Bow Your Head

[jetproppilot]

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We're not too good at that.

As doctors.

I'm pointing this at my colleague anesthesia RESIDENTS.

BOW YOUR HEAD.

WHY?

I know.

I, myself, Jet, have tried to immortalize the phrase I SACRIFICED MY TWENTIES FOR THIS GIG!!!

You're in the training phase of your career.

A career thats gonna bring you ALOT....

if you let it.

Its gonna bring you enough cash, and enough time off to enjoy your life.

Its gonna let you not worry about how much gas costs.

You'll be able to pull up whatever vehicle you drive up to the pump, and hold the handle until your tank is full.

We take that for granted, us anesthesia attendings.

To pull up to the pump and hold the handle.

Hundred bucks? Two hundred bucks?

Doesnt matter.

Just make it go fast so I can pay for it.

So while alotta America is struggling with increased prices, I gotta be honest with you and tell you my selection of trade, the same selection you've made, has sheltered me from worry.

Turning to the academic residency mode, where you're DEEP IN THE MOMENT, surgeon dude is angry, ICU nurse is reeling with personal issues and decides to make you a pulpit of her inner anger by f ukking with you about the way you decided to arrange your IV lines, your asslikking, lazy colleague clandestinely skirts outta the OR leaving you with 2 more pre-ops to see than you shouldda seen, your attending BARKS at you in fronna the whole OR because you chose an LMA over a tube, and even though its OK, in your sociopath-I-cant-handle-private-practice-attending's-mind, its not OK in his book so you get a public ass-wooping,

because you are a resident,

BOW YOUR HEAD.

Like I've said before, and yeah, I know you're a smart mo-fo,

BOW YOUR HEAD.

This residency is leading to your future.

Which is bright with professional satisfaction, cool s hit to do at work, plenty of cash, and alotta time off.

KNOW WHAT LEAD ME TO POST THIS?

ARCH. A.K.A. EEEEEZY E.

He posted on another thread to take the blame as a resident, even if the blame isnt yours.

Arch's humility is a model. A model to get you thru the s hit of residency, so you can enjoy what you're after......PROFESSIONAL SATISFACTION....MONEY.......TIME OFF......

Thanks, Arch.

For your wisdom.

Even out here in the Holy Grail, your words will lead me to BOW MY HEAD in those situations where I may not have.

 

[Arch Guillotti]

lol, thanks for the props JPP.

Usually I just bow my head and pour out a little of my forty or double-deuce to remember my hommies that couldn't be here w/me.

Residency is a pain in the @ss. Attendings getting on you for no good reason (especially the ones that are freaks themselves). Feeling lost at first in the OR. NURSES giving you the business. Circulators giving you a hard time (as they take a break from Sudoku or whatever that crap is). I bent over many a time and said "Thank you sir may I have another". You GOTTA do it. I always say "pick your battles". And pick them wisely, because 99% of the time they will come back to bite you in the @ss. Don't ever pick one w/an attending because you WILL lose. The attendings talk and you DO NOT want your name to become "mud on the street". Play the game, no matter what. As time goes on things get better, attendings trust you more, everyone else gets to know you etc. - that makes things better. But NEVER let down your guard. Whenever I was a fixin' to talk some trash I would always look around to make sure someone I didn't trust was within earshot. There were a few that were "one of the guys" but they were few and far between. Remember the House of God, nobody can ever stop the clock from tickin'.

 

[jetproppilot]

.

 

[cfdavid]

I'm on an OB/GYN rotation right now, Gyn at the present moment. So, we're in the OR a lot. Where I'm at they have an anesthesiology program, and I saw a great example of a dude in training (CA-1) just let an issue roll right off his back. I took major stock in this example.

He was preoping a patient and (this is quite petty mind you) approached her from the right side of the bed. Well, she was lying slightly towards the left. So, he introduces himself and the nurse that was handling this patient (not a CRNA) says in a bitchy tone "why don't you go over to the other side of the bed where she doesn't have to turn her head as much"..... Something like that, but again, in a bitchy tone.

So, this dude smiles and goes, "you know what. that's a great idea. thank you." Then he just does his thing. Friggin superb. Didn't rock the boat. Didn't make it an issue. Just let it roll and it most likely didn't even raise his BP in the slightest.

So far, I've interacted with some awesome dudes in anes training at my program.

 

[Jeff05]

jet is SO money with this one.

it's really good to read. ca3 year, although it just started, is the hardest year of my medical education to date - because i'm SO SO tired of all the BS.

 

[epidural man]

We're not too good at that.

As doctors.

I'm pointing this at my colleague anesthesia RESIDENTS.

