First Day Shadowing Annnddd..

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theBruceWayne

theBruceWayne

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Today I shadowed for the first time. I was shadowing an Anesthesiologist, and found surgery to be a complete eye opener (mostly in a good way.) I stayed the whole day, and went thru about five surgeries (about nine hours total..) However I was disgusted by one particular event.. We had an elderly lady who was clearly overweight come in due to a few hernias.. The Anesthesiologist was a wonderful guy. You could see he genuinely cared for the patient before, thru, and after the surgery. However the surgeon and staff where extremely vulgar, often making jokes on the patients condition (while she was knocked out of course.) I haven't felt so much anger and disgust in a long time.. Is this normal behavior during surgeries with larger than average patients or is this just a "freak" incident? As a current pre-med, I see patients as people who are coming to us for help, and on top of that they are paying us to help them as they go thru some of the most painful events of their lives.. On top of all this, after the surgery the surgeon/staff each slapped the patients sown up belly and walked off. I know I may be making a big deal over what may be something small..but in my head I still cannot get over it.. 🙁
 
In every single profession, you will see people that are good, and people that are bad.
 
It happens. Health care workers are, after all, only human. There are certainly going to be people that engage in this behavior. Yeah, yeah, there's the whole "professionalism" and "respect" jazz, but you should know that people say all sorts of things when you're not listening...
 
theBruceWayne said:
Today I shadowed for the first time. I was shadowing an Anesthesiologist, and found surgery to be a complete eye opener (mostly in a good way.) I stayed the whole day, and went thru about five surgeries (about nine hours total..) However I was disgusted by one particular event.. We had an elderly lady who was clearly overweight come in due to a few hernias.. The Anesthesiologist was a wonderful guy. You could see he genuinely cared for the patient before, thru, and after the surgery. However the surgeon and staff where extremely vulgar, often making jokes on the patients condition (while she was knocked out of course.) I haven't felt so much anger and disgust in a long time.. Is this normal behavior during surgeries with larger than average patients or is this just a "freak" incident? As a current pre-med, I see patients as people who are coming to us for help, and on top of that they are paying us to help them as they go thru some of the most painful events of their lives.. On top of all this, after the surgery the surgeon/staff each slapped the patients sown up belly and walked off. I know I may be making a big deal over what may be something small..but in my head I still cannot get over it.. 🙁
Click to expand...

I kind of know what you are getting at. I myself almost got into it (just verbally) with an Anesthesiologist at the hospital I work at...I know right. But the truth is that at best the guy was acting very unprofessionally and really, at worst, downright dangerously. I mean it was probably a confluence of circumstances partly having to do with the fact that provider order entry had just been initiated at our site and so there were some orders getting lost in the shuffle and he was probably having a bad day. But still, he's the "authority" in the room and he's acting like a bitch. I just took the high road and thought, "thanks for showing me how NOT to act when I practice"
 
Black humor ... a lot of physicians will call it very important to their work. There are limits to all of these things, sure, but you also have to remember that physicians put up with a lot. That stress has to be resolved somehow. If it's let out through a joke and not through internal depression and stress, isn't that better?
 
Often times, seeing things like this can help you decide what kind of practitioner you will be (at least that's what I tell myself). I once shadowed a surgeon that made me go in to an exam room, take a patient history (uuuuh.... what? I was a premed humanities major!😕) and when I came back with my "history" he proceeded to tell me that the patient was probably crazy because all patients were crazy.👎eek::eyebrow:

It was strange and definitely made me uncomfortable, but it showed me an example of who not to be!
 
Ahhh. Naivety. Fortunately I was wise beyond my years and never cursed with it.
 
Don't worry about it
 
Soulstice said:
Black humor ... a lot of physicians will call it very important to their work. There are limits to all of these things, sure, but you also have to remember that physicians put up with a lot. That stress has to be resolved somehow. If it's let out through a joke and not through internal depression and stress, isn't that better?
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This.

