Same Arrogant Surgeon Raises His Bloody Head Again

jetproppilot · Aug 12, 2008

I'm sitting in the anesthesia lounge today taking a well deserved break since I was on OB/pain/lines, and the pregnant women were everywhere... two C sections and four epidurals before 11am in addition to having to round on about 20 pain patients.... :bullcrap:

Man, I found the coolest product!!!

ALREADY PEELED HARDBOILED EGGS!!!!

Six to a package.

I pop open the package, take a load off, sit down at the table, and start enjoying my meal....six egg whites enhanced with salt, pepper, and Tabasco sauce.....mmmmmmmmmmmm I flip open an old People magazine...

Scott CRNA hangs up the phone.

"Difficult intubation in room nine, Dude. Doctor Ponnat's in there.

S HIT I think, halfway through my third Tabasco enhanced egg white.

I swallow whats left of the third chicken embryo sac, wipe my mouth, and walk to room nine.

I push open room nine's door and see Doctor P attempting to intubate.

Debbie CRNA tried first without success....now Dr P is on her second attempt.

Debbie CRNA is watching intently, as are the other OR staff in the room.

And so is Surgeon Grumpyfuk (GF).

"Bill!" Dr. P says.

"Need your muscle here."

Dude on the table is an average size male in the OR for a thyroid....I glance at his mandible while Dr P is attempting intubation and it looks small.

Dr P is a great anesthesiologist...she's hard working, knowledgable, well liked.....

turns out, though, on some difficult intubations strength is an asset...

yeah, I know we disseminate that intubation is more savvy than strength....which is mostly true....but some anterior airways, if you've got some...uhhhhh.....muscle, youre able to, with a Miller 2, once the blade is where you want it, provide a little wrist action that extends to the end of the blade which lifts the epiglottis justa little bit more.......a move that flips the epiglottis jussta little bit more without rokking back on the teeth....

...most times, after a deftly placed blade, that extra little bit is all you need.

I take position at the head and dive in with the Miller 2 knowing if Dr P couldnt see anything its gonna be hard.

Miller 2 homes in, positions correctly and I don't see s hit so I use the proprietary wrist movement I learned from MITCH LeBLANC CRNA who happens to be the best laryngoscopist on planet earth, bar none and the bottom of the arytenoids comes into view.

"Bougie please!" I say.

Blue stylette guided thru the orifice.

ETT Seldingered over the Bougie.

SUCCESS! :horns:

This is the beauty of a private practice with several anesthesiolgists on the floor.

We all run across difficulty at some point.

Having partners that can come help you is priceless during a busy day!

I've called for help many times. Noone should be above calling for help.

Back to current day... I've just saved this surgeon alotta time and potentially a cancellation of his case because of difficult airway issues.

Know what he says?....remember though this is the surgeon I had a run in with that I blogged about on the Dealing With Cocky Surgeons thread...kinda got all up in his personal space during that previous incident......HAHAHAHAHAHAHAHAHAHHAHA

Nothing.

No "Hey, Thanks!"

No "Hey, you're a dickhole!"

Nothing.

Thats OK.

Dr P thanks me and I wander out of room nine headed back to my spicy egg whites.

I'm sitting at the table again, on the fifth-of-six egg whites when I getta call back to room nine. :uhno:

I return.

Keep in mind this is the same surgeon I had a run in with I posted about on the thread Dealing With Cocky Surgeons.

I walk in, Dr P's there.

Dickhole surgeon speaks.

"His tooth is chipped! You're gonna haffta tell his wife who is a total BITCH."

Dr P is shaking her head.

FIRSTOFALL I was the third laryngoscopist, so if theres damage, its not clear who caused it.

Not that it matters.

I know my laryngoscopy was clean I think to myself....

I look at Dude's tooth.

No chip.

Theres a little irregularity at the bottom....maybe abraded a little...

but no chip.

Whats my reponse to Dickswinging Surgeon?"

"No problem, Dude. I'll touch base with his wife."

I exit.

SO HERE I AM TODAY ON OB ASSIGNMENT INNOCENTLY EATING SOME EGG WHITES AND DECIDE TO HELP A COLLEAGUE AND THIS IS WHAT I GET? :laugh:

UHHH, DIKKHOLE SURGEON, I SAVED YOU SOME TIME TODAY. AND I'M SURE IT WASNT ME THAT CAUSED AN ALMOST INVISIBLE IRREGULARITY TO YOUR THYROID DUDE'S TOOTH...AND I'M NOT EVEN SUPPOSED TO BE IN HERE, BUT I'M ALWAYS GONNA RESPOND TO A COLLEAGUE ASKING FOR HELP.

Funny how Dikkhole Surgeon is above giving thanks to such a cohesive anesthesia group and chooses to try and get a dig in on me.....the dude that got the tube in, enabling him to do his case...

Its all good.

Dikkhole surgeon has a long history of being difficult.

I make too much money, and am too happy at my gig to let some outlying surgeon dikkswinger get to me. Lets look at this objectively.....anesthesiologist secures airway.....surgeon takes that for granted and focuses on some insignificant issue....TIME TO ENTER THE OCTAGON, RIP OPEN DIKKHOLE SURGEONS OUT-OF-SHAPE THROAT????? HUH??? YEAH???? CAN I? PUHLEAAAAAAASE???

Nope.

Went and spoke with the wife about the difficult intubation and the unsubstantial "damage" to the dudes tooth....even though I'm sure it wasnt me that abraded the bottom of the incisor......

I thought about Arch while I completed all these tasks, and how, as a resident, Arch took the blame for some stuff that wasnt his fault.

I thought about the BOW YOUR HEAD thread.

That BOW YOUR HEAD thread is money, even out here in the HOLY GRAIL.

In the grand scheme of the OR environment, I'm an offensive lineman at best.

As an anesthesiologist I cater to surgeons.

Most of them are gratuitous for my expertise.

This surgeon dude is obviously eaten up by ego and is above telling a colleague thanks....

We work with all types of surgeons as anesthesiologists. Most of them are people. A few of them are narcissistic a ssholes. And it isnt worth most battles with the latter since they are few and far between.

Just parrta the job, ladies and gentlemen.

Cuz I'm happy at work, despite the rare run-in with Dikkhole Surgeon.

And those zeroes separated by commas keep accruing in the checking account.

I'll go face to face sometimes.

