What’s up you guys?
Hey. In this video, I wanna talk about how to deal with asshole surgeons. If you are a med school student or you’re thinking about being a med student or you’re a resident or you’re a nurse or a PA or an NP and you have to deal with asshole surgeons like myself all the time, let me tell you how to deal with them.
First, a little story.
When I was a second year resident…You rotate through lots of different categories or disciplines of surgery and one of them is cardiothoracic surgery. In cardiothoracic surgery, your main job as a second year resident – because you don’t really- They don’t want you to do (bleep) because you’re an idiot. The cardiothoracic surgeons are here, and you’re here so they’re like, don’t touch my (bleep) patients except in the ICU, which is really weird. You get to do the ICU rotation, cardiothoracic ICU. You take care of the post-op CABG patients and mitral valves and things like that and these guys are sick as (bleep) and they have, like, three compressors on and stuff. But you can’t do (bleep) in the operating room. The only thing you can do in the operating room is learn how to do a sternotomy, which is very important for a general surgeon because if you are a general surgeon in the middle of nowhere or in the middle of a city and there’s nobody else around that knows how to do a (bleep) sternotomy and somebody…Say, for instance, the cardiologist pokes a hole in the heart and the patient develops cardiac tamponade in the cath lab. They may call you to come do a sternotomy and fix the hole in the heart because there’s no…Some places don’t have cardiothoracic surgeons, they only have cardiologists, which is very interesting.
I say that because that’s exactly what happened to me. I’ve had it twice. Two (bleep) times. It’s just very important to learn how to do a sternotomy. When you’re a secondary resident, you’re all fired up. You’re like, yes, I’m gonna learn how to do a sternotomy. If you don’t know what a sternotomy is, it’s basically when you cut the sternum or the breastbone in half like this. You open up the chest so you can do…For this instance, you do CABG, which is coronary artery bypass grafting or mitral valves or i-ric valves, whatever.
A lot of the cardiac surgery includes a sternotomy.
You get all excited. You’re like, (bleep) yeah. I’m gonna do some badass (bleep). I’m gonna take a saw, I’m gonna zip somebody’s breastbone open. This is gonna be a sweet day.
You’re in cardiothoracic surgery rotation. That’s what you’re gonna learn.
Anyway, I go into this operation, and this is my first one with this cardiothoracic surgeon. He’s notorious for being a real dick. I’m not gonna lie about that. There’s a few of them, but he was really, really bad. There was a couple of other ones that we had that were really great, and everybody knew that. He was really bad, and I got stuck…
What happens is is that you get assigned to a surgeon, and that day I got assigned to him. I was like, oh (bleep). This is gonna be bad.
I’m a little bit nervous going in already, so I go in and he goes, the patient’s sleeping. The surgeon stands on the left side. Usually, the surgeon stands on the right side of the patient but in a teaching scenario, the surgeon stands on the left. The resident stands on the right ’cause the resident is trying to learn how to be the operating surgeon.
A lot of times in surgery the teaching surgeon will take a pen and draw where they want you to make the incision on the skin because, at first, it’s a little bit nerve-wracking and you maybe don’t do it straight and stuff like that. At this point, I never draw anything. I just make the incision. You’ve done it so many times it’s pretty straight.
This guy, instead of taking a pen, he takes a knife. A scalpel. He makes a little nick in the skin right there and then down below the breastbone right there, and he puts the scalpel on the patient’s chest and says, “Okay, connect the dots.” It’s kind of like that pool shot where there’s no other balls on the table, but the eight-ball or the pocket’s way away. It’s the other side of the table. This should be easy but oftentimes you miss.
What happened is I take the scalpel. 10 blade. I start here and I go all the way down. At this time, like I said, I don’t have a marker, marking pen, or a line to follow so I just have to eyeball it. I make the incision. I get all the way down to the bottom incision below the breastbone, and I miss it by a (bleep) millimeter! A millimeter! I (bleep) you not. It was a millimeter. It was so close. I joked a lot before. I was kind of class clown. I hit that and was like, oh no, I missed it! As in joking ’cause it’s so close. You can just take the skin in between, take it out and nobody will know the difference. At the same time he’s like, holy (bleep)! I thought he was joking too and I chuckled. Then I looked around the room and everybody in the room, the anesthesiologist, the scrub nurse, the scrub tech, they all put their head down and looked away from him. I was like, uh oh. He looks at me and goes, “What the (bleep) is your problem? What the (bleep) is going through your head? Are you (bleep) retarded? What is your- How could you (bleep) miss? I (bleep) gave you this!” I’m like, oh my God. Then he goes, “That’s it! Switch places with me.” Which means it’s the end of the surgery for you. Now you’re the assistant. Now you’re not gonna do (bleep). Now you’re not gonna learn (bleep). He’s not gonna teach you (bleep). Now I’m like, damn, I missed my chance to do a sternotomy. (Bleep).
He loses his mind. What you gotta do is you gotta walk around- You gotta go down at the foot of the patient, basically, around their feet and then come back up. Both of us do that and we meet in the middle. I’m like, oh God. I go to step around him and he steps in front of me, heads me off the passage. He’s like, “Seriously, what the (bleep) is going through your (bleep) brain? Are you (bleep) stupid?” I was like…What do you say, right? What do you say? “I guess so. Yeah, I must be. I don’t know. I’m sorry. I’m sorry.” He goes around. He’s still cussing. He’s still, (bleep) the (bleep), stupid (bleep) resident. Blah blah blah. I’m like, oh my God. At this time, I wanna quit. I’ve had enough. I’ve got my ass kicked for a year and a half and I’m like, “This is not worth it. This is stupid. This is (bleep) psychological abuse. I might as well just go get beat up every (bleep) day. Who cares?”