You have to understand that many surgeons have the attitude of frat boys/jocks... so there will always be some dark humor.

I recall one surgery where the surgeon was berating an obese patients lifestyle because he was over 400 lbs.. He was criticizing his laziness and how he let his condition worsen to the degree it did... which are all fair points.

It might come off as rude/blunt, but that doesn't change the fact that it is any less true.
Most doctors are empathetic with their patients to comfort them, but that doesnt mean that they behave that way when the patients aren't around.
 
VictorAlpha said:
I kind of know what you are getting at. I myself almost got into it (just verbally) with an Anesthesiologist at the hospital I work at...I know right. But the truth is that at best the guy was acting very unprofessionally and really, at worst, downright dangerously. I mean it was probably a confluence of circumstances partly having to do with the fact that provider order entry had just been initiated at our site and so there were some orders getting lost in the shuffle and he was probably having a bad day. But still, he's the "authority" in the room and he's acting like a bitch. I just took the high road and thought, "thanks for showing me how NOT to act when I practice"
Click to expand...

why did you refrain from displaying your maturity and wisdom? im sure the attending would have appreciated being set straight and hearing your opinion
 
Your future may not be in ER. The laid back, slightly rude culture is a big reason I like being there.
 
I think that, a lot of times, physicians use humor as a coping mechanism. If every single patient is treated with solemn and grave respect, I think a lot of doctors and medical staff in general would be very unhappy. It's hard to expect someone to be completely serious about absolutely every patient and procedure and condition they come across. Blatant disrespect certainly is not appropriate, but as long as a practitioners attitude doesn't affect their treatment, I don't know if it's fair to consider someone a poor physician based on them voicing opinions and comments about a patient to their colleagues.

It's hard. Seeing people get sick, die, become terminally ill, get grotesquely deformed, etc on a regular basis is sure to take a toll on anyone. I think it's healthy for people to find humor where they can, even if it may not seem tasteful to the outside ear. As long as they are able to treat the patient's medical condition appropriately, of course.

It's not the kind of practitioner I aspire to become, certainly. I hope to be able to maintain respect for my patients and treat them all with kindness and concern. But I have also seen enough medicine to know that this is likely unrealistic. Like I said, it's tricky. But try to not let these incidents determine if someone is a good or bad person/physician to you. Unless the comments were truly heinous and violated the patient, the doctor was probably blowing off steam with no cruel or sinister intentions.
 
The belly-slapping bit is definitely disturbing, but the rest of it I wouldn't get too caught up on. People make fun of other people, and that isn't any less true for doctors.
 
Ultimately, I imagine that it is especially difficult to appreciate the stress of surgeons for those of us who have never experienced that sort of responsibility. Often, they are performing difficult and complex procedures where complications do occur. At the end of the day, the support staff are the ones going home, whereas the surgeons are the ones post-rounding, often second-guessing their operative decisions, and hoping that their patient from last Tuesday's case doesn't present to the ER tonight. The point is that while I, too, have been appalled by things I've heard trusted physicians say in shadowing experiences, it's important to at least try to understand the whole picture. At the end of the day, most of these physicians do care, and the humor may be a tool to just get through the day. The best thing we can do as aspiring providers at this stage in our careers is to at least strive to be better, more outwardly empathetic doctors someday and to avoid becoming cynical so early on.
 
Lol @ people saying its a "coping mechanism".


Maybe they said those things because its hilarious?
 
theBruceWayne said:
Today I shadowed for the first time. I was shadowing an Anesthesiologist, and found surgery to be a complete eye opener (mostly in a good way.) I stayed the whole day, and went thru about five surgeries (about nine hours total..) However I was disgusted by one particular event.. We had an elderly lady who was clearly overweight come in due to a few hernias.. The Anesthesiologist was a wonderful guy. You could see he genuinely cared for the patient before, thru, and after the surgery. However the surgeon and staff where extremely vulgar, often making jokes on the patients condition (while she was knocked out of course.) I haven't felt so much anger and disgust in a long time.. Is this normal behavior during surgeries with larger than average patients or is this just a "freak" incident? As a current pre-med, I see patients as people who are coming to us for help, and on top of that they are paying us to help them as they go thru some of the most painful events of their lives.. On top of all this, after the surgery the surgeon/staff each slapped the patients sown up belly and walked off. I know I may be making a big deal over what may be something small..but in my head I still cannot get over it.. 🙁
Click to expand...