This wasnt one of them.

dfk · Aug 12, 2008

jetproppilot said:
I'm sitting in the anesthesia lounge today taking a well deserved break since I was on OB/pain/lines, and the pregnant women were everywhere... two C sections and four epidurals before 11am in addition to having to round on about 20 pain patients....

Man, I found the coolest product!!!

ALREADY PEELED HARDBOILED EGGS!!!!

Six to a package.

I pop open the package, take a load off, sit down at the table, and start enjoying my meal....six egg whites enhanced with salt, pepper, and Tabasco sauce.....mmmmmmmmmmmm I flip open an old People magazine...

Scott CRNA hangs up the phone.

"Difficult intubation in room nine, Dude. Doctor Ponnat's in there.

S HIT I think, halfway through my third Tabasco enhanced egg white.

I swallow whats left of the third chicken embryo sac, wipe my mouth, and walk to room nine.

I push open room nine's door and see Doctor P attempting to intubate.

Debbie CRNA tried first without success....now Dr P is on her second attempt.

Debbie CRNA is watching intently, as are the other OR staff in the room.

And so is Surgeon Grumpyfuk (GF).

"Bill!" Dr. P says.

"Need your muscle here."

Dude on the table is an average size male in the OR for a thyroid....I glance at his mandible while Dr P is attempting intubation and it looks small.

Dr P is a great anesthesiologist...she's hard working, knowledgable, well liked.....

turns out, though, on some difficult intubations strength is an asset...

yeah, I know we disseminate that intubation is more savvy than strength....which is mostly true....but some anterior airways, if you've got some...uhhhhh.....muscle, youre able to, with a Miller 2, once the blade is where you want it, provide a little wrist action that extends to the end of the blade which lifts the epiglottis justa little bit more.......a move that flips the epiglottis jussta little bit more without rokking back on the teeth....

...most times, after a deftly placed blade, that extra little bit is all you need.

I take position at the head and dive in with the Miller 2 knowing if Dr P couldnt see anything its gonna be hard.

Miller 2 homes in, positions correctly and I don't see s hit so I use the proprietary wrist movement I learned from MITCH LeBLANC CRNA who happens to be the best laryngoscopist on planet earth, bar none and the bottom of the arytenoids comes into view.

"Bougie please!" I say.

Blue stylette guided thru the orifice.

ETT Seldingered over the Bougie.

SUCCESS!

This is the beauty of a private practice with several anesthesiolgists on the floor.

We all run across difficulty at some point.

Having partners that can come help you is priceless during a busy day!

I've called for help many times. Noone should be above calling for help.

Back to current day... I've just saved this surgeon alotta time and potentially a cancellation of his case because of difficult airway issues.

Know what he says?

Nothing.

No "Hey, Thanks!"

No "Hey, you're a dickhole!"

Nothing.

Thats OK.

Dr P thanks me and I wander out of room nine headed back to my spicy egg whites.

I'm sitting at the table again, on the fifth-of-six egg whites when I getta call back to room nine.

I return.

Keep in mind this is the same surgeon I had a run in with I posted about on the thread Dealing With Cocky Surgeons.

I walk in, Dr P's there.

Dickhole surgeon speaks.

"His tooth is chipped! You're gonna haffta tell his wife who is a total BITCH."

Dr P is shaking her head.

FIRSTOFALL I was the third laryngoscopist, so if theres damage, its not clear who caused it.

Not that it matters.

I know my laryngoscopy was clean I think to myself....

I look at Dude's tooth.

No chip.

Theres a little irregularity at the bottom....maybe abraded a little...

but no chip.

Whats my reponse to Dickswinging Surgeon?"

"No problem, Dude. I'll touch base with his wife."

I exit.

SO HERE I AM TODAY ON OB ASSIGNMENT INNOCENTLY EATING SOME EGG WHITES AND DECIDE TO HELP A COLLEAGUE AND THIS IS WHAT I GET?

UHHH, DIKKHOLE SURGEON, I SAVED YOU SOME TIME TODAY. AND I'M SURE IT WASNT ME THAT CAUSED AN ALMOST INVISIBLE IRREGULARITY TO YOUR THYROID DUDE'S TOOTH...AND I'M NOT EVEN SUPPOSED TO BE IN HERE, BUT I'M ALWAYS GONNA RESPOND TO A COLLEAGUE ASKING FOR HELP.

Funny how Dikkhole Surgeon is above giving thanks to such a cohesive anesthesia group and chooses to try and get a dig in on me.....the dude that got the tube in, enabling him to do his case...

Its all good.

Dikkhole surgeon has a long history of being difficult.

I make too much money, and am too happy at my gig to let some outlying surgeon dikkswinger ruin it.

Went and spoke with the wife about the difficult intubation and the unsubstantial "damage" to the dudes tooth....even though I'm sure it wasnt me that abraded the bottom of the incisor......

I thought about Arch while I completed all these tasks, and how, as a resident, Arch took the blame for some stuff that wasnt his fault.

I thought about the BOW YOUR HEAD thread.

That BOW YOUR HEAD thread is money, even out here in the HOLY GRAIL.

In the grand scheme of the OR environment, I'm an offensive lineman at best.

As an anesthesiologist I cater to surgeons.

Most of them are gratuitous for my expertise.

This surgeon dude is obviously eaten up by ego and is above telling a colleague thanks....

We work with all types of surgeons as anesthesiologists. Most of them are people. A few of them are narcissistic a ssholes. And it isnt worth most battles with the latter since they are few and far between.

Just parrta the job, ladies and gentlemen.

Cuz I'm happy at work, despite the rare run-in with Dikkhole Surgeon.

And those zeroes separated by commas keep accruing in the checking account.

dude,
when can i work for/with you?
attitude is KEY!

Planktonmd · Aug 12, 2008

jetproppilot said:
Went and spoke with the wife about the difficult intubation and the unsubstantial "damage" to the dudes tooth....even though I'm sure it wasnt me that abraded the bottom of the incisor......

.

It's a little bit uncool of your colleague "Dr P" to let you take the blame solo for something you most likely did not cause.
If I called you to the OR to help me intubate some one and even if I saw you break the tooth I would not let you deal with the surgeon and the family alone.

OB1🤙 · Aug 12, 2008

jetproppilot said:
...I flip open an old People magazine...

And then you grabbed your fanny pack on the way to the room? :laugh:

I kid, I kid...

