malignant attending stories

[dragonfly99]

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OK, I had kind of a bad day at work and I wanted to see whether anyone has any good stories about experiences with malignant attendings.
There's one at my program who people had been telling me was "malignant" (as in nobody really likes this person) and I wondered what the hell they were talking about, and NOW I KNOW. I basically got chewed out today for not answering a page immediately, although I was scrubbed into a procedure and the nurses generally will refuse to answer my pages (I've pretty much given up). There was no sick patient or other emergency involved, by the way. I agree that it's important to answer pages, but I kind of can't if nobody will return my calls while I'm scrubbed in. If I don't try to do the cases, then I'll get labeled as uninterested and get a bad evaluation. If I do and I miss any pages, I'll get continually chewed out. If I complain to the nurses or keep asking them repetitively to answer my pages, then they'll screw me over by doing little things to make my life hard. So I'm a little bit screwed for this rotation I think. Oh well.

 

[docdaname]

so as a med student I was doing an anesthesia rotation. Normally, the surgeons clip the drape to the IV pole. seeing that the pole was too far away from the table, i grabbed it and moved it forward. That was a mistake. The surgeon then yelled at at me for a solid 5 minutes about how I need to let him run the case because he is the surgeon, and he only clips the drape to one of the poles and lets the other corner of the drape hang down (and no it didnt affect his surgical field to clip it up). After he was done with me he yelled at the nursing staff for 5 minutes becuase the hospital switched the brand of scalpel blades they used, and he did not like the change, and really let the nurses have it. Another case, the medstudent was holding the scissors, and her hand was shaking a bit i guess. So he slapped her hand and said "stop shaking! what, do you have tabes doralis or something?" Where I come from asking the student if they have teritiary syphilis would be considered malingnant.

 

[DarthNeurology]

OK, I had kind of a bad day at work and I wanted to see whether anyone has any good stories about experiences with malignant attendings.
There's one at my program who people had been telling me was "malignant" (as in nobody really likes this person) and I wondered what the hell they were talking about, and NOW I KNOW.

Well, I don't have a "good" story about an experience with a malignant attending as malignant attendings just make people's lives miserable around them. I suppose a good story about a malignant attending would be one where one of them falls down an elevator shaft or somebody drops a house on one of them.

(I was under the impression that DF was in IM and doing a cardiology fellowship or something, but I guess she is a general surgery resident? If so I am surprised that DF hasn't run into a malignant attending before on some surgery/ob/gyn/IM service. )

It does suck trying to explain to people who have never worked with a truly malignant attending what exactly the person is like.

Welcome to Hell.

I am sure this malignant attending will ball you out again as first impressions mean everything to these histrionic people. No doubt you will be paged during a procedure again, and bawled out again. I would explain what happened as a preventive measure, though he may just yell at you to make the nurses follow your orders. Being around these people is like stepping in a bucket of tar as they are stuck on you and mess up what your doing.

 

[drfunktacular]

Why does medicine attract so many DB's? I wonder this frequently.

 

[Winged Scapula]

(I was under the impression that DF was in IM and doing a cardiology fellowship or something, but I guess she is a general surgery resident? If so I am surprised that DF hasn't run into a malignant attending before on some surgery/ob/gyn/IM service.

Dragonfly is not a surgical fellow. She is doing an IM fellowship as you previously assumed - she mentions doing a procedure (not a case). 🙂

 

[WholeLottaGame7]

so as a med student I was doing an anesthesia rotation. Normally, the surgeons clip the drape to the IV pole. seeing that the pole was too far away from the table, i grabbed it and moved it forward. That was a mistake. The surgeon then yelled at at me for a solid 5 minutes about how I need to let him run the case because he is the surgeon, and he only clips the drape to one of the poles and lets the other corner of the drape hang down (and no it didnt affect his surgical field to clip it up). After he was done with me he yelled at the nursing staff for 5 minutes becuase the hospital switched the brand of scalpel blades they used, and he did not like the change, and really let the nurses have it. Another case, the medstudent was holding the scissors, and her hand was shaking a bit i guess. So he slapped her hand and said "stop shaking! what, do you have tabes doralis or something?" Where I come from asking the student if they have teritiary syphilis would be considered malingnant.

