The "Quiet" Effect: Superstitious Language and Code Calls in an Academic Medical Center

Tuesday, March 24, 2026

11:15 AM - 12:15 PM Central Time

Location: Connections Central - RST 01

Ryan Garay, BS (he/him/his)

Virginia

Disclosure(s): No relevant financial relationship(s) to disclose.
DY

David Yamane, MD

Associate Professor
George Washington University

Disclosure information not submitted.
ES

Eduard R. Shaykhinurov, N/A

District of Columbia

Disclosure(s): No relevant financial relationship(s) to disclose.
DK

Daniel King, MD

George Washington University Hospital

Disclosure(s): No relevant financial relationship(s) to disclose.
KM

Katherine Mann, BS

Medical Student
The George Washington University School of Medicine and Health Sciences

Disclosure information not submitted.
Danielle Davison, MD (she/her/hers)

George Washington University Hospital, District of Columbia

Disclosure information not submitted.
Ayal Pierce, MD

George Washington University Hospital

Disclosure(s): No relevant financial relationship(s) to disclose.
KH

Katrina Hawkins, MD

Physician, Critical Care
George Washington University Hospital

Disclosure information not submitted.
JL

John Lucas, N/A

Fellow
George Washington Hospital

Disclosure information not submitted.
GP

Gina Patel, MD

Critical Care Fellow
George Washington University Hospital

Disclosure information not submitted.
AP

Akhil Patel, N/A

Physician
George Washington Hospital

Disclosure information not submitted.
DB

David Bronstein, n/a

Resident
Harbor-UCLA Department of Emergency Medicine

Disclosure information not submitted.

Introduction: Superstitious beliefs surrounding language are frequently observed in high-stress clinical environments. Among these, the word “quiet” is the most widely recognized, often believed to precipitate increased workload or emergencies. Previous research examining its use in clinical settings has found no measurable effect, yet the superstition persists. To date, no study has longitudinally examined whether other “charged” words with superstitious connotations significantly impact hospital activity. This study aimed to broaden the scope beyond “quiet” and evaluate whether uttering such words influences subsequent code calls in an academic medical center.

Methods: Over a nine-month period (October 29, 2024 – July 20, 2025), a “word of the day” was announced to the ICU team during morning rounds at George Washington University Hospital. 25 words were randomly selected: 10 positive words including “busy” and its synonyms, 10 negative words including “quiet” and its synonyms, and 5 neutral words including “neutral” and its synonyms. On each intervention day, all hospital code calls were recorded and tallied. A one-way ANOVA was used to determine whether mean daily code counts differed significantly between word connotation groups, with significance set at α = 0.05.

Results: A total of 231 study days were analyzed, excluding days when the designated word was not spoken by clinical staff. No statistically significant differences were observed in mean daily activations across word connotation groups for any code type. ANOVA results showed: Trauma White (F=0.16, p=0.85), Trauma Yellow (F=1.49, p=0.23), DART (F=0.64, p=0.53), Cath Attack (F=2.22, p=0.11), Brain Attack (F=0.52, p=0.60), Rapid Response (F=1.52, p=0.22), Code Blue (F=2.18, p=0.11), and Total Codes (F=0.23, p=0.80).

Conclusions: This study found no evidence that using positive, negative, or neutral words influenced the frequency of hospital code activations. These findings reinforce the idea that superstitious language does not alter clinical events, challenging the long-held belief that certain words can provoke emergent activity. Although limited by a single-center design and potential unmeasured confounders, this analysis supports the conclusion that superstitious phrases have no measurable effect on clinical workflows or patient acuity.