Seriously man, another great story with another great moral. Screw that surgeon- he can go home at the end of the day back to his unhappy life and sexless marriage, and you'll be kicking back sippin' Patron, living the High Life.

There have been times these past couple months when I've just wanted to lose my $hit and lash back at whoever is trying to make my life more difficult- be it the attending with personality disorder, arrogant surgerizer who doesn't say thanks for taking fan-freaking-tastic care of "his" unstable, hemodynamically labile patient, disgruntled cafeteria lady who seeks out the smallest damn piece of fish she can find on purpose, whoever.

But it's not worth it. No way.

I just grin and bear it, remember the truth and wisdom in the Bow Your Head thread, realize that when the workday ends, my life is a hell of a lot better than any of the aforementioned characters' is, and let it go. And if I have job satisfaction and a good life as a freaking resident, there's no way that doesn't get a thousand-fold better once this long jump through the academic hoop is done.

Thanks for dropping some more eloquent wisdom on us, Jet.

cfdavid · Aug 12, 2008

Jet, man, I can NOT communicate enough how valuable these threads are to us med students. Especially those amongst us that don't like to take a lotta needless BS.

But, you know what? Just 6 weeks into my 1st rotation of MSIII, I've already learned the VALUE of just letting **** slide.....

***********Make NO mistake, the people that are a..sholes are those that are insecure, unhappy, or are losing in life (on the grand scheme). So, we'd make ourselves truly subservant if we were to play their game, getting all wired up and all.......

On a more pragmatic note, those of us that KEEP THE MORAL HIGH GROUND will rarely loose in a contested disagreement. It's when dudes the size of JPP DO lose their cool, that they give up a VERY VALUABLE assest, the moral high ground....

cf

cfdavid · Aug 12, 2008

Hawaiian Bruin said:
And then you grabbed your fanny pack on the way to the room?

I kid, I kid...

Seriously man, another great story with another great moral. Screw that surgeon- he can go home at the end of the day back to his unhappy life and sexless marriage, and you'll be kicking back sippin' Patron, living the High Life.

There have been times these past couple months when I've just wanted to lose my $hit and lash back at whoever is trying to make my life more difficult- be it the attending with personality disorder, arrogant surgerizer who doesn't say thanks for taking fan-freaking-tastic care of "his" unstable, hemodynamically labile patient, disgruntled cafeteria lady who seeks out the smallest damn piece of fish she can find on purpose, whoever.

But it's not worth it. No way.

I just grin and bear it, remember the truth and wisdom in the Bow Your Head thread, realize that when the workday ends, my life is a hell of a lot better than any of the aforementioned characters' is, and let it go. And if I have job satisfaction and a good life as a freaking resident, there's no way that doesn't get a thousand-fold better once this long jump through the academic hoop is done.

Thanks for dropping some more eloquent wisdom on us, Jet.

My brother. I totally agree. Nice eloquence...lol

BTW gentlemen, I just signed up for our Anesthesiology Interest Group, which is only open to 3rd and 4th years (much to my dismay the last two years). So, looks like I'm gonna go for it. Can't wait. Looking to do some leadership if I can add anything..
Happy to focus in on a big interest even before coming to med school.

jetproppilot · Aug 12, 2008

Planktonmd said:
It's a little bit uncool of your colleague "Dr P" to let you take the blame solo for something you most likely did not cause.
If I called you to the OR to help me intubate some one and even if I saw you break the tooth I would not let you deal with the surgeon and the family alone.

I respect your post.

Keep in mind Dr P is a GIRL... and yeah, thats kinda politically incorrect...but this surgeon dude is THE most dikkswinging jerk we work with....

I didnt sense Dr P was s h itting on me....

Rather I think she knew it'd be easier in the grand scheme of things to let me deal with it.

This is politically incorrect, but there are still some dumba ss clinicians out there, namely older surgeons, who are more-easier-influenced by bowed-up-males than diminutive female physicians.

I think NOY can relate to this....since he's seen my girlfriend, who is a surgeon, and he agreed that the surgeons he works with, if she and I were to relocate to Colorado, may have a hard time accepting this FIVE FOOT TWO, HUNDRED TEN POUND FEMALE as a surgeon, even though GF can operate circles around them.... :laugh:

THATS PARTTA THIS GIG, FRIENDS.

ACCEPTING IGNORANCE AMONG OLDER SURGEON CUSTOMERS and accepting you are not gonna change their chauvanistic views.

And if possible if the situation is a soft call to quell it eloquently remembering the job security and the multiple zeroes in the checking account.

HARD CALL? Like in the COCKY SURGEON thread?

Hey, I've got no problems standing my ground.

But I let the soft calls slide.

Saves me inner peace, which is much more important than some egotistical, dikkswinging power battle.

I JUST TUBED THE DUDE WHICH SAVED YOUR CASE, AND I'LL GO SPEAK WITH THE WIFE, DUDE. NO PROBLEM.

There are much bigger dragons to slay than your PUNK A SS, EGOTISTICAL SELF.😀

cfdavid · Aug 12, 2008

Jet, I'm pretty sure you're SO surgeon is 110, NOT 210!!! lol (especially at 5'0")........😀

jetproppilot · Aug 12, 2008

cfdavid said:
Jet, I'm pretty sure you're SO surgeon is 110, NOT 210!!! lol (especially at 5'0")........😀

HAHAHAHAHAHHAHAHAHAHAH

No, Dude.

FIVE FOOT TWO, hundred ten.

Not five foot TWO HUNDRED TEN.

HAHAHAHAHAHAHAHAHAHAHHHAA

man the relevance of a comma, huh?

aphistis · Aug 12, 2008

cfdavid said:
Jet, I'm pretty sure you're SO surgeon is 110, NOT 210!!! lol (especially at 5'0")........😀

You didn't scuff the guy's tooth. I guarantee it. There's no way on God's green earth a blunt plastic (heck, not even metal) Miller produced a noticeable scratch on a grossly intact tooth. Complete BS, just like you said.

jetproppilot · Aug 12, 2008

cfdavid said:
Jet, I'm pretty sure you're SO surgeon is 110, NOT 210!!! lol (especially at 5'0")........😀

Speaking of arrogance, as dudes,

THINK WE GOT A BAD RAP?

Lets talk about my GENERAL SURGEON GF for a minute.

Diminutive female, physically.uhhhhh......she's SMALL.