BOW YOUR HEAD.

WHY?

I know.

I, myself, Jet, have tried to immortalize the phrase I SACRIFICED MY TWENTIES FOR THIS GIG!!!

You're in the training phase of your career.

A career thats gonna bring you ALOT....

if you let it.

Its gonna bring you enough cash, and enough time off to enjoy your life.

Its gonna let you not worry about how much gas costs.

You'll be able to pull up whatever vehicle you drive up to the pump, and hold the handle until your tank is full.

We take that for granted, us anesthesia attendings.

To pull up to the pump and hold the handle.

Hundred bucks? Two hundred bucks?

Doesnt matter.

Just make it go fast so I can pay for it.

So while alotta America is struggling with increased prices, I gotta be honest with you and tell you my selection of trade, the same selection you've made, has sheltered me from worry.

Turning to the academic residency mode, where you're DEEP IN THE MOMENT, surgeon dude is angry, ICU nurse is reeling with personal issues and decides to make you a pulpit of her inner anger by f ukking with you about the way you decided to arrange your IV lines, your asslikking, lazy colleague clandestinely skirts outta the OR leaving you with 2 more pre-ops to see than you shouldda seen, your attending BARKS at you in fronna the whole OR because you chose an LMA over a tube, and even though its OK, in your sociopath-I-cant-handle-private-practice-attending's-mind, its not OK in his book so you get a public ass-wooping,

because you are a resident,

BOW YOUR HEAD.

Like I've said before, and yeah, I know you're a smart mo-fo,

BOW YOUR HEAD.

This residency is leading to your future.

Which is bright with professional satisfaction, cool s hit to do at work, plenty of cash, and alotta time off.

KNOW WHAT LEAD ME TO POST THIS?

ARCH. A.K.A. EEEEEZY E.

He posted on another thread to take the blame as a resident, even if the blame isnt yours.

Arch's humility is a model. A model to get you thru the s hit of residency, so you can enjoy what you're after......PROFESSIONAL SATISFACTION....MONEY.......TIME OFF......

Thanks, Arch.

For your wisdom.

Even out here in the Holy Grail, your words will lead me to BOW MY HEAD in those situations where I may not have.

Once again, great post👍👍

I had an attending once (when I was on the block team) tell me that a patient refused a block so we weren't going to do it, then when the anesthesiologist in the room asked why we didn't block the patient, the ******ed attending turned to me and yelled in front of the OR front desk, "WHY didn't we block him? Listen, if you can't run this block team, I'll do it myself!" All I could say was, "someone told me that we weren't going to block him. Sorry." I wasn't really sure if he couldn't remember that he told me that because he truly was ******ED, or just a coward.

Anyway, I will soon be able to have residents under my wing and I can't wait to make mistakes, be lazy, and blame it all on some unsuspecting CA-2.

 

[OldManDave]

Awesome post JPP - as is the norm with you. You can cut thru the BS & get to the heart like few can (MilMD & Noyac too). My sanity, what little there is, was saved by reminder myself that residency = paying your dues. There ain't $hit in this life worth getting that you do not have pay for...the dues for this gig are steep because the rewards, which I am just getting to see & appreciate, are substantial.

This forum & my own gig over at OldPreMeds (www.oldpremeds.org) have helped sustain me & remind me of the 'big picture' - the biggest players in keeping me grounded & honest have been "My Girls" - the wife & 2 daughters/offspring.

Life is good & only getting better!

 

[CanGas]

Can I vote to sticky this post? It needs to be at the top.

CanGas

 

[CanGas]

Ok, so I've gone and compiled some of my favorite posts in this forum regarding survival and succeeding (Into, during and after residency) as a resource for those in the thick of it. I'm sure I missed some so feel free to add them to the thread. It's stickied at the top.

CanGas


Residency and Beyond Survival Guide: Pearls From The Anesthesiology Forum
http://forums.studentdoctor.net/showthread.php?t=553263

 

[jetproppilot]

Ok, so I've gone and compiled some of my favorite posts in this forum regarding survival and succeeding (Into, during and after residency) as a resource for those in the thick of it. I'm sure I missed some so feel free to add them to the thread. It's stickied at the top.

CanGas


Residency and Beyond Survival Guide: Pearls From The Anesthesiology Forum
http://forums.studentdoctor.net/showthread.php?t=553263

Thanks alot for your effort, Can.

 

[coprolalia]

Sorry, dudes. I ain't Jesus F. Christ. If you act like a doormat, you're gonna get walked on.

I'm not saying that you shouldn't try to get along with people and play nice, but there are times you have to "step up to the mic with Micatin." If you don't learn this in residency, you won't in the real world.

