Sunday, October 28, 2007

the yeller

Most surgical residencies are set up where you rotate on one service, say vascular surgery, for a while, and then you switch to something else like cardiothoracic. The purpose of this is to create a well-rounded general surgeon.

I am currently on a rotation that deals with the liver and pancreas. We do some of the biggest surgeries there are, like Whipples. The only thing bigger would be a liver or heart transplant, really. Which means that almost all of our patients are very, very sick, and/or have a very bad cancer. There is a reason there is the old surgical dictum of "Don't f--k with the pancreas," yet we do on a nearly daily basis

The surgeon in charge (we'll call him Dr. P) is a yeller. Maybe becuase of all the stress of these big operations? But even outside the OR (operating room), he yells and treats people like sh-t. You know, condescending, insulting, that sort of thing. They say he's calmed down over the years (after he had a heart attack), but it's hard to imagine how things can be any worse.

A few days ago, I was in the OR with Dr. P a few days ago. It was a routine surgery for him, really, but one that required the organization of a lot of staff to run machines that were out of the sterile field. We were doing an RFA for metastatic renal cell carcinoma, which meant we needed to use the ultrasound probe directly on the liver to find the tumor. Then we needed to use the radiofrequency machine to fry it. Each machine is run by a separate person, and when we needed them, neither of them were in the room.

We paged them. And waited. It was probably only a minute or two, but in the operating room, if you're just waiting for something, it seems like an eternity. Then the screaming began. "Where is Carl? I want him in the room NOW! Get him in here NOOOW!!!! And write his ass up!!!!"

Once that starts, it just perpetuates itself. The yelling continued. At the scrub nurse. At anesthesia. At the circulating nurse. The only person that didn't get yelled at was me. Which is good, but I'm stading there, doing my absolute best to read his mind about what he wants me to do so I don't get yelled at. The silly thing was that the patient was fine and the only reason the tantrum occurred was because an entire slew of people weren't standing behind him ready to jump the second he spoke. Yelling can be a normal thing when someone is dying just because of the stress of the situation. But when you have to wait a few minutes because someone had to go the bathroom or something?

There is just no reason to be that way. None.


Bongi said...

agreed. it speaks a bit of his upbringing maybe. i actually think people who perform like that seem to think they are somehow more important than other mere mortals. who wants a surgeon who intrinsically believes he is better than you.

by the way, welcome to the blogosphere.

UnsinkableMB said...

hi there... i'm an or nurse at a level 1 trauma center. this scenario is painfully familiar - especially when i worked at a hospital with so many academics. maybe it's a professor thing?

luckily, those moments are few and far between at my current hospital. we started out as a small community hospital and the that feeling stayed despite our growth to one of the busiest level 1 trauma centers in our metro area.