Her diminutive physical attributes are the only smallness she knows.....partner in a successful general surg group....part owner of surg center...great schedule since she's so fast.....twenty minute lap gallbladders.....one hour lap colectomies......thirty minute lap-ventral hernias...😱

CHIKS GOT GAME, DUDES.

And yet she still endures discrimination I never knew could exist towards a successful, deft general surgeon with eight years in private practice.....just because her outward physical attributes are that of a little girl...

She jokes to this day about wanna the elder gen surgeons who thinks her presence in the doctor's lounge is to restock the refrigerator with cookies :laugh:

Theres an "elder" general surgeon who STILL mispronounces her name even though she's been here for many, many years.....and even though GF takes about twenty minutes for a lap gallbladder and he takes TWO HOURS.....GF operates CIRCLES around this chauvanistic motherfukker and yet he refuses to recognize her existence...

THAT FACT ALONE WOULD KILL ME.

It doesnt phase her......she could give a s hit less!

This is a (surgeon) girl who, to achieve efficiency, is willing to go get the patient from the ER, THE FLOOR, WHEREVER, WHEEL THE PATIENT DOWN TO THE OR LIKE A TRANSPORTER..., put the foley in, whatever....

SURGEON HOTTIE GIRLFRIEND KEEPS ME GROUNDED.

Whenever I feel myself getting big and egotistical I remember how she routinely goes to get her own patient.....puts in the foley.....and heres a chick who's a deft surgeon....who owns part of a surgery center....

BOW YOUR HEAD, JET.

BOW YOUR HEAD.

Thanks, Honey.

For your wisdom in the grand scheme of things.

Noyac · Aug 12, 2008

cfdavid said:
Jet, I'm pretty sure you're SO surgeon is 110, NOT 210!!! lol (especially at 5'0")........😀

If this were true, she'd be easier to jump over than to run around. :laugh:

I can vouch, It ain't 210.

Leverage · Aug 12, 2008

Jet is 100% BAD A S S

Noyac · Aug 12, 2008

Jet, I can't tell you how much better I feel now that you refer to your surgeon friend as "girlfriend" and no longer call her S.O. All is right again in the world. Yeah Dude.

Noyac · Aug 13, 2008

I also agree with what someone said earlier about your partner not handling the incident with dikkhead surgeon and calling you into the room in a sense blaming you for the tooth. I agree with your handling of the situation 100% but I wouldn't forget it. If she made a habit of this I'd have to take some action with her.

EDIT: I'm not saying anything Jet doesn't know. This is more for those of you that may find yourselves in this position in the future.

cfdavid · Aug 13, 2008

All I can say dudes is that I'm so happy for this forum. Unbelieveable that we have so many dudes step up and chat about pretty much everything.

I've wondered about my ego and where it would fit in the grander scheme of medicine. Well, I've truly reflected on this. And when I put my giant friggin ego in the midst of ANY specialty, it's gonna get hit, and hit hard. SO, what's the lesson here??

The lesson is that NO MATTER WHAT you choose, the best of the best BOW THEIR HEADS. I can't emphasize this enough. Even though I'm paraphrazing JPP and others.

jetproppilot · Aug 13, 2008

Noyac said:
Jet, I can't tell you how much better I feel now that you refer to your surgeon friend as "girlfriend" and no longer call her S.O. All is right again in the world. Yeah Dude.

yessir.

jetproppilot · Aug 13, 2008

jetproppilot · Aug 13, 2008

cfdavid said:
Jet, man, I can NOT communicate enough how valuable these threads are to us med students. Especially those amongst us that don't like to take a lotta needless BS.

But, you know what? Just 6 weeks into my 1st rotation of MSIII, I've already learned the VALUE of just letting **** slide.....

***********Make NO mistake, the people that are a..sholes are those that are insecure, unhappy, or are losing in life (on the grand scheme). So, we'd make ourselves truly subservant if we were to play their game, getting all wired up and all.......

On a more pragmatic note, those of us that KEEP THE MORAL HIGH GROUND will rarely loose in a contested disagreement. It's when dudes the size of JPP DO lose their cool, that they give up a VERY VALUABLE assest, the moral high ground....

cf

Thats what this thread is about, my friend.

And here you are, an MS-3, recognizing that...

I'm humbled.

Cuz even out here in the HOLY GRAIL, even though I've experienced it, I've reacted appropriately, hell I've sought inner peace by blogging here on SDN about it,

ITS STILL HARD.

To BOW MY HEAD in situations where I know I'm RIGHT....or I know surgeon dikkswinger is just throwing his weight around....and I know I'd be justified....

its THESE EXACT SITUATIONS where it takes ALL OF ME to muster HUMILITY.....RESTRAIN.......takes practice.....I've taught myself restrain/humility....this wasnt a natural transition for a 210 lb physical dude....took practice...inner study....if I can achieve this, believe me, so can YOU....

You're a third year med student recognizing the value of BOWING YOUR HEAD.

My hat is off to you, CF.

You are maturing beyond your years.👍

cfdavid · Aug 13, 2008

jetproppilot said:
Thats what this thread is about, my friend.

And here you are, an MS-3, recognizing that...

I'm humbled.

Cuz even out here in the HOLY GRAIL, even though I've experienced it, I've reacted appropriately, hell I've sought inner peace by blogging here on SDN about it,

ITS STILL HARD.

To BOW MY HEAD in situations where I know I'm RIGHT....or I know surgeon dikkswinger is just throwing his weight around....and I know I'd be justified....

its THESE EXACT SITUATIONS where it takes ALL OF ME to muster HUMILITY.....RESTRAIN.......takes practice.....I've taught myself restrain/humility....this wasnt a natural transition for a 210 lb physical dude....took practice...inner study....if I can achieve this, believe me, so can YOU....

You're a third year med student recognizing the value of BOWING YOUR HEAD.

My hat is off to you, CF.

You are maturing beyond your years.👍

Jet et al.