You're not going to get along with everyone. Some people, if they perceive you as weak, will attack... incessantly. Medicine is a tough business. I've had medical students tell me after they've seen someone bitch me out publicly, "Man, I can't believe how you kept your cool." What they don't see is the subsequent mental bitch-slap I give that person later in private.

I have a pretty good technique about making that person feel one-inch tall. Usually, they act out in the heat of the moment, and if you catch them later their guard is down. You address them socratically... "Did you think that was an appropriate way to handle that situation? Do you believe that I'm a child that should be subject to belittlement instead of your colleague? Do you think the people around the room that heard your pubic outburst admired and respected you for it?"

That's how you handle things. Use your psychiatric powers. Get in their head.

Just my $0.02.

-copro

 

[jetproppilot]

Sorry, dudes. I ain't Jesus F. Christ. If you act like a doormat, you're gonna get walked on.

I'm not saying that you shouldn't try to get along with people and play nice, but there are times you have to "step up to the mic with Micatin." If you don't learn this in residency, you won't in the real world.

You're not going to get along with everyone. Some people, if they perceive you as weak, will attack... incessantly. Medicine is a tough business. I've had medical students tell me after they've seen someone bitch me out publicly, "Man, I can't believe how you kept your cool." What they don't see is the subsequent mental bitch-slap I give that person later in private.

I have a pretty good technique about making that person feel one-inch tall. Usually, they act out in the heat of the moment, and if you catch them later their guard is down. You address them socratically... "Did you think that was an appropriate way to handle that situation? Do you believe that I'm a child that should be subject to belittlement instead of your colleague? Do you think the people around the room that heard your pubic outburst admired and respected you for it?"

That's how you handle things. Use your psychiatric powers. Get in their head.

Just my $0.02.

-copro

I respect what you're saying, Brother.

I think Walking Softly But Carrying A Big Stick goes a long way too....in other words PICK YOUR BATTLES.

Thanks, Cop, for your post.

It is meaningful and relevant.

Its also meaningful and relevant to remember how SILLY most "dramatic situations" in residency are, and how easy it is to just let it slide off your back......i.e. BOW YOUR HEAD.

Not intended to mean you haffta act like a doormat, cuz you dont.....there are times when you gotta STEP UP TO THE MIKE WITH MICATIN but those situations are surprisingly-few.

Its harder mosta the time in those silly, melodramatic situations THAT MEAN NOTHING to take the high road and walk away from them.....thats what I meant by this thread.

Thanks for the post.

 

[coprolalia]

Its also meaningful and relevant to remember how SILLY most "dramatic situations" in residency are, and how easy it is to just let it slide off your back......i.e. BOW YOUR HEAD.

Yeah, I hear you too. You definitely have to watch out for your own ass in residency, because you are clearly on display. Everyone is going to be watching every move you make, and some people take sick pleasure in trying to beat down residents.

But, there are also situations that will repeat themselves if you let them. I had a problem (recently) with one of the surgical chief residents. The guy kept coming up to me and talking to me like I was some order-taker at McDonalds. He did this repeatedly. He would bark out a plan and just expect me to follow it.

It finally came to a head when he interupted me (when I was with another patient) to bitch me out how I hadn't yet ordered a set of labs on a trauma patient as we'd previously agreed upon that was going to get transferred out of the trauma bay to the SICU. Not my responsibility, but I knew their team was slammed and I was trying to help out. I was the senior anesthesia guy on call, and was in full triage mode.

Now, remember, he pulled his temper tantrum in front of another patient, that patient's family, and two other nurses. After his little 5-year-old hissy fit face all red and whatnot, he walked out of the room. I apologized to those present for his behavior, but he made me look like a jackass in front of another patient for whom I was providing care, potentially making me look like an incompetent physician.

Shortly thereafter when I left that patient, I pulled him aside and simply said this, "Dude, you cannot talk to me like that in front of another patient. I would never interupt you when you were with another patient, especially to talk about another patient. That was completely disrespectful and inappropriate. You have your priorities, and I have mine. Your other patient was completely stable. I was aware of what was going on at the time. And, if you do that again, I'm going to your chair."

The guy completely blows his stack and tries to argue back to me, "Did we not agree..." and "If you couldn't handle it..." and "I wouldn't get so mad if you just did what you're told..." etc., etc.

He was getting pissed. I was getting equally pissed. Then, I just shut-up and let him get it out. Then, after that I asked him, "Am I a physician? Am I your colleague or something else?" No response. "Was the patient unstable?" "That's not the point. We agreed..." I cut him off. "Do you think that your patient is the only one that I'm assessing and dealing with right now?" No response. "Do you think that people are going to continue to offer to help you if you abuse them like that, especially in front of another patient?" At that point, he just turned and walked away.