I think the hardest part of being a med student is dissociating yourself from other people's reactions. You're so trained to make everybody happy, if somebody's yelling at you you just assume you've done something wrong. We're kind of like beaten-down puppies in that regard. (I may or may not have left a mess in the corner of the room out of shame.)

The toughest thing for me has been to realize that some people are just having a crappy day (or a crappy life), and that it's not a value judgment on me. The real trick then is making sure you recognize the times that you're actually deserving of the criticism.

 

[docB]

When I was on my third year (med student) clerkship in IM I had an attending who was actually really good except for one morning. I was presenting a patient admitted on call the night before, "Mr. X is a 55 yo M admitted for neutrapenic fever secondary to chemo for his widely metestatic colon CA..."

She stopped me there and asked if I had assessed the patient's risk factors for colon CA.

I sort of chuckled as I thought she was kidding. Big mistake. She then launched into a speech about how I should have been asking the guy about his family history and how much fiber he had in his diet.

I had asked about the family history but skipped the dietary bit. She apparently wanted my to work up this guy's risk for the disease we knew he had. "Gosh, Sir. You have very few risk factors for the cancer that is currently killing you." I'd say his risk for colon cancer was extremely high.

 

[error404]

I had asked about the family history but skipped the dietary bit. She apparently wanted my to work up this guy's risk for the disease we knew he had. "Gosh, Sir. You have very few risk factors for the cancer that is currently killing you." I'd say his risk for colon cancer was extremely high.

lol.

While a med student, I scrubbed into a neurosurg case with the chief, who was a genuinely awesome person. The attending showed up late, asked my name, and said, "You know, Error, you can tell how much an attending likes teaching by how much time he spends talking with the med students."

Those were his last words to me for the 4 hour case.

 

[Winged Scapula]

Not an attending story, but a malignant Chief Resident:

I was an intern and one of my Chief Residents fancied himself quite the lady killer.

One day I was post-call (remember this was pre-80 hr) on Vascular Surgery. Lots of patients, busy night. I feel like a cartoon character in the afternoon (around hour 36)...you know how they draw drunks with bubbles over their head and spirals or Xs for eyes? All I can think about is going home. Now I was excited to go home not just for sleep but because I had a new BF I was crazy about and who always cooked for me for me when I was post-call, but tonight was his birthday, so I was hoping to get home before I was comatose.

Lady Killer pages me around 6 pm to tell me that he was going home for dinner and that we would do evening rounds when he got back.

Me (in small voice): when will that be?
Him: when I get back...<click>

Now mind you, he generally tried this all of the time, but the Vascular fellow (whom we all loved - miss you Shaheen) would overrule him about time of rounds and send the post-call resident home). Unfortunately he was out on job interviews.

He (evil Chief resident) returns around 8 pm and asks me why I wanted to know when we were going to be done. I said I didn't ask that but wanted to know an approximate time because I'd hoped to get home to celebrate my BF's birthday (funny factoid: in my original draft of this response, I actually typed "BF's boyfriend". I am jet lagged which feels a lot like being post-call...as I stayed up most of last night and operated all day.)

Him: well, he's a loser blah blah blah (personal details omitted)
Me: <stunned into silence that he would comment about my BF/family/whatever>

On rounds he proceeds to harangue me, telling me he wants to know all the lab values on the patients without me looking at my sheets - mind you, post-call hour 39 when I'm not sure I can even read, let alone memorize.

He <I think> purposely drags rounds on, as he floats through the SICU, inviting all the young nurses to sit on his lap, while he tells stories about how great he was. <Tee hee...laugh from gullible young nurses>

As I am leaning my chin on my hand on the countertop listening to his dribble with some young nurse (his fiancee was an employee in the hospital), I fall over, reportedly nearly striking my head on the way down. I was confused why I was on the floor, didn't remember falling asleep <but who does?>. Turns out, by report from one of the older SICU nurses who saw it <and told me two days later>, he saw me and struck my arm out from under me, causing me to lose my balance.

