Sunday, October 23, 2011

Attendings with a temper

Anyone who's worked with doctors, especially surgeons, know that some of them have a bad temper. I have no idea if more doctors have a bad temper than in the general population. I have no idea if they started out with the rotten temper or if it developed from being giddy with "attending power." I have no idea if the bad tempered doctors are bad tempered outside of the hospital as well. All I know is that I've gotten yelled at a lot for no good reason (and sometimes for kind of a good reason).

For example, during my sub-I, there was one day when our attending Dr. Brown decided to systematically rip apart the whole time. (At the end of his rampage, the senior resident actually said, "Stop it, Dr. Brown, you're ripping apart my team!")

I still remember why he started screaming at me. It was because one of my patients was supposed to be discharged that day, but he needed PT to walk him around first. I had put in the order and even called PT, but they failed to show. Was this my fault? No. But Dr. Brown said what I did wrong was that when PT didn't show up, I should have walked the patient around myself. Of course, my patient was an elderly obese man who weighed twice what I did and was attached to an IV pole. Absolutely nothing could go wrong with that.

Another time, during residency, I got yelled at by an attending named Dr. Green in front of several other residents for something I did wrong on home call. I still honestly am not sure what I did wrong, other than being unable to instantaneously transport myself from home to the hospital after getting paged. In any case, after it was over, the other residents comforted me and said that everyone knew I didn't do anything wrong, and that Dr. Green just had a bad temper.

A couple of months later, Dr. Green was telling us about how he'd been walking through a parking lot with his daughter in her stroller, and a car had driven dangerously close to them. His response was to yell and kick the car hard enough that he said he dented it pretty badly (scaring the female driver into quickly driving away). Although I was silently cheering for him because I'd been in that same situation and not had the nerve to do anything, I also recognized that this was not normal behavior. It was pretty obvious Dr. Green had anger issues and we were all just at his mercy.


  1. I did hear of some nurses calling security on a surgeon once. He apparently threw a big tatrum, was being quite abusive and they had had enough. Being a student nurse, I wonder if I would ever have the balls to call someone on it.... Or if it would be worth (potentially) losing my job over....

  2. Many people are afraid of anger, and many more don't have the emotional maturity to be able to use it effectively. Anger can be a useful emotion, but anger is only useful when it's appropriately focused on the root cause, and only when such a response actually has any hope of accomplishing anything. Diffuse, unfocused anger is toxic and destructive and serves no useful purpose. It is also a sign of emotional immaturity. I agree that yelling randomly at residents is probably an example of the latter. But the example of kicking the car actually seems appropriate, and may fall under one of the useful expressions of anger. Of course, people can switch back and forth from appropriate expressions of anger that are actually useful to inappropriate, immature tantrums.

  3. An enraged orthopedic doc through a chair in the OR (back in 80s - don't know if they'd do that kind of thing now)and lost privileges for a year.

    There was also a general surgeon who was demanding and difficult and everyone snapped to attention when he was around. They even did a parody of him as "the King" red robe, crown and all, at a Christmas party. He laughed.

    I read in another blog written by an ED resident, when discussing different rotations that "surgical residents eat there young."

    I wonder if surgeons are of a certain personality type and does the specialty bring it out even more? Then again ...I know some easier going ones too.

    Interesting post. Maybe they weed out the weak?

  4. I don't know, angry can be scary, but passive aggressive can be just as bad in its own special way. And there is a TON of passive aggressive behavior outside of surgery.

  5. I am not a doctor or anything besides participant, and I certainly don't have any conscious view of the Dark Side, but I have to say that doing most of my participating in a teaching hospital environment I can remember only one case where the doctor involved was an a..... an unpleasant person.

    When I got back to my GP and reported the events, his response was "well, we will have to be sure he is not so busy anymore.

    The surgeon I mentioned in email strikes me as a delight, having watched him in during a near-emergency pre-op--the way he treated me (patient) and everybody else (consisting of largely unlabeled nurses, students, anesthesiologists and other doctors) is best described using an old fashioned term: charming.

    I can not imagine him being unpleasant except, maybe, in the face of unrelenting stupidity.

  6. On the other hand.....

    When my wife was in the recovery room after a breast biopsy and we were listening to the surgeon deliver the bad news and hearing the alternatives he saw, a nurse leaned over the back of his chair and lectured him about pressuring her (he wasn't), that she had time to make up her mind (he was saying that when she interrupted).....

    And some time later after the mastectomy, a resident came in and removed her dressings when she had had no preparation for what the wreckage was going to look like.

    Fortunately, a non-medical researcher at the hospital and who is a personal friend and who was a parishioner at her church happened by just then and was able (almost literally) to provide life support (I don't know why I was not there for that).

    And the last story that is sort of funny now involves the time she was in the hospital for a Uvulectomy (as fraudulent a bit of surgery as I have ever heard of) some brainiac ordered her first solid food for her.

    Dry white toast. The closest I have ever come to committing a felony occurred a few moments later.

  7. One of my attendings on trauma (a surgeon, obvi) had a bad habit of throwing things out of rage. He threw stuff twice over the maybe 4-5 shifts I had with him. He never threw anything directly *at* anyone, but he definitely threw things in a trajectory that could, theoretically, have hit someone. It was a little scary.

    -a med student

  8. There are some days where i swear, half my time at the hospital is spent waiting to see who yells at me next. Doctors, nurses, PCAs, respiratory therapists, that charge nurse in the ER is particularly poisonous.

    The worst treatment I've ever had was by a palliative care doc who called me a "bad doctor" for not doing a hip replacement on a patient who had a stroke less than a week before that. I had called her from my cell so she had my cell number and she called me multiple times a day to tell me I was ruining the patient's life and I shouldn't be allowed to practice medicine because I clearly didn't care about the patient. I've gotten yelled at my surgeons plenty, and anesthesiologists a fair amount, and the ICU docs around here get sort of unpleasant, but my worst treatment was by palliative care, which seems pretty out of character.

    (the palliative care doc found a different surgeon, the patient stroked out during the surgery and wound up going to hospice, and I seriously hope the palliative care doc can't sleep at night)

  9. Dr. Green seems SO scary! I would be afraid of him and secretly tell someone about him. I just wonder what he will do if something terribly wrong happened, he might throw an used needle or scalpel at your eye. Just kidding but those are the thoughts running through my head.

  10. You know what aggravates me more than anything? The fact that it's considered acceptable for physicians to behave in this fashion.

    If a nurse, tech, physical therapist, or some other hospital employee behaved in the same manner.... You can bet your rear that they'd be canned in short order... But not doctors.

    Why is that?

  11. I've got a friend who's been a nurse in a local hospital for over 20 years. She recently told me that she will write up any doc or any other staff member that is abusive. She used to describe herself as a melted puddle of Jello when faced with conflict. The job toughened her up.

  12. Wow, a lot of dr bashing going on here. FWIW I've seen more angry nurses than drs at my institution, but maybe where I go to school is just special.

  13. OMDG: I could definitely tell stories about nurses, but I'm more comfortable bashing my own.

  14. We had an ER doc (the only one on shift) lock himself in the on-call room because he was sick of seeing patients. Um, really?
    But mostly I'm scared of OR nurses. Those mostly) ladies are SCARY. Mean to your face AND behind your back.

  15. I meant in the comments. We both know you're equal opportunity.