We mature in part because of the leadership we see on this forum. This is what's so cool about the anes group here. We can, and DO, learn from your individual experiences. Very good stuff, friends

ucsfgaspain · Aug 13, 2008

Jet,

Excellent post. I often tell my significant other that it's tough to be an anesthesiologist cuz you are very rarely recognized for good things but always pointed out for bad things. Unfortunately, we work with many people (surgeons, nurses, OB) that are too stupid to recognize when they are in the presence of brilliance. Sigh...it is a big part of why I did a pain fellowship to run my own show. But then you realize that even when you do...your patients often don't appreciate what you do either....you never win🙁

Like you, I've stopped playing the game of who's got the biggest d*ck in the OR. I'm just kicking back in the OR, surfing my iphone, and tracking my portfolios till I hit my F*CK Y*u number. I day dream about that day, cuz that's the day I'm coming into the OR and taking a big dump on the OR table and telling everyone to Kiss my A $ $ cuz I'm outta here :laugh:

dfk · Aug 13, 2008

ucsfgaspain said:
... that's the day I'm coming into the OR and taking a big dump on the OR table and telling everyone to Kiss my A $ $ cuz I'm outta here

👍👍

militarymd · Aug 13, 2008

Great post as usual....

but on a side note...may I suggest a light wand in the future for this type of patient.

1) no muscle needed (80 lb weaklings can use this effectively)
2) no metal parts....(no WAY they can blame you for dental injury)
3) you look REALLY cool doing it in the dark (dik head surgeon won't know what happened - someone could even spill some crap on him in the dark while you work your magic with the wand)

Keeva is digging it.

radslooking · Aug 13, 2008

Planktonmd said:
It's a little bit uncool of your colleague "Dr P" to let you take the blame solo for something you most likely did not cause.
If I called you to the OR to help me intubate some one and even if I saw you break the tooth I would not let you deal with the surgeon and the family alone.

agreed. man, that surgeon is a douche. Just imagine if you'd mentioned some complication to him after 3 people had operated on his patient, and attributed to him, and watch him go bonkers. That guy needs an asskicking.

Arch Guillotti · Aug 13, 2008

Unfortunately there are dikkswingers and dikkholes everywhere you turn in life.

I always said, pick your battles in residency. I only ever picked one and it was pretty dumb. I borrowed an ultarsound from an ICU and I forgot to clean it (which involves all of washing the probe off). A nurse came up to me and said in a very confrontational way "You NEED to clean that probe NOW". I looked her staright in the eye and said "Do not speak to me that way!" It went downhill from there, she asked for my name (which I gladly gave her, I got hers even though I didn't really give a crap. So we had a little ugly scene and that was the end of it. Didn't really make me feel any better. Especially the next day when I got a page from the office of the surgical services director (a big wig MD). I didn't return it because I was post call and I never heard anything else from it.

Towards the end of my CA-3 year I was doing a ditzel hand case that I left the propofol running on till the end of the case. The pt. was a PITA and I didn't want to fool w/her waking up till we were absolutely done. So we had to use the roller to move her over to the stretcher (she weighed all of 90 lbs soaking wet). The b!tch-@ss cireculator announced in a loud voice that "looks like we got another one here who doesn't know how to use his drugs!" I shoulda reached back like a pimp and slapped that ho. But I didn't. In hindsight I should have blasted her because I was about to finish and WTF did I care. It doesn't matter now. She is ugly and fat and the only thing she is good at is Sudoku.

So anyways it is different when you are an attending. Things change, but you still do have to put up w/BS. And it still is better to lay low. Let the dickhole have a hissy fit or whatever. I would imagine that for us new grads coming out that none of use would want to create any waves when joining a new group nor should we try to reinvent the wheel. Not only is it not worth it but I would think that not getting along w/others (even if they are jerks) might be seen as a liabilty to the partners whose position you aspire to be in one day.

Anyways, just my .02 as usual.

badasshairday · Aug 13, 2008

I want to be like JPP when I grow up. 👍

Pooh & Annie · Aug 13, 2008

Arch Guillotti said:
Unfortunately there are dikkswingers and dikkholes everywhere you turn in life.

The b!tch-@ss cireculator announced in a loud voice that "looks like we got another one here who doesn't know how to use his drugs!"

When anyone says something this freakin' offensive, I always automatically assume it's just an attempt to joke around, and it doesn't bug me. But if I knew she was being serious, I'd have to let her know I'm not havin' that S&*t. I think some of these people see timid anesthesia residents come along and they think they can show some dominance in front of the other staff. It won't hurt our profession if we show we're not pushovers. What's important is that we BE REASONABLE, and know when we're in the right.

Pooh & Annie · Aug 13, 2008

By the way, as someone who just finished his CA1 year, I can say there were plenty of times that I screwed up and overdid the relaxant or something and caused everyone to have to hang out awhile longer then should be necessary (not your case, Arch. You obviously knew what you were doing). Anyway, I've apologized when this has happened. You do that and I guarantee the hairy-eyeballs will be kept to a minimum. Also, the people who get hosed the worst in these situations (surgery residents who have to see the pt to the PACU, and THEN go round) have been without exception understanding. I always respect that and let them know.

jwk · Aug 13, 2008

Arch Guillotti said:
The b!tch-@ss cireculator announced in a loud voice that "looks like we got another one here who doesn't know how to use his drugs!" I shoulda reached back like a pimp and slapped that ho. But I didn't. In hindsight I should have blasted her because I was about to finish and WTF did I care.

You can always be slower if need be. 😉

maceo · Aug 13, 2008

Hawaiian Bruin said:
And then you grabbed your fanny pack on the way to the room?

I kid, I kid...

Seriously man, another great story with another great moral. Screw that surgeon- he can go home at the end of the day back to his unhappy life and sexless marriage, and you'll be kicking back sippin' Patron, living the High Life.

There have been times these past couple months when I've just wanted to lose my $hit and lash back at whoever is trying to make my life more difficult- be it the attending with personality disorder, arrogant surgerizer who doesn't say thanks for taking fan-freaking-tastic care of "his" unstable, hemodynamically labile patient, disgruntled cafeteria lady who seeks out the smallest damn piece of fish she can find on purpose, whoever.

But it's not worth it. No way.

I just grin and bear it, remember the truth and wisdom in the Bow Your Head thread, realize that when the workday ends, my life is a hell of a lot better than any of the aforementioned characters' is, and let it go. And if I have job satisfaction and a good life as a freaking resident, there's no way that doesn't get a thousand-fold better once this long jump through the academic hoop is done.

Thanks for dropping some more eloquent wisdom on us, Jet.

you can only let it go and grin and bear it for so long until you lose your cookies. and when you do it aint gonna be pretty

OB1🤙 · Aug 13, 2008

maceo said:
you can only let it go and grin and bear it for so long until you lose your cookies. and when you do it aint gonna be pretty

Son, I'm a married man. If there was an Olympic event for "grinning and bearing it," I'd be the freaking record-shattering gold medalist.