Can't the patients still hear even though they're knocked out or something?
 
It's not just in surgery. Every doc I've shadowed has talked crap about at least one patient, often within earshot of the patient. It really made me uncomfortable too. I thought doctors were supposed to be empathetic? I can't tell if they just got that way after becoming jaded or if this whole notion of compassionate, empathetic doctors is a very recent phenomena.

hunterjumper14 said:
Often times, seeing things like this can help you decide what kind of practitioner you will be (at least that's what I tell myself). I once shadowed a surgeon that made me go in to an exam room, take a patient history (uuuuh.... what? I was a premed humanities major!😕) and when I came back with my "history" he proceeded to tell me that the patient was probably crazy because all patients were crazy.👎eek::eyebrow:

It was strange and definitely made me uncomfortable, but it showed me an example of who not to be!
Click to expand...

Heh, reminds me of a time a primary care physician I shadowed briefed me on a patient outside the exam room and then said "I think I'll let you handle this one". At least I had a degree in neuroscience, but it still went about the way you'd expect:

Me: "So I see you're back for your appointment. You lost some weight, good to see, every bit counts! So, how are things?"
Patient: "Well, I've got a bad cough..."
Me, to myself: Well, that could be one of a few thousand different things...this would probably be a good time to have some medical training...

Cue a minute of nervous laughter and staring at the physician until he figured out that a pre-med isn't a third year medical student and took over.
 
yehhhboiii said:
why did you refrain from displaying your maturity and wisdom? im sure the attending would have appreciated being set straight and hearing your opinion
Click to expand...

I did display my maturity...by NOT acting like a bitch in front of the patient, unlike the Dr. Would he have appreciated the critique on his (lack of) professionalism? He should, but he probably wouldn't in that moment anyway. I'm not sure your comment isn't meant in sarcasm but I mean, it was an objective reality that the Dr. was exhibiting unprofessional conduct. I'd like to think/hope that anyone with such responsibility: wouldn't act that way OR at the least, wouldn't argue when being called out. But all people are fallible and everyone has bad days...myself included
 
Yes, its not right and it was unprofessional of the Doctor, however, as someone else said, they're human too. With that said the only thing I'd be concerned about is if someone made a joke they laughed so hard and cut the wrong thing, miscut, forgot a tool (<-happens), etc. Would not be good. Surprised no one mentioned this...
 
There's only two mature responses to have in this situation. Say something or laugh about it. Being passive aggressive is not one of these two. You're asking people to empathize with YOU, but you can't even do it with someone higher up in a field you want to join. Cool story bro.
 
theBruceWayne said:
Today I shadowed for the first time. I was shadowing an Anesthesiologist, and found surgery to be a complete eye opener (mostly in a good way.) I stayed the whole day, and went thru about five surgeries (about nine hours total..) However I was disgusted by one particular event.. We had an elderly lady who was clearly overweight come in due to a few hernias.. The Anesthesiologist was a wonderful guy. You could see he genuinely cared for the patient before, thru, and after the surgery. However the surgeon and staff where extremely vulgar, often making jokes on the patients condition (while she was knocked out of course.) I haven't felt so much anger and disgust in a long time.. Is this normal behavior during surgeries with larger than average patients or is this just a "freak" incident? As a current pre-med, I see patients as people who are coming to us for help, and on top of that they are paying us to help them as they go thru some of the most painful events of their lives.. On top of all this, after the surgery the surgeon/staff each slapped the patients sown up belly and walked off. I know I may be making a big deal over what may be something small..but in my head I still cannot get over it.. 🙁
Click to expand...

