. House, that you are at best going to be a very well-functioning gear in a vast machine that does often tedious but always valuable work. –Scott Alexander
Recursive Heroic Responsibility
Heroic responsibility for average humans under average conditions
I can predict at least one thing that people will say in the comments, because I've heard it hundreds of times–that Swimmer963 is a clear example of someone who should leave nursing, take the meta-level responsibility, and do something higher impact for the usual. Because she's smart. Because she's rational. Whatever.
Fine. This post isn't about me. Whether I like it or not, the concept of heroic responsibility is now a part of my value system, and I probably am going to leave nursing.
But what about the other nurses on my unit, the ones who are competent and motivated and curious and really care? Would familiarity with the concept of heroic responsibility help or hinder them in their work? Honestly, I predict that they would feel alienated, that they would assume I held a low opinion of them (which I don't, and I really don't want them to think that I do), and that they would flinch away and go back to the things that they were doing anyway, the role where they were comfortable–or that, if they did accept it, it would cause them to burn out. So as a consequentialist, I'm not going to tell them.
And yeah, that bothers me. Because I'm not a special snowflake. Because I want to live in a world where rationality helps everyone. Because I feel like the reason they would react that was isn't because of anything about them as people, or because heroic responsibility is a bad thing, but because I'm not able to communicate to them what I mean. Maybe stupid reasons. Still bothers me.
I'm realizing that my attitude towards heroic responsibility is heavily driven by the anxiety-disorder perspective, but telling me that I am responsible for x doesn't tell me that I am allowed to delegate x to someone else, and - especially in contexts like Harry's decision (and Swimmer's decision in the OP) - doesn't tell me whether "those nominally responsible can't do x" or "those nominally responsible don't know that they should do x". Harry's idea of heroic responsibility led him to conflate these states of affairs re: McGonagall, and the point of advice is to make people do better, not to win philosophy arguments.
When I came up with the three-point plan I gave to you, I did not do so by asking, "what would be the best way to stop this bullying?" I did so by asking myself, "if McGonagall is the person best placed to stop bullying, but official school action might only drive bullying underground without stopping it, what should I do?" I asked myself this because subsidiarity includes something that heroic responsibility does not: the idea that some people are more responsible - better placed, better trained, better equipped, etc. - than others for any given problem, and that, unless the primary responsibility-holder cannot do the job, those farther away should give support instead of acting on their own.
(Actually, thinking about localism suggested a modification to my Step 1: brief the prefects on the situation in addition to briefing McGonagall. That said, I don't know if that would be a good idea in this case - again, I stopped reading twenty chapters before.)
Surprisingly, so is mine, yet we've arrived at entirely different philosophical conclusions. Perfectionistic, intelligent idealist with visceral aversions to injustice walk a fine line when it comes to managing anxiety and the potential for either burn out or helpless existential dispair. To remain sane and effectively harness my passion and energy I had to learn a few critical lessons: