“God dammit just follow the F**KING directions!” This was said to me the other day in the middle of a surgery. The person who said it is actually someone I typically enjoy working with. We were doing a pretty routine case that I had done dozens of times with other staff at different hospitals. One of the positives of surgical training (although often frustrating) is that many staff do the same procedure in different ways. It is a benefit in that you see many ways to get to the same end result. But it is extremely frustrating as you gain seniority and attempt to take the reigns on a case only to get shot down because you aren’t throwing a stitch the way this particular staff wants you to throw it. Anyway, we were getting through the procedure and I started to load an instrument in the only way I have seen done. My staff was frustrated (as he often seems in the OR) and told me to load it in a very uncomfortable and in my opinion [weird] way. Of course I fumbled and then he raised his voice and yelled at me. This is in front of 2 junior residents, the anesthesia team, the circulating nurse and the scrub tech.
I would be lying if I told you that this didn’t ruin the rest of my day. It was embarrassing and unnecessary. But this is the culture of surgery. Albeit, it is changing and I’d like to credit the current rising generation of surgeons for not tolerating this type of behavior anymore. I wasn’t sure what to do about this. If I told my program director about this and this staff got in trouble, he would know it was because I said something. I decided to keep it to myself, try to process it and not let it affect me.
I want to describe the chain of reaction though that this interaction had. After the case I was upset. My new intern asked me a question about how to put an order in and I snapped at him. I got a consult from the medicine team who was concerned about a patient but hadn’t called the appropriate people before just reacting and consulting surgery…stat. It took a lot of deep breathing for me to not be incredibly rude over the phone. I’m sure I came off though as that “grumpy surgeon.” It is a domino effect of rudeness!
I think that this type of demeaning culture that the older generation of surgeons trained under needs to cease to exist. This type of language used in what is supposed to be a professional environment is no longer acceptable. I’m sure that patient would have been horrified if he heard what was happening around him as he had this procedure. I also believe that this type of language used and environment created by staff contributes to resident burnout.
So what should I do? Should I tell my program director? Should I tell the CEO of the hospital? Why doesn’t any of the OR staff or Anesthesia staff say something? Did they think it was okay? Why is it acceptable to watch a colleague get spoken to in this way? Surgery, it’s time for a change.
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