To be fair, my wife would probably win silver.

Gern Blansten · Aug 14, 2008

Arch Guillotti said:
The b!tch-@ss cireculator announced in a loud voice that "looks like we got another one here who doesn't know how to use his drugs!"

The best way to handle people such as this is to make them and everyone in the room realize how dumb they are and how smart you are. A technique I find useful is the following:

"It's not advisable to offer unsolicited opinions. You should spare yourself the embarrassing discovery of their exact value to everyone else."

It will usually take them a couple of minutes to figure out that they have just been insulted and it will probably diffuse the situation without having to resort to yelling.

filter07 · Aug 14, 2008

Even as a surgery resident I run into annoying personalities all the time. And most of the time I let it slide like I just ate at White Castle. Circulators and such are loud mouths because they've been working in the same OR for like 20 years and know where some stupid suture is. And they make stupid comments to residents like me because they can't take it out on the attending surgeon. It's stupid for them to insult someone like me who pretty much has excelled in all important aspects of my life (let's be objective, it's true). Their idiocy isn't worth my time or effort, because it's just a distraction on my one way road to being a total badass. So my input as a surgeon in training is that we all have to eat **** sandwiches, even us surgeons. We all have to take it in stride.

I will also say that I have met some rude anesthesiologists too. Anyone can be a poophead. The moral of the story is that there are poopheads everywhere. But we are professionals and pettiness is for losers. So whenever someone is being a total bitch, just remind yourself that you are a badass and you won't become a petty little bitch like them. That's how you win in life. Don't let petty bitches bring you down to their level. Like they say, success is the best revenge.

militarymd · Aug 14, 2008

nice

filter07 said:
Even as a surgery resident I run into annoying personalities all the time. And most of the time I let it slide like I just ate at White Castle. Circulators and such are loud mouths because they've been working in the same OR for like 20 years and know where some stupid suture is. And they make stupid comments to residents like me because they can't take it out on the attending surgeon. It's stupid for them to insult someone like me who pretty much has excelled in all important aspects of my life (let's be objective, it's true). Their idiocy isn't worth my time or effort, because it's just a distraction on my one way road to being a total badass. So my input as a surgeon in training is that we all have to eat **** sandwiches, even us surgeons. We all have to take it in stride.

I will also say that I have met some rude anesthesiologists too. Anyone can be a poophead. The moral of the story is that there are poopheads everywhere. But we are professionals and pettiness is for losers. So whenever someone is being a total bitch, just remind yourself that you are a badass and you won't become a petty little bitch like them. That's how you win in life. Don't let petty bitches bring you down to their level. Like they say, success is the best revenge.

jetproppilot · Aug 14, 2008

filter07 said:
Even as a surgery resident I run into annoying personalities all the time. And most of the time I let it slide like I just ate at White Castle. Circulators and such are loud mouths because they've been working in the same OR for like 20 years and know where some stupid suture is. And they make stupid comments to residents like me because they can't take it out on the attending surgeon. It's stupid for them to insult someone like me who pretty much has excelled in all important aspects of my life (let's be objective, it's true). Their idiocy isn't worth my time or effort, because it's just a distraction on my one way road to being a total badass. So my input as a surgeon in training is that we all have to eat **** sandwiches, even us surgeons. We all have to take it in stride.

I will also say that I have met some rude anesthesiologists too. Anyone can be a poophead. The moral of the story is that there are poopheads everywhere. But we are professionals and pettiness is for losers. So whenever someone is being a total bitch, just remind yourself that you are a badass and you won't become a petty little bitch like them. That's how you win in life. Don't let petty bitches bring you down to their level. Like they say, success is the best revenge.

Thats a great post.

Thanks for your contribution.

Bougie · Aug 14, 2008

Noyac said:
Jet, I can't tell you how much better I feel now that you refer to your surgeon friend as "girlfriend" and no longer call her S.O. All is right again in the world. Yeah Dude.

I also noticed that our jedi master promoted his S.O.

Congrats bro. Next thing you know you'll have a platinum band on the finger, ask permission to go have a beer with the guys, and explain how buying a Playstation 3 actually will improve family bonding time.

Awesome post too. I'm slowly learning to choose my battles.....

gasrookie · Aug 14, 2008

yeah, I know we disseminate that intubation is more savvy than strength....which is mostly true....but some anterior airways, if you've got some...uhhhhh.....muscle, youre able to, with a Miller 2, once the blade is where you want it, provide a little wrist action that extends to the end of the blade which lifts the epiglottis justa little bit more..,

Though I'm relatively new with just about 2 months experience, I've had some difficulty with these anterior airways. I'm not sure what I'm doing different than my attendings who are lesser size but it's embarrassing getting shown up. It seems on these airways I barely am able to lift the epiglottis up, whereas my attending who eventually get the view see the posterior arytenoids. Any tips?

lvspro · Aug 15, 2008

I haven't really had any problems w/any surgeons, but being 5'11" 215 may help.🙂

Kubed · Aug 15, 2008

lvspro said:
I haven't really had any problems w/any surgeons, but being 5'11" 215 may help.🙂

We call that "tiny" in 6'2" linebacker world 😀

radslooking · Aug 15, 2008

Kubed said:
We call that "tiny" in 6'2" linebacker world 😀

allpro linebacka sam mills was 5'9'' 🙂

lvspro · Aug 15, 2008

Kubed said:
We call that "tiny" in 6'2" linebacker world 😀

Our program looks like it needs to be tested for doping... seriously. Everyone's au natural, but dedicated as hell. Can't tell if we're a residency or a friggin football team.

cfdavid · Aug 15, 2008

filter07 said:
Even as a surgery resident I run into annoying personalities all the time. And most of the time I let it slide like I just ate at White Castle. Circulators and such are loud mouths because they've been working in the same OR for like 20 years and know where some stupid suture is. And they make stupid comments to residents like me because they can't take it out on the attending surgeon. It's stupid for them to insult someone like me who pretty much has excelled in all important aspects of my life (let's be objective, it's true). Their idiocy isn't worth my time or effort, because it's just a distraction on my one way road to being a total badass. So my input as a surgeon in training is that we all have to eat **** sandwiches, even us surgeons. We all have to take it in stride.

