As you may already have guessed, I am a huge Atul Gawande fan. For those who don't know, Dr. Gawande is a surgeon in Mass Gen who is also the bestselling author of Better, Complications and The Checklist Manifesto. He is clearly brilliant but also manages to portray medicine in an accessible, realistic, yet somehow highly inspiring way. The title of this blog is actually taken from his book Better:
“Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.”
Over the last two grueling academic years of medical school, whenever I felt disheartened, or had lost sight of the reason I had chosen this life in the first place, I found myself rereading his books. They recreated for me this vision of medicine as not only a science, which being in class for multiple hours a day was already giving me a good sense of, but also as an art of healing, connection and bettering oneself.
These days, after being out of the house from 5 am to about 8:30 at night, I hardly have time to put food in my mouth before crashing into bed, so I certainly don't have time to reread a book. (This thought both amuses and saddens me by turns.) However, I have gotten in the habit of referring to terrible, uninspiring days in a numerical scale of 1- 5 "Gawandes" based on how badly I needed to read one of his books. For example, a day when I sat in the call room for 6 hours, afraid to look bored despite wanting to tear my own hair out, was a 4 Gawande day. A day where I watched a good hearted nurse anesthetist sit with a scared 8 year old girl about to go in for surgery for far longer than duty asked of him, was a 0 or even negative Gawande day.
But every so often, there are 5 Gawande days. These are mostly when someone who is supposed to be a role model epically fails in that regard and reveals him or herself as a doctor or human being I would sooner leave medicine than emulate.
A few days ago, I watched my first surgeon meltdown. Thus far I had been lucky enough to be in the OR with surgeons who were either reasonable people, or crazy people who had not been challenged in my presence by anything going awry. These meltdowns are notorious amongst third year medical students (and I'm sure the rest of the OR team as well). Surgeons have a pretty terrible reputation for being tyrannical dictators of the OR who, on occasion, will simply lose their minds at one person or another. On those occasions, you pray to god that it isn't you that is the subject of their unchecked wrath.
This surgeon is an interesting study. For the purposes of the story, I'll call her Dr. L. She's a tiny woman who is chummy with everyone, wildly egotistical, with a flash-flood temper that makes nurses tremble. In a lot of the qualities mentioned above, she reminds me of my dad. And paradoxically, I kinda like her. Not to mention that having spent my childhood dealing with napoleonic mood swings from an ebullient person friendly with everyone, I knew exactly how to interact with her and quickly established myself as "on her good side."
The surgery we were doing was a fairly complex one, using the Da Vinci robot. (Look it up- it's as cool as it sounds.) Something had gone wrong with the screen and Dr. L's legendary temper was flaring. However, when a reasonable human being gets upset, especially in a workplace, it is as least somewhat constrained by the dictates of etiquette and normalcy. Not so in the OR.
I watched, amazed and more than a little terrified, as she unleashed a torrent of abuse on a random nurse, yelling multiple times, "Why are you here if you can't do anything??" She also would scream, "I am the surgeon!" over and over. When the nurse tried to speak up and defend herself, Dr. L would cut her off with, "I don't even want to talk about it anymore," and then continue to rant at her. Loudly. Eventually the nurse manager was brought in to try and rein in the situation. I honestly didn't know where to look.
Strangely enough, later that week I was in another surgery with the Dr. L. and that very same nurse, and they were joking around in an indirect way about what had happened. I laughed along with them, but I knew what I had witnessed was not normal in the slightest.
No comments:
Post a Comment