The Cardiac Surgeon Who Made Me Cry: You Were A Bully and We All Need To Stop
June 6, 2021
I was having a conversation with a wonderful person the other day. We talked about wellness and physican burnout, and just catching up with eachother in life. But even wonderful people (including Dr. Plastic Picker) sometimes we have comments and snippets of conversations that are not helpful about others. I used to be a culprit. I’m not sure if I was worse than others, but certainly party to it too. Everytime I talk to this particular person or think about about 4 pediatricians in our group that came from the same department before they reached our HMO, I am reminded what a culture of bullying does to a group of young physicians. I am not sure what was exactly going on at the local children’s hospital in town in the emergency room, but it was toxic. Toxic enough that we had a mass migration and mass attempted migration of pediatricians into our HMO. We needed per diems at that time, but not that many phyisicans. As is with the nature of things, some we hired. Some work part-time. And some went on to other cities and hopefully went on to have solid careers.
The dynamic between the pediatricians that came from that previous work situation, and then to us – is interesting. It’s been years but the interactions they all had was layered with a culture of bullying (financial, professional, and probably real). I think their “boss” or my equivalent position person even left the organization. I sometimes feel like an exhausted teacher, trying to point out to this particular friend that even four years later their interactions are influneced by that time they worked together in that toxic environment. I will shout out to the internet blogging unviverse and to those that were part of forming that system, and it’s usually those who are driving nice cars and living in big houses who actually don’t do any work – even some MDs with really long CEOCFOBULLSH1T titles. All I have to say, is that you should be ashamed of yourselves. You should absolutely be ashamed of yourselves for what you did to those young pediatricians. I had to emotionally and financially help them deal with these issues, and it permeated into our department. They are all really solid and really good physicians, and are fine now. But I can see the professional ramifications for all of them, especially financial. Again they are fine, but it was not easy for any of them.
As for me, it reminds me how lucky I am as Dr. Plastic Picker. I was bullied like every physician out there – but did not train in a culture of bullying. My particular training program was known to be relatively kind and collegial. My first job was as an endocrine fellow and then a reserach lab, where I was supported as a new young attending and even supported during a difficult pregnancy. I do remember three particular times I was bullied in medicine and they stand out in stark contrast to the general nurturing environment I was trained in.
The three times I was bullied were all by surgeons. I had a cardiac surgeon when I was a third year medical student (I was rotating in anesthesia also) berate me for not knowing the arteries of the heart, and made me cry in front of the entire OR. The residents and even the attending anesthesiologist stood there completely silent. This particular surgeon had just NOT made tenure at Crimson University, and when he asked me where I had gone for undergraduate and I told him Crimson University – it just set him off. He continued to berate me for 2 hours during the surgery. With snot running down my nose and just standing there, I did the first brave thing I ever did as a student. I just walked out. I walked straight out of that OR, that hospital, and right into the medical school offices of Dr. Robert Masland. I sat there and I cried in Dr. Robert Masland’s office. Dr. Masland was a very famous pediatric endocrinologist and almost 80 years old at that point. He was the head of our “society” we called it. He listened to me and he was understanding and upset at what had happened. He was a very famous doctor in our school. He picked up the phone, and said something to someone. And I took the rest of the day off. I returned to rounds the next day and the residents didn’t say a word. I remember thinking that they and the anesthesiologist were cowards. And now that I am Assistant Boss, I realize that they were.
The second time I remember being bullied, was when I was rotating as the pediatric intern on the pediatric surgical service. We were pediatric residents, but rotated with the surgical residents. The surgical senior on that rotation, was super toxic. He was just mean throughout the entire month when he was the supervising senior. I think I was on just as a covering intern because one of the other residents left the rotation because he had been bullying her so much. I had done that rotation already, and was asked to sub in for my friend. The previous senior resident had been phenomenol and I already knew my stuff. This toxic surgical senior resident would tell us to do not put social work referrals, or not do this or that – that we knew we needed to do for the care of our patients. One child was having such bad withdrawal from ativan and opiods, and he had us tapering her too fast off her meds. We wanted to consult the pain service, and he refused to allow them to be involved. I remember being part of the 1-2 other pediatric residents that were brave. We knew we were right and we knew the surgical attendings well. We just sometimes called them directly and asked them in the OR if we could do this or that, and just superceeded this toxic surgical senior. Sometimes he would mismanage patients so badly, that in the middle of the night – we would go over to the pediatric hospitalist attendings and just ask them to take a particular patient onto their service. We would make calls to their primary pediatricians and ask them to intercede, and that’s what happened. In the morning when this surgical senior would appear, magically patients that we were worried that were being mismanaged were suddenly part of another service and we were just the “consulting” service. Now when I think back to this, we were really brave.
The third time I remember being bullied wasn’t that bad. It’s because I didn’t particular know those two people, but the bullying was physical. Come to think about it, these days I could probably call the police on them. One time a vascular surgeon threw a scalpel in my direction. It was a clean scalpel but he cut me. He was having a bad day. I was just the medical student standing there. I knew I had nothing to do with it, but he threw a scalpel at me. Isn’t that assault? I had to go to occupational health and discuss whether I needed to get AIDS prophylactic medications. Even the occupational health attending didn’t say anything. And then once when I was a student on ob-gyn, there was a stat Csection and the attending wanted me to scrub into the OR. I was thinking of going into OB-GYN back then and I had impressed them during that rotation. I think I got high honors. I went to position the OR light in the right direction as directed by the fellow, and the OR scrub (who was male and southeast asian like me and had I’m sure some colonial and gender issues) grabbed my wrist somewhat violently and yelled at me. The fellow looked at him and glared and told him to let me go and that I had been invited to scrub it. I remember thinking, thank god there was a badbass female high-risk OB fellow and what a jerk.
And that is it. Just wanted to work through some of these issues that were kind of in my brain. We need to recognize the culture of bullying and we all need to stop. I see the ramifications in folks work and financial lives. I was fortunate to generally have been trained in supportive environments. But let’s stop the negatively and realize that we don’t need to recapitulate any of it. That is all. And today, I am living a dream and going to do a park clean and trash art project with a Brownie Troop! I’ve worked with them once before and very excited to connect with them again. They are so fun, and I’m going to make them into mini-Dr. Plastic Pickers. Fighting litter and bullying at the same time!