KB-Room 355, on Voice, Power, and the Quiet Work of Courage (sequel)

A few days after I left the hospital, after sending an email summarizing what former doctors had diagnosed and explaining, in concrete terms, the pain and the functional limitations I was experiencing, my phone rang. The intern who had carefully followed the process and quietly listened, informed me that during a multidisciplinary meeting, my case had again been discussed. This time, the outcome had changed: a treatment would be initiated. She sounded relieved. Perhaps quietly satisfied. I was grateful not only for the decision, but for the fact that someone had paid attention when it would have been easier not to.

That is when I understood something: I had defended my case. Not by escalating, not by pleading, and certainly not by performing. But simply by holding my ground, by articulating the situation precisely, and by not flinching in front of someone else’s title. I did it by asking questions that required answers, even when those answers were inconvenient. I do not particularly enjoy contradiction, but I have learned that clarity often arrives through discomfort and that silence, especially when expected, too often serves the wrong side of the equation.

What stayed with me wasn’t just the relief that I had been heard, and the promisse of a better health. It was the awareness of how many aren’t. Not because they lack proof, or insight, or experience but because they don’t speak the way the room expects truth to sound. Because too often, we confuse volume with conviction, confidence with competence, and status with substance.

We forget that voice is more than speech. Voice carries the soul of a person. It holds reasoning, doubt, memory, clarity, presence. It reveals who we are, not just what we think. And that is why it has power. Across history, the voice has been the medium through which people lent meaning to each other, the instrument through which testimony, warning, and guidance traveled. People gave their voice not just to protest, but to protect, to witness, and to keep what mattered alive.

Today, too many voices are ignored not because they are incoherent, but because they are inconvenient. Too many are filtered out because they don’t fit the syntax of authority. And too often, we don’t notice because we have trained ourselves to only hear what sounds like us, what sounds familiar, what sounds certain.

And if I have learned anything over the years, it is this: systems whether medical, institutional, or corporate do not listen equally. They are designed to listen to those who sound like knowledge, who look like certainty, and who already speak the language of those in charge.

In the professional world, this doesn’t get called injustice. It gets aestheticized, and becomes “culture,” “leadership presence,” “strategic communication,” or “fit.” But what we are really dealing with is asymmetry in who gets heard and whose voice is reduced to noise, emotion, or inconvenience, no matter how precise or thoughtful it is.

Let’s name this clearly: it is epistemic inequality. A structural bias in who is allowed to carry truth, and who is asked to explain themselves twice. It is not just about hierarchy. It is about background, tone, timing, about whose hesitation is read as humility and whose as uncertainty. About whose insistence is seen as leadership, and whose is labeled difficult and untrustworthy.

The same patterns I experienced in that hospital show up every day in customer meetings, performance reviews, scientific discussions, and decision-making processes. People aren’t just weighing arguments, they are reading postures, accents, cadence. They are listening not just for meaning, but for familiarity. And they are discarding too much simply because it comes from the wrong mouth, at the wrong moment, in the wrong tone.

Many adapt. They rehearse, self-edit, speak in measured tones to preempt dismissal. Others stop speaking because they have learned how quickly their voice becomes a threat to those who mistake certainty for truth and fluency for insight.

And leadership tends to imagine this is a question of confidence. That if people just “spoke up,” they would be heard. But speaking up is never neutral. It is a calculated act, a risk. And the more a person sits outside the usual power frames because of their lack of title, language, background, expression, the more that calculation tightens. It is not a lack of courage, it is a learned knowledge of consequence.

None of this is always intentional but that doesn’t make it harmless.

If we want leadership that is more than polished image, a melting pot of ideas and strategies or tactical empathy, then we need to be honest about who is consistently heard, who is granted the benefit of the doubt, and who has to provide not just the insight but the scaffolding for others to understand it. We need to ask not only who we listen to, but why, and who we should be listening to, but aren’t.

The intern who called me could have remained quiet. She could have deferred to a title. She could have preserved her position by absorbing the contradiction. But she didn’t. She reviewed the material, and acted not to perform courage, but because courage is often just refusing to abandon what is evident.

That decision didn’t just change my personal, private life. It reminded me once again what responsibility looks like when it isn’t seeking recognition.

That, to me, is leadership. Not because it came from authority, but because it came from discernment.

And for those of us who do have voice, not just vocal cords, but access, articulation, and the capacity to hold attention, it isn’t enough to use it for ourselves. There are people who carry knowledge but are rarely treated as its keepers. Not because they are uncertain, but because the room was never built to hear them. Not because they are afraid, but because they have calculated, often accurately, that their words will be met with a closed door, or a smile that conceals dismissal.

Believe me, I paid my fair share for speaking up. Not speaking would have meant betraying myself and the values and ethics I genuinely follow. It is a hard choice I have made for myself, and I do not expect anyone to follow. But if more people stayed put, held the line, maybe the power balance would begin to shift. Maybe people would learn to actively listen to those who just want to name things by their names.

Sometimes, lending your voice is not about speaking louder. It is about using it where someone else has been systematically ignored, not to confront, but to reveal, and not to replace but just to amplify.

And no, this isn’t only about hospitals or companies. It is about what happens every day, in spaces where authority is mistaken for clarity. It is about the vendor at the counter handing the bruised fish to the elderly woman who won’t push back. It is about the question left unanswered because the person asking didn’t look like they were worth listening to. It is about how quickly we tune out when we don’t recognize ourselves in the speaker, and how easily we equate difference with irrelevance.

Voice is not decoration, it is how dignity speaks. The question isn’t just who speaks the loudest and quickest, it is who is heard. And if leadership means anything at all, it should begin with that.

#Leadership #VoiceAndPower #EthicalLeadership #CommunicationBias #OrganizationalCulture #DeepWork #EpistemicInjustice