I will also say that I have met some rude anesthesiologists too. Anyone can be a poophead. The moral of the story is that there are poopheads everywhere. But we are professionals and pettiness is for losers. So whenever someone is being a total bitch, just remind yourself that you are a badass and you won't become a petty little bitch like them. That's how you win in life. Don't let petty bitches bring you down to their level. Like they say, success is the best revenge.

"petty little bitch" :laugh:

Great post.

Interestingly, I often see OB/GYN residents get virtually harassed in the OR by the Surg Tech. It got so bad that I almost said something as a MED STUDENT. But, I thought back to some of these threads and let it roll.

I actually felt bad for the residents (it was a C-section) because they'd get huge sighs whenever they'd ask for "another spunge" or whatever. One resident said to me in private (she was the senior and was being patient with a 1st year since we didn't have a 2nd year that day) that "apparently someone never had to learn anything ever....".

But, I commend them for not blowing their cool. They just let it roll and moved on. In other words, they refrained from becoming "petty little bitches".

cf

Monty Python · Aug 15, 2008

cfdavid said:
"petty little bitch" Great post.

Interestingly, I often see OB/GYN residents get virtually harassed in the OR by the Surg Tech. It got so bad that I almost said something as a MED STUDENT. But, I thought back to some of these threads and let it roll.

I actually felt bad for the residents (it was a C-section) because they'd get huge sighs whenever they'd ask for "another spunge" or whatever. One resident said to me in private (she was the senior and was being patient with a 1st year since we didn't have a 2nd year that day) that "apparently someone never had to learn anything ever....".

But, I commend them for not blowing their cool. They just let it roll and moved on. In other words, they refrained from becoming "petty little bitches".

cf

First and foremost PICK YOUR BATTLES WISELY.

I've been in the OR since 1982, starting as a scrub tech. About half of my time has been in the private sector, the other half in the public/charity/teaching sector.

Generally speaking, you'll find considerably fewer a@@hole circulators or techs working in the private sector. The system simply won't tolerate them.

On the other hand, a large percentage of losers find their one-and-only niche in the public/charity/teaching system. Once they get civil service tenure, they're almost impossible to fire.

When faced with the unacceptably bitchy person who is completely inappropriate you have three choices:

1. simply ignore them.
2. tell them you don't appreciate their comments
3. go to their supervisor and threaten them with a harrassment complaint, along with potential slander acccusation. The JCAHO is big on harrassment in the workplace this year, stressing the importance of non-threatening work environments fostering better patient care. Oh yeah, tell the a@@hole's supervisor that they will also be included in the complaint for failure to properly supervise.

Refer to my first sentence at top.

jetproppilot · Mar 31, 2009

jetproppilot said:
I'm sitting in the anesthesia lounge today taking a well deserved break since I was on OB/pain/lines, and the pregnant women were everywhere... two C sections and four epidurals before 11am in addition to having to round on about 20 pain patients....

Man, I found the coolest product!!!

ALREADY PEELED HARDBOILED EGGS!!!!

Six to a package.

I pop open the package, take a load off, sit down at the table, and start enjoying my meal....six egg whites enhanced with salt, pepper, and Tabasco sauce.....mmmmmmmmmmmm I flip open an old People magazine...

Scott CRNA hangs up the phone.

"Difficult intubation in room nine, Dude. Doctor Ponnat's in there.

S HIT I think, halfway through my third Tabasco enhanced egg white.

I swallow whats left of the third chicken embryo sac, wipe my mouth, and walk to room nine.

I push open room nine's door and see Doctor P attempting to intubate.

Debbie CRNA tried first without success....now Dr P is on her second attempt.

Debbie CRNA is watching intently, as are the other OR staff in the room.

And so is Surgeon Grumpyfuk (GF).

"Bill!" Dr. P says.

"Need your muscle here."

Dude on the table is an average size male in the OR for a thyroid....I glance at his mandible while Dr P is attempting intubation and it looks small.

Dr P is a great anesthesiologist...she's hard working, knowledgable, well liked.....

turns out, though, on some difficult intubations strength is an asset...

yeah, I know we disseminate that intubation is more savvy than strength....which is mostly true....but some anterior airways, if you've got some...uhhhhh.....muscle, youre able to, with a Miller 2, once the blade is where you want it, provide a little wrist action that extends to the end of the blade which lifts the epiglottis justa little bit more.......a move that flips the epiglottis jussta little bit more without rokking back on the teeth....

...most times, after a deftly placed blade, that extra little bit is all you need.

I take position at the head and dive in with the Miller 2 knowing if Dr P couldnt see anything its gonna be hard.

Miller 2 homes in, positions correctly and I don't see s hit so I use the proprietary wrist movement I learned from MITCH LeBLANC CRNA who happens to be the best laryngoscopist on planet earth, bar none and the bottom of the arytenoids comes into view.

"Bougie please!" I say.

Blue stylette guided thru the orifice.

ETT Seldingered over the Bougie.

SUCCESS!

This is the beauty of a private practice with several anesthesiolgists on the floor.

We all run across difficulty at some point.

Having partners that can come help you is priceless during a busy day!

I've called for help many times. Noone should be above calling for help.

Back to current day... I've just saved this surgeon alotta time and potentially a cancellation of his case because of difficult airway issues.

Know what he says?....remember though this is the surgeon I had a run in with that I blogged about on the Dealing With Cocky Surgeons thread...kinda got all up in his personal space during that previous incident......HAHAHAHAHAHAHAHAHAHHAHA

Nothing.

No "Hey, Thanks!"

No "Hey, you're a dickhole!"

Nothing.

Thats OK.

Dr P thanks me and I wander out of room nine headed back to my spicy egg whites.

I'm sitting at the table again, on the fifth-of-six egg whites when I getta call back to room nine.

I return.

Keep in mind this is the same surgeon I had a run in with I posted about on the thread Dealing With Cocky Surgeons.

I walk in, Dr P's there.

Dickhole surgeon speaks.

"His tooth is chipped! You're gonna haffta tell his wife who is a total BITCH."

Dr P is shaking her head.

FIRSTOFALL I was the third laryngoscopist, so if theres damage, its not clear who caused it.

Not that it matters.

I know my laryngoscopy was clean I think to myself....

I look at Dude's tooth.

No chip.

Theres a little irregularity at the bottom....maybe abraded a little...

but no chip.

Whats my reponse to Dickswinging Surgeon?"

"No problem, Dude. I'll touch base with his wife."

I exit.

