Friday, April 15, 2011

Sometimes It's Easier Not to Write

I've been neglecting this blog because I've had some recurrent feelings of annoyance lately, and I like to keep my unsolicited invective to a minimum. After all, when I see whiny complaints or bitter criticisms on other blogs sometimes all I want to do is roll my eyes and say, "Who died and made you queen?"

Still, I can't deny that I have some of those thoughts and feelings too. I got a lot of heat when I disclosed the behind-the-scenes frustration that sometimes gets vented "around the water cooler" about certain less conscientious members of the anesthesia and/or nursing staff at my workplace. Lately the same people have exhibited the same lack of professionalism, not around calling in "sick," but avoiding work while at work (disappearing between cases, not checking in with the person in charge before leaving, refusing to see a patient on rounds twenty minutes prior to the appointed departure time because "it's almost time to go," etc.). And the same loud, obnoxious people who have often pontificated about things they don't know enough to pontificate about have continued to be loud and obnoxious and under-informed.

Then there are the surgeons with narcissistic priorities. Some examples:

Dr. Narcissus: "Can you bring the patient to the recovery room without extubating him, please, so we can get the next case in faster?"
Our team: "No, that's not the safest way to conclude the anesthetic for this patient."
Dr. Narcissus: "What difference does it make, extubating there versus extubating in the O.R. with me having to wait around for turn-over?"
Us: "Extubation is safest in the controlled environment of the O.R. We'd still have to watch over and extubate the patient in recovery. It wouldn't save any time and we'd have less available anesthesia equipment outside the O.R."
Dr. Narcissus: "Bring it with you."
Us: "Huh? You don't seem to be understanding the relevant issues..."


Me: "I did something a little different for the anesthetic based on some studies in the British Journal of Anesthesia."
Dr. Contemptuus (looking at patient in recovery room and not understanding that he's actually doing better than expected): "Well, I don't think the patient read that study."
Me: "His pain score is already less than expected considering you cut him open from stem to stern."
Dr. Contemptuus: (shrugs)
Patient: (chatting comfortably with family, laughing, and telling jokes)


Me (through the nurse-in-charge): "I'm sorry, tell Dr. P I have to delay his case because I have a hemorrhaging pregnant woman who needs an immediate C-section to attend to."
Dr. Puerilus: "I'm going to call the administration." He proceeds to do so AND to call my chief at home to LIE and say I asked him to come immediately to help with the C-section (only because the surgeon actually wanted to avoid the delay of his own, NON-emergency case).
Chief (to me, on the phone): "Hey, Dr. P said you really need me there. I'm on my way."
Me: "I don't. I never said that. In fact, I never actually spoke to him because I had to run up to O.B."
Chief: "Oh. You mean he made that up?"
Me: "Yup."
Pencil-pushing administrative nurse calling me to ask about delay of Dr. P's case: "I guess I shouldn't be distracting you with this while -"
Me: "While our patient's about to bleed to death and lose her child? NO, I guess you shouldn't."
Pencil pusher: "Well, he's just wondering when-"
Me: "We'll be able to start Dr. P's case once THIS LIFE-THREATENING EMERGENCY is stable."


It's not the clinical medicine that's the most stressful part of this job, though that can be demanding enough. It's the short-sighted PEOPLE.

I've cut back my hours and elected to spend more time enjoying life with my family. Life requires balance, and medicine tips the scales pretty forcefully. So we try as a family to keep the equilibrium. I recently took my daughter to her first Shakespeare play (The Merchant of Venice, with F. Murray Abraham as Shylock), a feminist theater festival highlighting women's rights abuses across cultures, and a wonderful performance of The Fantasticks in New York. My husband and I have had lunch a couple of times, been to the movies, spent some lovely quiet time talking. My son and I have had some time to ourselves. I wouldn't trade any of this to make more money; it's just not worth it. My family's love keeps me going and helps me remember why I need to keep looking past the little frustrations at work and focus on taking really good care of patients and those who love them.


Robert said...

I adore the part about spending more time with your fam. More people should make the choice.

Brian said...

Your patients AND your family are lucky to have you, even if they have to share...

Patient Bunny said...

It's always the people that make you happy or miserable, right? Loved your post! Thank you!

Sonsomar said...

The same people, the same circunstancies all over the world. But the world is Surgeons's world by now. We have to work to change it.
It's good to spend time with your family.
Good luck

Danimal said...

I'm with Nurse XY: Time spent with your family, rather than the knobs with whom you work, is what it's really about. and the fact that advocate more for your patients than their surgeons sure makes you look like a good doc. I'd certainly prefer someone with your outlook should any of my family members need your services.

Margaret Polaneczky, MD (aka TBTAM) said...

so jealous of your ability to work part time - that s one choice I'd make in a hearbeat were it possible both where I work and financially for my family - unfortunately for both reasons, it is not.

Next time you're in New York, give a holler!