I think a very important quality in a young physician is the ability to remain calm and not lose your temper. As a trainee, you are dealing with angry attendings, angry patients... basically, everyone is yelling at you. If you start losing your temper when it happens, you're finished.
I remember during my intern year, I was talking on the phone to the son of a patient. He was angry about something that had nothing to do with me, but he wanted to yell, so he spent about 20 minutes yelling at me. I continued writing my notes, checking labs, etc, while intermittently saying something like, "I'm so sorry." When he finally finished yelling, I talked to him calmly for another minute, then we hung up.
Unfortunately, I do think part of being a physician is being able to take a moderate amount of abuse while still remaining calm yourself.
I'd like to think I have a good ability to keep my temper in check during my other personal interactions as well. It can be hard when someone lets loose on you for no reason, but I feel like you can't go wrong from remaining calm and polite at all times.
Keeping my temper on the internet is slightly more of a challenge. In general, the things people say on the internet make me sad for society. Is this really what people are like inside? When someone comments on a blog post I wrote calling me an idiot or something along those lines, it's hard to reply calmly. I can't say I've always done that. In the past, I've definitely allowed myself to be provoked.
Recently I've been attempting to change that. I've been at least trying to respond to all comments respectfully and calmly. Sometimes achieving this involves writing a very nasty response, deleting it, then starting over. I feel like as I get older, I have more responsibility to act like an adult. Or at least, act the way I believe an adult should act.
So if you ever notice me acting really bitchy to someone in the comments, you can totally call me on it. You can link to this entry and say, "Hey, Fizzy, you said you weren't going to do that!"
Thanks for this post Fizzy. This is one of the things I'm pretty scared about regarding my medical training... I hate being yelled at! I don't so much mind being made to feel like crap if I actually did something wrong or whatever, but I can't handle being yelled at for something that's totally not my fault. Maybe I need to enlist my friends and family to berate me freely as practice for attendings/angry patients/everyone higher up the totem pole than my lowly med student self. Ha.
ReplyDeletePS: For what it's worth, for at least as long as I've been reading your blog you seem very respectful and non-bitchy when responding to comments.
DeleteThank you for saying so, but it isn't really true. Like on my Top 10 Movies post, someone made a comment saying, "Don't you like any independent movies or movies from before you were born?" I don't think I was super nice in response, but then again, how can you respond politely to something like that?
DeleteNo I do not because I'm not a pretentious artsy hipster?
DeleteAhh I see your point. I guess my temper needs work too!
Well I guess I don't pay that close attention to the comments then, or I haven't been reading long enough.
DeleteHi, I'm the person that asked if you liked old or indy movies. I wasn't trying to be rude, maybe a little provocative (I admit). But I was sincerely curious to see if you liked those kinds of movies and maybe you'd tell me why or why not.
DeleteI didn't think your reply was overly testy. I think the reply was appropriate for the question.
Anyhow I follow your blog daily. Keep up the good work.
Anon: Your comment was a bit obnoxious because it implied that I somehow have inferior movie tastes because I didn't list any movies that fell into those two categories. Even though, in actuality, as I said, there was a movie from each of those categories on the list. And I personally take offense because I am more of a movie buff than practically anyone I know, and to imply I don't like any old or indy films is highly insulting to me. I even saw the one about the guy from MIT who fucks his mom.
DeleteMy husband claims Clerks is not an indy film, but I think a film that cost $25K that Kevin Smith paid for by charging it to his own credit card, which won an independent film award is certainly independent. Just because an indy film is actually *good* and gets widespread recognition, that doesn't mean it's no longer indy.
Ultimately, a movie being independent or old doesn't make it better or more worthy in any way. I like movies that are good. That pretty much sums it up.
JooJoo - it is easier to hand yelling for what is not your fault. Just tune out like Fizzy did, dictating, wirting notes and knodding occasionally. That said, as a trainee I had hard time with being yelled at for what was not my fault. I tried to prove my point to attending that got upset with me transfering pt to ER for what attending thought did not warrant ER. It is now in my personal file that I do not take critisism well. And if you want to know pt that I sent to ER and was worried about, and ER sent home, died a few days later, found at home by neighbours. So much for patient advocacy. And so sad for insecure attendings and bad institution culture, its more important for them to humiliate a trainee than good patient outcome.
ReplyDeletePatient yelling is a different issue, I try to get on their side, and let them know I "hear them". But no longer take any of these personally.
JooJoo -- I also hate being yelled at, but for some reason when patients did it to me, it didn't bother me so much. I told myself that they were really upset about their SITUATIONS rather than at me (which may or may not be true) and that seemed to help. When a resident or attending yelled at me it was a little harder to take, but you get beaten down and eventually it starts to bother you less. Also, after a while you realize that even if you are working with an especially malignant resident or attending, you'll probably only be with them a month, and then you'll move on to someone else who hopefully is less malignant. It helps.
ReplyDeleteI was definitely way, way more upset by being yelled at by a resident/attending vs. a patient. Like you said, with the patient, it was usually about the situation more than anything I did. Sometimes I even encouraged them to yell at me to get it out of their system.
DeleteGood for you. You seem to have a very mature outlook and that's refreshing to see.
ReplyDeleteI hope so. Sometimes I'm in an argument with someone and trying to remain calm, and the other person is just getting very personal, which makes it difficult.
Deletesoooo I shouldn't burst out crying when an attending yells at me? that may be harder said than done. I will however tread lightly to make sure I don't screw up sooo bad that yelling is needed. As a side note, attendings/residents, yelling at those lower on the totem pole reflects badly on you. Yelling if life/death mistake may be justified, but chances are they are beating themselves up worse already (unless they're complete jacka**es in which case yell away), so speaking firmlly and seriously I think is better.
ReplyDeleteIt's not possible to never get yelled at by an attending. That's how some attendings communicate. I got yelled at in the OR for not being able to hold five things at once. I could have done it easily if I had five hands.
DeleteI think I'm more worried about the whole "bursting out crying" bit. I can stay calm when someone is yelling at me, regardless of whether its my fault or not. But whether or not it ACTUALLY emotionally affects me or not, its hard for me not to tear up even a little bit :-/ Any suggestions?
DeletePinch the skin between your thumb and first finger really really hard and say, "Thank you so much for taking the time to give me this valuable feedback. I will try very hard to do better at XYandZ in the future."
DeleteI completely agree with your post about keeping your temper when dealing with patients. Remaining polite and calm will always serve you well, and even keep you from having to deal with baseless (but annoying and time-consuming) patient complaints. As was already mentioned, the majority of the time, the patient/family is angry about the situation and you're just the closest person to unload on. I think we get paid more than adequately to deal with these situations in a professional manner.
ReplyDeleteAs for the site, I've never noticed you to be rude or disrespectful in your responses, but, really, this is your space to express your opinions, and you shouldn't have to censor yourself. You don't have a duty to care, or any obligations toward the people who read this site, so say whatever you want!
Interesting post - thanks. I'm amazed that you can remain calm and even carry on your work while getting yelled at. Can you elaborate on how?! I know that it's not about me, not to take it personally... but I can't seem to remain calm when my body reacts with palpitations and tremor. Any advice on how to calm down in the moment? I think I have the opposite problem as you: I can't calm down face-to-face, but with internet comments, I can distance myself and at least I have time to calm myself down before responding.
ReplyDeletethanks for sharing.
ReplyDelete