The best part of residency was, after this particular Chief finished his fellowship, he applied for a job back at our hospital. As an intern, I thought all the attendings liked him. I soon found out that they thought he was as much of a prick as I did and that there would be no chance he'd be hired. Unfortunately, they gave him an interview and I actually briefly saw him...heard his voice before I saw him and instantly felt sick to my stomach.

Funny about the tincture of time though. We had another unpleasant Chief resident whom I and almost everyone else hated. He was just angry almost all of the time...the only time we saw a smile was when his small boy visited. Despite his bad attitude, I do think I learned some good habits from him. Years later, when I was a Chief, this particular man came back to our hospital to see some rare pediatric CT thing. I saw him in the PC's office and I HUGGED him. I don't know what got over me...instantly I thought - WTF?

Sorry you had a bad day DF - it happens to almost all of us.

 

[JPmamd09]

Sorry for the crappy day DF. It'll get better (right?) 😉

If you want to hear my stories (since misery loves company), I've gotten chewed out/ had my hand slapped by an OB attending during a delivery (to the point that after the delivery the patient gave me a hug and told me she'd never go back to that doc after seeing the way he treated me); while on anesthesia I was yelled at by an attending for doing a pre-op H&P on one patient (I was the sub-i and residents were all on cases, as it was the weekend), then yelled at for NOT doing the H&P on the next patient; and got hollered at in front of patient, pt's family, and nursing staff by another OB for not cutting the suture short enough during a repair - I believe the tirade included "Are you stupid or something?" - which resulted in me crying in the bathroom for fifteen minutes while on call on a Saturday which was also my birthday.

I don't get why people are like this. I'm not perfect, but I'm not lazy or dumb; even if I were it wouldn't warrant such treatment. Nobody deserves to be treated like crap.. so again DF, sorry for your crappy day and I hope things start looking up soon.

 

[dragonfly99]

Jpam,
I got the "Are you just stupid or something?" comment as well as a medical student. That is definitely malignant and not something an attending should say to a student, even if the student isn't doing well...I can't imagine a situation where that would be constructive criticism.

I actually had a much better day today. And the attending who chewed me out was totally nice...hard to figure out. I think it's just that person's personality...life with no gray areas and only one right way to do things. I have to say that his way (medically speaking) is a good way though...he's an excellent doctor. I think everything is worse when you are tired as well,and I definitely was. Normally nobody could make me cry, but I almost did yesterday. I had a really sweet patient in clinic today...one of those little old guys who has a great attitude. I wish I could be this cool before I'm 85 like that...he was just one of those old guys that seems to have it all figured out.

 

[smq123]

I've gotten chewed out/ had my hand slapped by an OB attending during a delivery (to the point that after the delivery the patient gave me a hug and told me she'd never go back to that doc after seeing the way he treated me)

That's pretty awesome. Good for the patient. I hope that's what she told the doctor's office when she called to cancel her follow-up appointments.

That attending had probably never been reprimanded for his behavior. Who would want to do that and jeopardize a grade/eval? I'm glad that he's going to see some of the consequences for acting like that.

 

[Tigerz_Fan]

We are changing to a new EMR, and have had to attend classes periodically. The classes mix interns/residents/fellows/attendings from all specialties. In my last class, we were mixed with private practice OB and cards. The other fellows and myself were asking a ton of questions, and one OB attending in particular made it very clear that she was getting pissed about our questions. After the class, she came over introduced herself (big mistake) and told me, "let's hope I am never in your area, and you are never in mine."

I recognized her name immediately because I am 8 months pregnant and she is one of the partners my OB's practice. Ironically, I had an appt with her the next week because the patients have to see all the OBs in the practice since you don't know who is on call when you deliver. So, I stood up to show off my very large bump and told her that their practice has just been fired as my OB. The look on that jerk's face was priceless. When my OB called the next day, I told her to ask her partner for an explanation, and of course, a referral to another practice.

