Now a doctor, still an asshole.
Wow! Getting through it. I'm a bit more than half through residency (5/8, to be exact), and really enjoying the thought that all of this ends. Let's dump a couple annoying experiences from residency so that I never forget how it feels to be chastised for something that isn't my fault and don't do that to someone else.
1. Immediate telephone
The majority of our pediatric hospital admissions happen overnight, and on teams that are related to subspecialties of pediatrics (GI, cardiology, pulmonology, etc.), the team staffs with a fellow overnight. The patient's information, including why they came in, their abnormal labs, and the plan for the next day, is subsequently signed out to the day team with the understanding that you will not re-collect the information again in the morning nor discuss the plan before talking to the family and the most senior doctor on the team together during rounds.
On this particular morning, I picked up a patient with Crohn's disease who, according to the night team, was not having a Crohn's flare but just had a few episodes of loose stool. The plan, per the fellow was that we would not do a colonoscopy. Yay!
The team and I get to the room and present all of the information I have, including the fact that the plan is not to do a scope. The attending stands outside of the room as I stand in the doorway, presenting to the patient and family and quietly and sternly states, "We're going to scope." A good peon, I backpedal immediately and re-relay that information, but it's too late. The attending has now eroded any trust the family has in me. Do I get scolded later about my poor communication skills? Yes. Yay.
2. I'm a dick, and that's ok! You want to help the patient? Let me punish you!
On the phone with a particularly difficult psychiatry attending, I start the conversation out pleasantly, asking if I can clarify some recommendations from the weekend with regard to a patient on my team. The immediate response is, "Read the note. There are very clear recommendations."
I take a deep breath and steel myself for what is all but guaranteed to be a situation I will be punished for later. "I read the note very carefully, but I still have some questions about the recommendations. Do you want us to discontinue this medication permanently or is this just a medication the patient doesn't require in the hospital?"
"Well, he hasn't required it here!"
As you might expect, this conversation, much like the plot of most M. Night Shyamalan movies, progressed poorly. The attending reported me for questioning his recommendations (WHAT RECOMMENDATIONS? THAT'S WHAT I WANTED! COME ON!), and I was told I need to be more professional. And, of course, being exceedingly grateful for being paid at a rate of approximately $12/hr to provide 80 hours per week of medical care, I accepted the "constructive" criticism and mentally flipped off everyone who had ever acted as an administrator in graduate medical education.
I am excited for training to be over. I'm on vacation now, so everything feels fine, but I'm not looking forward to going back. I count down the months, and I look forward to entering a time when I can count down the days.
1. Immediate telephone
The majority of our pediatric hospital admissions happen overnight, and on teams that are related to subspecialties of pediatrics (GI, cardiology, pulmonology, etc.), the team staffs with a fellow overnight. The patient's information, including why they came in, their abnormal labs, and the plan for the next day, is subsequently signed out to the day team with the understanding that you will not re-collect the information again in the morning nor discuss the plan before talking to the family and the most senior doctor on the team together during rounds.
On this particular morning, I picked up a patient with Crohn's disease who, according to the night team, was not having a Crohn's flare but just had a few episodes of loose stool. The plan, per the fellow was that we would not do a colonoscopy. Yay!
The team and I get to the room and present all of the information I have, including the fact that the plan is not to do a scope. The attending stands outside of the room as I stand in the doorway, presenting to the patient and family and quietly and sternly states, "We're going to scope." A good peon, I backpedal immediately and re-relay that information, but it's too late. The attending has now eroded any trust the family has in me. Do I get scolded later about my poor communication skills? Yes. Yay.
2. I'm a dick, and that's ok! You want to help the patient? Let me punish you!
On the phone with a particularly difficult psychiatry attending, I start the conversation out pleasantly, asking if I can clarify some recommendations from the weekend with regard to a patient on my team. The immediate response is, "Read the note. There are very clear recommendations."
I take a deep breath and steel myself for what is all but guaranteed to be a situation I will be punished for later. "I read the note very carefully, but I still have some questions about the recommendations. Do you want us to discontinue this medication permanently or is this just a medication the patient doesn't require in the hospital?"
"Well, he hasn't required it here!"
As you might expect, this conversation, much like the plot of most M. Night Shyamalan movies, progressed poorly. The attending reported me for questioning his recommendations (WHAT RECOMMENDATIONS? THAT'S WHAT I WANTED! COME ON!), and I was told I need to be more professional. And, of course, being exceedingly grateful for being paid at a rate of approximately $12/hr to provide 80 hours per week of medical care, I accepted the "constructive" criticism and mentally flipped off everyone who had ever acted as an administrator in graduate medical education.
I am excited for training to be over. I'm on vacation now, so everything feels fine, but I'm not looking forward to going back. I count down the months, and I look forward to entering a time when I can count down the days.