Mr. Jekyll becomes Dr. Hyde

I don't think anyone will argue with the fact that a disproportionate number of physicians out there are pompous assholes. When I say disproportionate, I mean that when you compare the number of assholes per hundred physicians, it seems to be much higher than the per capita number of assholes in any other profession. Way back when, some of my medical friends discussed this topic at length. Does medicine select people with pompous tendancies, or does the pursuit of a career in medicine make us this way?

I am currently doing a month of anaesthesia. In theory, anaesthesia is an incredible learning opportunity. (Newbie note: anaesthesia is the area of medicine responsible for the patient's vital signs-- breathing, blood pressure, heart rate, etc.-- during surgery. Basically, it's the doctor who puts you to sleep.) You have an entire day of what basically amounts to one-on-one mentorship from an anaesthesia attending. You're there for every step of the patient's operative care from the pre-operative assessment to the post-anaesthetic care unit. It's a great opportunity for someone in emergency medicine to learn about pharmacology (they have all the best drugs), fluid balances and ventilation, and a great chance to learn and practice skills like intubating, starting central lines, starting IV's, lumbar punctures and other crazy things that I still can't believe they let me do on real people.

Instead, I'm hating every minute of it. Every anesthesiologist I've worked with is an ass. Instead of taking the time to teach me things, they humiliate me for not already knowing what I'm doing (in my first week, natch). On my second day, I asked the staff guy I was with why he used Sufentanyl when the guy I'd worked with the day before had used Fentanyl and here is what he told me: "I'm not here to answer your questions". I shit you not. Dude! You work in a freaking ACADEMIC CENTRE. You are employed not only by the hospital, but by the university. IT IS YOUR FREAKING JOB TO ANSWER MY QUESTIONS. What an ass.

The guy I worked with the next day was no better. He basically went about his day and completely ignored my existence. It wasn't the best room... long surgeries. This isn't as much fun for me since the only time I really do anything is during induction (putting people to sleep at the beginning of surgery). But two of the three patients needed everything for their surgery... epidural, arterial line, central line, intubation and general anaesthetic. A gold mine of procedures for a rookie... particularly one in emergency medicine who needs to become proficient in them (except epidurals... that's strictly an anaesthesia thing). But what does this guy do? He does every single thing himself, silently. Doesn't even explain what he's doing as he goes along. Here I was, trying to get close enough to see without contaminating his sterile field, and he was just going about his business like I wasn't even there.

Sometimes I hate the "culture" of medicine. The rigid hierarchy, the unfriendly rivalry between specialties (not to mention the way all specialties seem to look down on family doctors), the pompous asses that seem to be everywhere you look...

I'm hoping to God that this is just a tertiary care/academic centre thing. I'm really counting on the fact that when I get the hell out of here and start practicing in a smaller town away from the academic bullshit that this will all go away. For now, although I love my job, I'm really dreading going to work in the mornings. Sigh.