 

[Winged Scapula]

Good for you TigerzFan!

 

[dragonfly99]

Wow, that's a heck of a story, Tigerz fan!
We had a neurosurgery attending @my med school who was very unpleasant and would regularly throw surgical instruments like a 2 year old. I never understood how the nurses and anesthesiologists could put up with him. I think he'd never have survived in private practice. And I won't even go into how he treated the house staff. Strangely, he never bothered to yell at me...he was one who ignored the med students in general.

 

[grumbo]

During my MS3 surgery rotation, there was a general surgeon who would always yell at everyone. Supposedly the rotation before me, he threw a scalpel at another med student. I didn't see that. What I did see more funny and less psycho.

We were scrubbed in on a lab gastric bypass, and he always had the student run the camera. He would yell about being too far, too close, not looking at what he was looking at (as if we knew what he was looking at). He would often slap hands and give new directions. On this particular case, he was escpecially annoyed with the camera work and slapped the student's hand away and took over the camera. About two minutes later, he yells at the student about the camera work. My fellow student could only say, "sir, you're driving the camera." His response, "oh, well......good."

 

[WholeLottaGame7]

During my MS3 surgery rotation, there was a general surgeon who would always yell at everyone. Supposedly the rotation before me, he threw a scalpel at another med student. I didn't see that. What I did see more funny and less psycho.

We were scrubbed in on a lab gastric bypass, and he always had the student run the camera. He would yell about being too far, too close, not looking at what he was looking at (as if we knew what he was looking at). He would often slap hands and give new directions. On this particular case, he was escpecially annoyed with the camera work and slapped the student's hand away and took over the camera. About two minutes later, he yells at the student about the camera work. My fellow student could only say, "sir, you're driving the camera." His response, "oh, well......good."

As a frequent camera driver on many lap choles/gyn cases...love it

 

[Tigerz_Fan]

Wow, that's a heck of a story, Tigerz fan!
We had a neurosurgery attending @my med school who was very unpleasant and would regularly throw surgical instruments like a 2 year old. I never understood how the nurses and anesthesiologists could put up with him. I think he'd never have survived in private practice. And I won't even go into how he treated the house staff. Strangely, he never bothered to yell at me...he was one who ignored the med students in general.

This happened a couple of weeks ago, and I saw her in the hospital today. She couldn't even look at me, and I just had to smile to myself in satisfaction 😉

 

[dotdash]

This is a second-hand story, but I wanted to get people's responses...

As a med student, my husband had experience with two different trauma surgeons. One was a real b*st*rd and yelled scathingly at everyone in the OR for the least little hesitation, etc. The other was a nice guy, seemed to understand when little things went wrong, etc. Both good surgeons.

The weird thing was, my husband reported, that the OR staff seemed to respect and obey the first guy with a little more alacrity than the nicer guy.

So my question is whether being a b*st*rd might actually produce better outcomes in certain circumstances, even as it lays waste to the self-esteem and well-being of co-workers?

 

[Winged Scapula]

This is a second-hand story, but I wanted to get people's responses...

As a med student, my husband had experience with two different trauma surgeons. One was a real b*st*rd and yelled scathingly at everyone in the OR for the least little hesitation, etc. The other was a nice guy, seemed to understand when little things went wrong, etc. Both good surgeons.

The weird thing was, my husband reported, that the OR staff seemed to respect and obey the first guy with a little more alacrity than the nicer guy.

So my question is whether being a b*st*rd might actually produce better outcomes in certain circumstances, even as it lays waste to the self-esteem and well-being of co-workers?

Respected or feared? The two are often confused especially in the high stress environment of the OR.

A lot of things go into getting the OR to "move" for you. If the bastard surgeon brings in high volume, is considered a technically great surgeon or otherwise treats the staff well outside of the OR, he may well get better treatment - either because the staff is instructed to keep him happy because he brings in a lot of money to the hospital or prestige.

