Never Become the Monday Morning Quarterback

There is a particular kind of behaviour that appears after every conflict, every kinetic deployment, every traumatic event where clinicians and medics have intervened under fire. It creeps into conversations, audits, social media commentary, and even formal reviews. It is the phenomenon of the Monday morning quarterback, the individual who analyses events from a place of perfect safety and perfect hindsight, dissecting decisions made by people who were, at that very moment, genuinely trying to save a life while someone was trying to take theirs.

We must never become that person. Full stop.

It is extraordinarily easy to critique someone’s decision when you were not the one in the killzone, when you did not have rounds snapping overhead, when you did not feel the vibration of the blast or the bite of the cold or the crush of the uncertainty. It is astonishingly simple to talk about how someone “should have” done something differently when you are reviewing a case on a laptop, in a heated building, with coffee on the table and the luxury of unlimited time.

But that is not the reality of interventions under fire.

Decisions Made Under Direct Threat Are Not the Same as Decisions Made in Peace

Medical interventions performed under fire are among the most difficult decisions a human being can make. They require balancing:

• personal survival,
• team safety,
• the tactical situation, and
• the clinical needs of the casualty…

all within seconds, not minutes.

Nobody performing a tourniquet application behind a rock outcrop, or a shunt insertion in the dust and smoke of a collapsing compound, is thinking about textbook perfection. They are thinking about survival, theirs and the casualty’s. They are not performing in a quiet theatre with bright lighting and full monitoring. They are operating inside chaos, balancing courage with instinct, training with terror.

And for anyone who has never been in that position: you do not get to judge them harshly.

Full stop.

Lessons Can and Must Be Learned, But They Must Be Delivered With Respect

There is nothing wrong with review. There is nothing wrong with learning. In fact, it is essential. But there is a world of difference between learning and judging, between reflection and criticism, between “this is what we can improve next time” and “they should have done X”.

There is a way of discussing lessons without demeaning the individual who risked their life. There is a way of elevating standards without humiliating the people who stood in harm’s way to maintain them. There is a way of improving care without erasing the reality of danger.

AARs, debriefs, morbidity and mortality meetings, these must always be grounded in respect for the tactical truth: people performed under conditions most ordinary folk would be running from or hiding under a table to avoid.

The tone matters.

The humility matters.

And the recognition of the circumstances matters.

If You Were Not There, Be Careful How You Speak

Commentary from those not present is perhaps the most corrosive. It erodes morale. It undermines trust. It alienates the very individuals who stepped forward in the first place. When critiques come from people who have never faced the threat, who have never felt the sting of adrenaline meeting fear, who have never had to decide whether to move, to treat, or to return fire, the effect is toxic.

If someone was not in that position, my suggestion is very simple:

either go there and undertake it yourself, or refrain from harsh critique.

That may sound stark, but it is the only honest framing. If you cannot comprehend the environment, you cannot ethically pass judgement on the micro-decisions made within it.

Courage Must Be Honoured, Not Dismantled

Those who intervene under fire demonstrate a level of courage that most people will never be asked to show in their entire lives. They do not deserve armchair dissection. They deserve gratitude, support, and, afterwards, a learning environment that honours both their bravery and their humanity.

We improve care by standing with them, not above them.

We build capability by understanding the context, not erasing it.

We grow by embracing humility, not hindsight superiority.

Final Thoughts

The Monday morning quarterback damages teams, erodes trust, and misunderstands the reality of combat medicine. We must never allow ourselves to become that voice. Our duty is to learn with compassion, to teach with humility, and to speak with the understanding that courage under fire deserves respect, always.

And if anyone wishes to critique without understanding the environment, the invitation stands open:

Go, stand in that dust, under that sky, in that noise, and then see if your words sound the same.