You're getting paid to shadow? I've never heard of that...
 
It's interesting to see people on here confusing dark humor/gallows humor with making fun of a patient. Big difference. One's a coping mechanism, one's just being a jerk.

But yeah, having worked in healthcare for awhile, this isn't uncommon behavior. With respect to the comment that as long as the patient doesn't hear it or isn't aware of it and as long as it doesn't impact their care, it's fine.... there are all kinds of unconscious bias that impact patient care and studies have shown that obese people get substandard care because of the same stigma these docs are joking about. Studies have shown that women get "diagnosed" with stress or anxiety more frequently, while men with the same symptoms are more likely to have their symptoms be attributed to a more organic medical cause when the only factor that's changed is the gender of the patient.

Do you think it's the more empathetic doc who isn't joking about this stuff that's short changing the patient or the one that is making snide remarks about patients?

I've got no problems with laughing to deal with the crazy, ridiculous, depressing stuff that that those of us that work in healthcare have to deal with. Having spent plenty of time watching the drunks and seekers in the ED, I can't begin to imagine how aggravating it is to have the same person back every night like clockwork. Gallows humor is a coping mechanism, but a lot of the bad behavior described in healthcare workers isn't just gallows humor.

OP, you probably aren't going to change the people doing and I wouldn't advise calling people out on it, but definitely as you progress through the field definitely try to set a good example for those around you.
 
hunterjumper14 said:
Often times, seeing things like this can help you decide what kind of practitioner you will be (at least that's what I tell myself). I once shadowed a surgeon that made me go in to an exam room, take a patient history (uuuuh.... what? I was a premed humanities major!😕) and when I came back with my "history" he proceeded to tell me that the patient was probably crazy because all patients were crazy.👎eek::eyebrow:

It was strange and definitely made me uncomfortable, but it showed me an example of who not to be!
Click to expand...

A lot are.

Mt Kilimanjaro said:
Read the house of god.
Click to expand...

Don't. At least not until you have taken Step 1 (maybe even finished residency?). It will suck the motivation from your soul like the black hole that took out the Romulans.
 
jw3600 said:
A lot are.



Don't. At least not until you have taken Step 1 (maybe even finished residency?). It will suck the motivation from your soul like the black hole that took out the Romulans.
Click to expand...


I've already read House of God. :naughty:
 
I shadowed in the endoscopy dept. before and make G.I.s make inappropriate remarks about females body parts.
 
The one aspect that kinda surprised me was the belly-slapping. I mean, even in some hospital-TV shows, you'll see a lot of what you described. Except not the belly-slap. To me, your description does show that doctors aren't really thinking of that patient as a person, but rather as thing.
 
So they finished operating and slapped the belly as they walked out of the room? Kinda reminds me of when opposing teams shake hands after the game.

I worked as an ED tech for a long time. 99% of the docs were very respectful, and it was usually the nursing staff making ill comments. There are exceptions, but they usually occur far away from the patient. In any case, your job in this situation is to ignore it. Just don't be a doodoo head when you're in charge.
 
It's pretty common to "slap the belly" to see how much CO2 is left in the abdomen.

I still think the OP has to be a troll.
 
The belly slap on the way out of the OR reminds me of slapping the team logo on the way out of the locker room for good luck.
 
OP, lets see how sanctimonious you still are after you've spent your 20s and most of your 30s studying and working 80+ hour weeks to become a surgeon. He's a hard man who lives a hard life. Let him have a bit of fun.
 
yehhhboiii said:
Obese people take substandard care of themselves
Click to expand...

A hospital is a place for smart people who take care of people who aren't smart enough to keep themselves healthy...
 
