I think of myself as a rule-follower, but there is one rule that I find myself breaking more and more as time goes by. The rule I break most often is the unspoken rule that says we have to “be nice.” This usually means, “keep quiet and don’t rock the boat.”

For example, when the resident at my uncle’s ICU bedside said his intern (= first year resident) was going to put in my uncle’s central line (a procedure done commonly in the ICU, with known complications such as a collapsed lung), I said no. He argued and told me we were in a teaching hospital and that those were the rules. I said no again. He said he was going to take it to his attending. I said fine.

I was once an intern, and I learned to put in central lines when I did my first ICU rotation. Because my patients and their family members were generous with their permission, I learned a valuable skill.

That day, in my uncle’s ICU room, I was not generous with my permission, because at that moment, I was not the intern’s advocate; I was my uncle’s advocate. And his well-being came first–before someone else’s learning experience—and definitely before my need for people to think I was nice.

The resident told me his attending was coming.

“Great,” I said, standing by my uncle’s bed. Then I asked the intern if he’d ever put in a central line before.

“No.”

When the attending arrived, I told him I didn’t want the intern putting in the central line. He said, “fine,” and that was that.

I’ve been thinking about unspoken rules lately as a number of clients have come to me with different issues, but with the same underlying question: Can I put myself (or my loved one) first?

One client told me she wanted to quit her job “but I don’t want to let my team down.”

I said, “So your team’s (theoretical) happiness is more important than yours?”

“Well, when you put it like that,” she said, “no.”

Another client wanted to celebrate Mother’s Day with her family at home, rather than at her mother-in-law’s house, “but I don’t want to hurt her feelings.” They had been spending Mother’s Day at her mother-in-law’s since the year they married.

When I said, “So, you’re never going to celebrate Mother’s Day your way because avoiding upsetting your mother-in-law is more important that anything you want?

She said, “yes,” but then she realized she was also thinking: She’s not going to live forever, which was so morbid she decided to change things while the woman was still living.

As a coach, I articulate the rules my clients unconsciously live by. Once spoken aloud, the rules often seem ridiculous—which allows them to be changed or ignored.

What are the rules you live by?