Guess what? No probs with the dude since. Treats me like gold. Sometimes people aren't aware that they're being an ******* until it's pointed out to them.

-copro

 

[jetproppilot]

Yeah, I hear you too. You definitely have to watch out for your own ass in residency, because you are clearly on display. Everyone is going to be watching every move you make, and some people take sick pleasure in trying to beat down residents.

But, there are also situations that will repeat themselves if you let them. I had a problem (recently) with one of the surgical chief residents. The guy kept coming up to me and talking to me like I was some order-taker at McDonalds. He did this repeatedly. He would bark out a plan and just expect me to follow it.

It finally came to a head when he interupted me (when I was with another patient) to bitch me out how I hadn't yet ordered a set of labs on a trauma patient as we'd previously agreed upon that was going to get transferred out of the trauma bay to the SICU. Not my responsibility, but I knew their team was slammed and I was trying to help out. I was the senior anesthesia guy on call, and was in full triage mode.

Now, remember, he pulled his temper tantrum in front of another patient, that patient's family, and two other nurses. After his little 5-year-old hissy fit face all red and whatnot, he walked out of the room. I apologized to those present for his behavior, but he made me look like a jackass in front of another patient for whom I was providing care, potentially making me look like an incompetent physician.

Shortly thereafter when I left that patient, I pulled him aside and simply said this, "Dude, you cannot talk to me like that in front of another patient. I would never interupt you when you were with another patient, especially to talk about another patient. That was completely disrespectful and inappropriate. You have your priorities, and I have mine. Your other patient was completely stable. I was aware of what was going on at the time. And, if you do that again, I'm going to your chair."

The guy completely blows his stack and tries to argue back to me, "Did we not agree..." and "If you couldn't handle it..." and "I wouldn't get so mad if you just did what you're told..." etc., etc.

He was getting pissed. I was getting equally pissed. Then, I just shut-up and let him get it out. Then, after that I asked him, "Am I a physician? Am I your colleague or something else?" No response. "Was the patient unstable?" "That's not the point. We agreed..." I cut him off. "Do you think that your patient is the only one that I'm assessing and dealing with right now?" No response. "Do you think that people are going to continue to offer to help you if you abuse them like that, especially in front of another patient?" At that point, he just turned and walked away.

Guess what? No probs with the dude since. Treats me like gold. Sometimes people aren't aware that they're being an ******* until it's pointed out to them.

-copro

Well said. 👍

 

[GassiusClay]

Well said. 👍

If his team is getting slammed, I don't give a rat's @ss. If its on the surgery residents service, then I tell em I'm doing your @ss a favor. That's how I'd put it. Don't yell at me if you can't manage your own patients.

Hell, I had to deal with an ortho resident who was completely a prick. Was pissy about waiting for a block to be done. I couldn't do it without my attending so he was going to have to wait. I did the block (brachial plexus via infracoracoid approach) in less than 5 minutes. Then, he's still pissy because somehow I held him back. Brat wouldn't even steer the front of the bed right, and pretty much tried to drag the bed out of the block room with the monitors still on.

Then at the end of the case, this douche takes forever to put on a cast after he said only 10 more minutes twice. So the patient who is now pretty much awake but in no pain thanks to a good block is watching her hand getting man-handled. She asks ME how much longer, and I just SMILE and look at douchebag and say "Well, I think you'll have to ask Dr. X that, but I'm aware its only about 10 minutes!" Hopefully, the patient thinks this ***** is incompetent at his job.

Subtle payback is sweet!!! Find out when I do a post-op check.


And by the way, screw CRNAs. Don't give my patient Ephedrine during my break when the BP is 90s/50s when thats where they run PREop. Common sense or treating numbers.

 

[Idiopathic]

ive learned its just part of the deal. no other specialty in medicine requires humility and subjugation quite like anesthesiology. you have to be good at what you do all the time, for every patient, and also expeditious. in most interactions, the best you can hope to be viewed as is competent and not a source of delay.

with that said, there is no more badass in the hospital than the well trained, confident anesthesiologist. he/she is in control whenever they step into a situation.

in the OR, as residents, we transition from difficult crani to thoracic case to management of labor pain to 2 week old NEC babies to 95 year old redo hips with critical AS, and we have to be ready to handle any of these cases every day,

but, for the most part, the love we get comes from positive interactions with patients and families, the occasional nursing compliment and knowledge of job well done (oh yeah and the $$$ and call schedule)