Arkangeloid said:
OP, lets see how sanctimonious you still are after you've spent your 20s and most of your 30s studying and working 80+ hour weeks to become a surgeon. He's a hard man who lives a hard life. Let him have a bit of fun.
Click to expand...

My free clinic patient who is working 3 jobs and 80+ hours a week to take care of his sick mother in addition to his wife and kids because none of his jobs give him health insurance probably disagrees with you. He's been busting his butt since his teens and isn't making enough to put away for retirement either. Pretty sure that counts as sacrificing your early years as well.

A lot of people out in the real world work demanding jobs with crap hours to provide for their families. Medicine is unique, yeah, and a big sacrifice, and should be rewarded, but a little perspective goes a long way. Doing a difficult job doesn't give you license to be disrespectful to others.
 
wholeheartedly said:
A lot of people out in the real world work demanding jobs with crap hours to provide for their families. Medicine is unique, yeah, and a big sacrifice, and should be rewarded, but a little perspective goes a long way. Doing a difficult job doesn't give you license to be disrespectful to others.
Click to expand...

Being in medicine also gives you a new perspective on very fat people. You start to lose any sympathy and respect for a person who smokes cigarettes and gorges himself on fried chicken when all the medical personnel he knows are begging him to stop. In light of such circumstances, I think it's perfectly okay to have a laugh at this stubborn patient's expense.
 
Arkangeloid said:
Being in medicine also gives you a new perspective on very fat people. You start to lose any sympathy and respect for a person who smokes cigarettes and gorges himself on fried chicken when all the medical personnel he knows are begging him to stop. In light of such circumstances, I think it's perfectly okay to have a laugh at this stubborn patient's expense.
Click to expand...

Another aspect is we see patients who are bad off and humor is just a way to deal with the situation. We could become hypertensive ourselves dealing with noncompliance, or we can laugh it off.
 
Arkangeloid said:
Being in medicine also gives you a new perspective on very fat people. You start to lose any sympathy and respect for a person who smokes cigarettes and gorges himself on fried chicken when all the medical personnel he knows are begging him to stop. In light of such circumstances, I think it's perfectly okay to have a laugh at this stubborn patient's expense.
Click to expand...
Medical staff which is necessary qualities
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alpinism said:
A hospital is a place for smart people who take care of people who aren't smart enough to keep themselves healthy...
Click to expand...

Yeah look at that idiot, he got cancer.
 
Arkangeloid said:
Being in medicine also gives you a new perspective on very fat people. You start to lose any sympathy and respect for a person who smokes cigarettes and gorges himself on fried chicken when all the medical personnel he knows are begging him to stop. In light of such circumstances, I think it's perfectly okay to have a laugh at this stubborn patient's expense.
Click to expand...

Don't let the pre-med status fool you. I might not be a doctor yet, but I've been working in medicine for quite a few years now. I'm quite well aware of all of the self-destructive things people do to themselves. It's fine to be frustrated with those patients, I definitely have wanted to bang my head into a wall a few times, but it's still true that unconscious (or conscious bias) feelings like that hurt patients. You can vent that frustration to your colleagues, you can have gallows humor/dark humor without dehumanizing people or making fun of them. There are plenty of ways to vent, some are acceptable some just aren't.

If you think the patients don't pick up on how you feel just because you don't say it in front of them, you're wrong. And alienating and stereotyping somebody isn't going to give them the confidence to make the change when they finally decide they need to. If everyone else thinks they're a failure, why bother trying? You can't box all obese people into the same category. There are a whole host of reasons people get that way and once they get there it's extremely hard for them to get out. It turns into a vicious cycle for a lot of people.

The patient is the one with the disease, not you. They're the ones suffering whether they act like they care outwardly or not.
 
Lamel said:
Possibly. Or it could be genetic and completely out of his control.

I hope you guys are being sarcastic with this.
Click to expand...

I have no idea if everyone's being sarcastic or not, but one thing is for sure. All people occasional do things they probably aren't proud of. Doctors are not exception.
 
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