He gets there, and he makes a little nick in the skin and takes that piece of skin off. Now you can’t even tell the difference. Then I’m sitting there. I’m just super still. It’s all quiet for a little while. Nobody talks in the room. Everybody’s like, oh (bleep). Then he goes, “Well, maybe I overreacted.” You think? Holy (bleep). Lucky for me, he said that because I would never be able to talk to him again. How do you deal with that? Five minutes later he goes, “You should see my kids. They’re all (bleep) up.” I’m like, okay. Kind of in the back end conversing with him and stuff.
He was just so hard, and that was not the only time that (bleep) happened to me in residency. Residents, senior residents, will basically scream at you almost every single day but having a cardiothoracic surgeon…You’re a resident. You’re [a] second-year resident. You’re trying to learn this stuff. You’re getting your ass kicked. You’re super tired. You never get enough sleep so you’re chronically tired. Now this guy comes and just rips you a new one ’cause your brain is inadequate. That’s what we all think. Our brain is malformed, and it doesn’t work right. I’m stupid. That’s, I think, the bottom line of all this stuff when you get yelled at or something like that from a surgeon. There’s a long story about that, but I’m getting to the point of, how do you deal with that?
I think that, in the moment, it’s very hard. It’s very har- You can’t walk out. ‘Cause I thought about it. It went through my head just to (bleep) just take my gown off and be like, “Go (bleep) yourself.” And walk out and quit residency. That’s the place I was at. I was just…I was ready to quit the entire residency, give up everything. You’re so pissed. You’ve done all this work. I’ve taken years and years of my life, sat in a chair and read for 10 to 12 hours a day for years. And at this point, I’m like “I wanna throw it all away. (Bleep) it.”
So what do you do? How do you deal with this? I think, first of all, you have to remember that there’s another side. As in, there’s a human there and he’s going through his own (bleep). It may or may not be that I did this thing wrong or that I’m stupid. Most likely, most people are not actually stupid. Their IQ is fine, especially if you’re in residency. That’s not the case. Some people work harder than others, I would definitely say that. But at that point, you’re not dumb. What you have to remember is that there is, number one, that’s just that moment. Don’t quit, okay? Do not do that. Don’t throw it away for a stupid thing like that. That guy’s an asshole, and he probably hates his life. He just took it out on you that day. You don’t know what happened to him that morning.
Number one is to remember do not (bleep) give up. It’s easy to say that, but it’s hard to do. Number two, you have to remember that there is a person over there and they probably have their own shit going on. Number three is remember that you are a student. That was the other thing for me. I didn’t quite see it then, but I see it now. I see why- I see the gap in knowledge. And it’s not really knowledge, it’s experience. When you have enough experience to know what consequences a very small action has in a person’s life, in a human’s life…You’re the attending cardiothoracic surgeon. You’re responsible for this person’s life.
This person is sleeping. You’re gonna open their chest. You’re gonna stop their heart. You’re gonna start it back up again after you re-pro-freez their vessels. It’s a big deal. Not every surgeon has that kind of responsibility, but most doctors feel a responsibility. As in, I’m responsible for this person’s life. That’s where that person’s coming- That’s where that surgeon or doctor’s coming from.
I’m responsible for this person’s life. You just did something to this person which I’m responsible for.
If you can think about that and be respectful of that, at the same time, hating that person because you will, that’s the place where you need to get. Don’t quit. Realize that there is a person with his own shit. Realize that there’s responsibility of that person, for this person’s life and there’s a big gap in experience.
When you can do that and stay humble – this is so hard, right – then you can learn from that person.
Even though I totally hated him, I could learn from him the next couple months on that rotation and actually even after that.
I guess what I’m saying is to try and separate the personality, the person, from that experience that you can get. That’s the main thing. Because there’s tons of people around, walking around the hospitals and wherever that you can get experience from. Just because they’re a (bleep) asshole doesn’t mean that you can’t improve yourself. It’s tricky, isn’t it? It’s really hard.
That’s where you separate yourself from average to excellent. In the hospital and especially medicine, you’re gonna read a lot of books but it ends up being your experience and what you experience and how you relate that to the things that you read.
Some of those experiences are not just your patient exactly but it’s another surgeon, another doctor talking about what they’ve had problems with. Some of those things I still do. I’ve never seen- I’ve never had a patient that died from an overdose of benzodiazepines but in our residency, we had somebody do that. Something happened. It was an overdose in the ICU. That was before I showed up. That hermiated our entire residency for six years. I was never allowed to give IV benzos to a patient on the floor without a monitor and still, I don’t like to do that. That’s an experience that I had that was indirect.
That’s my challenge to you is to take those really difficult situations and turn them into an experience for you and for you to gain knowledge. If you can do that, then you’ll be way ahead of everybody. But it’s not easy. Hashtag, adulting is hard, mother(bleep). Try that.
All right, you guys. Hey, thanks for watching this video. It’s a little long one. I thought it was gonna be short but turned out to be a little long. If you like my channel, if you like these videos, please subscribe. Comment below. Definitely I wanna hear all your comments. I love hearing everyone’s comments and share the videos and like them and all that stuff. I’ll talk to you in the next one. See you.
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