SO HERE I AM TODAY ON OB ASSIGNMENT INNOCENTLY EATING SOME EGG WHITES AND DECIDE TO HELP A COLLEAGUE AND THIS IS WHAT I GET?

UHHH, DIKKHOLE SURGEON, I SAVED YOU SOME TIME TODAY. AND I'M SURE IT WASNT ME THAT CAUSED AN ALMOST INVISIBLE IRREGULARITY TO YOUR THYROID DUDE'S TOOTH...AND I'M NOT EVEN SUPPOSED TO BE IN HERE, BUT I'M ALWAYS GONNA RESPOND TO A COLLEAGUE ASKING FOR HELP.

Funny how Dikkhole Surgeon is above giving thanks to such a cohesive anesthesia group and chooses to try and get a dig in on me.....the dude that got the tube in, enabling him to do his case...

Its all good.

Dikkhole surgeon has a long history of being difficult.

I make too much money, and am too happy at my gig to let some outlying surgeon dikkswinger get to me. Lets look at this objectively.....anesthesiologist secures airway.....surgeon takes that for granted and focuses on some insignificant issue....TIME TO ENTER THE OCTAGON, RIP OPEN DIKKHOLE SURGEONS OUT-OF-SHAPE THROAT????? HUH??? YEAH???? CAN I? PUHLEAAAAAAASE???

Nope.

Went and spoke with the wife about the difficult intubation and the unsubstantial "damage" to the dudes tooth....even though I'm sure it wasnt me that abraded the bottom of the incisor......

I thought about Arch while I completed all these tasks, and how, as a resident, Arch took the blame for some stuff that wasnt his fault.

I thought about the BOW YOUR HEAD thread.

That BOW YOUR HEAD thread is money, even out here in the HOLY GRAIL.

In the grand scheme of the OR environment, I'm an offensive lineman at best.

As an anesthesiologist I cater to surgeons.

Most of them are gratuitous for my expertise.

This surgeon dude is obviously eaten up by ego and is above telling a colleague thanks....

We work with all types of surgeons as anesthesiologists. Most of them are people. A few of them are narcissistic a ssholes. And it isnt worth most battles with the latter since they are few and far between.

Just parrta the job, ladies and gentlemen.

Cuz I'm happy at work, despite the rare run-in with Dikkhole Surgeon.

And those zeroes separated by commas keep accruing in the checking account.

I'll go face to face sometimes.

This wasnt one of them.

Bumped for my CA-3 colleagues.

TheSandMan · Mar 31, 2009

jetproppilot said:
Bumped for my CA-3 colleagues.

Solid post Jet. Greatly appreciated 👍

Monty Python · Mar 31, 2009

trinityalumnus said:
First and foremost PICK YOUR BATTLES WISELY.

I've been in the OR since 1982, starting as a scrub tech. About half of my time has been in the private sector, the other half in the public/charity/teaching sector.

Generally speaking, you'll find considerably fewer a@@hole circulators or techs working in the private sector. The system simply won't tolerate them.

On the other hand, a large percentage of losers find their one-and-only niche in the public/charity/teaching system. Once they get civil service tenure, they're almost impossible to fire.

When faced with the unacceptably bitchy person who is completely inappropriate you have three choices:

1. simply ignore them.
2. tell them you don't appreciate their comments
3. go to their supervisor and threaten them with a harrassment complaint, along with potential slander acccusation. The JCAHO is big on harrassment in the workplace this year, stressing the importance of non-threatening work environments fostering better patient care. Oh yeah, tell the a@@hole's supervisor that they will also be included in the complaint for failure to properly supervise.

Refer to my first sentence at top.

Another handy method for remaining calm: "The Dear Abby Ten Year Test."
(I read this in Dear Abby many years ago).

When faced with a given situation which momentarily makes you want to rip someone's head off, stop and ask yourself, "ten years from now, will this particular issue still be affecting me financially/emotionally/professionally/spiritually?"

If the answer is "yes" then you need to take proactive action right then and there.

If the answer is "no" ..... just let it slide off your back. Stay grounded and centered, the island of calm in a sea of chaos. Your colleagues and coworkers will look upon you with amazement.

Then go home at the end of the day, and take a nice walk around the neighborhood to let off steam.

maceo · Mar 31, 2009

trinityalumnus said:
Another handy method for remaining calm: "The Dear Abby Ten Year Test."
(I read this in Dear Abby many years ago).

When faced with a given situation which momentarily makes you want to rip someone's head off, stop and ask yourself, "ten years from now, will this particular issue still be affecting me financially/emotionally/professionally/spiritually?"

If the answer is "yes" then you need to take proactive action right then and there.

If the answer is "no" ..... just let it slide off your back. Stay grounded and centered, the island of calm in a sea of chaos. Your colleagues and coworkers will look upon you with amazement.

Then go home at the end of the day, and take a nice walk around the neighborhood to let off steam.

While I agree with you, this will lead to psychological damage at some point. whether it manifests as fentanyl addiction, poor relations with spouse, depression suicide etc. there must be an outlet. I dont know what that outlet is. but i know internalizing everything is not a good rule of thumb.

Josh L.Ac. · Apr 1, 2009

Suitable outlets:

- Moving heavy metal objects from point A to B. Repeat for 4 sets / exercise.
- Punching training partners in the face while failing to avoid their rebuttal.
- Sex.
- Scotch.
- Homebrew.

lfesiam · Apr 1, 2009

Jet, great post!! As always!!

radslooking · Apr 1, 2009

trinityalumnus said:
Another handy method for remaining calm: "The Dear Abby Ten Year Test."
(I read this in Dear Abby many years ago).

When faced with a given situation which momentarily makes you want to rip someone's head off, stop and ask yourself, "ten years from now, will this particular issue still be affecting me financially/emotionally/professionally/spiritually?"

If the answer is "yes" then you need to take proactive action right then and there.

If the answer is "no" ..... just let it slide off your back. Stay grounded and centered, the island of calm in a sea of chaos. Your colleagues and coworkers will look upon you with amazement.

Then go home at the end of the day, and take a nice walk around the neighborhood to let off steam.

yeah, no offense, but I can't stand this advice. as maceo said, it leads to severe frustration and psychological distress. I wish I had picked a few more battles, honestly. I wouldnt have been so angry and resentful if I had stuck up for myself a few more times. Then again, I may have been in trouble as well. But I'd rather have that and known i'd stuck to some principles.

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