I'm considered pretty nice by my OR staff and have no problem getting them to do things. As a matter of fact, just a few weeks ago one of my anesthesiologists remarked that the staff did things for me that he doesn't see them do for others. But you cannot be a doormat if it means poor care for your patients. So the nicer guy may be less respected or the staff doesn't do stuff with as much alacrity because he doesn't appear to demand it and the staff doesn't have any impetus to keep him happy. Most OR staff I've met, except for the "lifers", will do pretty much the basic minimum to keep their jobs and no more. With these types, you have to demand that they keep up the standard and take some pride in their work and taking care of the patient.

 

[surrender903]

We have an attending at our hospital who is not allowed to have med students or residents on his service anymore because his attitude is so malignant. He recently cursed out two of my fellow interns and then hung up on them. One of these incidents occurred last night where he proceeded to brow beat Intern Y for 5 mins cursing at him, the intern put the phone, went and saw another pt, returned 5 mins later and he was STILL going off.

Needless to say, the PD and DME have been notified as well as the Chief of Medicine.

 

[JPmamd09]

That's pretty awesome. Good for the patient. I hope that's what she told the doctor's office when she called to cancel her follow-up appointments.

That attending had probably never been reprimanded for his behavior. Who would want to do that and jeopardize a grade/eval? I'm glad that he's going to see some of the consequences for acting like that.

It's true, that patient really was awesome. I'm thankful that it was her delivery - both because she helped make me feel like less of a jackass and also because I felt privileged to be a part of that moment in her life (trite, I know, but true). I've heard through the grapevine that that attending is now retired and that it wasn't really a voluntary situation. He's also notorious for racist comments, which may or may not have played a role in that.

Anyway, I'm glad to hear things are looking up, DF. And thanks to you and to SMQ for your insightful posts, they're always a pleasure to read.

 

[cali-ob]

So, I stood up to show off my very large bump and told her that their practice has just been fired as my OB. The look on that jerk's face was priceless. When my OB called the next day, I told her to ask her partner for an explanation, and of course, a referral to another practice.

I LOVE this story! Excellent!

 

[medicinesux]

dragonfly, I think I found your attending on youtube!

[YOUTUBE]XDqvCmIadXk[/YOUTUBE]

 

[dragonfly99]

No, it's a dude.

 

[Tigerz_Fan]

DF, are the days getting better?

 

[ocean11]

Hey I'll add to this.. I'm a PGY-2 at an IM program .. I did my ED rotation a few weeks ago. I actually tend to like my ED shifts and find them interesting... but one of my shifts ended up badly. I was the only resident in this small section of the ED. The attending kept on pushing more and more patients in. The cap for this section is only 7, but he pushed in more than 11 (some quite ill and very acute). They were spilling over into the hallway. Anyhow, I had 3 different attendings come in and out and talk about the patients... confusing as to 'who was in charge' as this was my first day at this particular section. Anyhow, one patient came back from CT scan and developed an anaphylactic reaction to the dye. I quickly gave her an epi injection, which resolved her symptoms (got much better FAST) and was back to baseline. Ofcourse I paged the last ED attending who admitted her (2 hours previously). When I didn't hear back, I assumed that he was busy, perhaps taking care of the code in the other section? anyhow, an hour later... another attending rolls in and asks whats going on in the room. I procede to tell him about everyone. When I told him about the anaphylactic patient he blows up... "why didn't you page me..." etc etc... I was like "Listen I didn't know you were in charge.. just spoke to another attending"... he continued to chew me out for 10 minutes about how I should know who's in charge (even though it was my first shift at this particular department) and I'm not an ED resident. "you've been here 2 years, you should know how things are run..." etc etc... proceded to slam his hand on the table... douchbag!

The next day he actually apologized but still said I made a mistake... yeah the only mistake I made was that I didn't walk out on him and have him do all the scutwork... he's known for being a douch though... my colleague almost walked out on him during his ED shift last week! He's chewed out several RN's as well ... who proceded to tell me that he's 'known for this'.

All I can say is Bad Karma.....

 

[marsupial]

In the ED I saw an attending teaching a resident using a Wikipedia article, and I jokingly said "Wikipedia? Seriously?" He took me aside for a "talking to" about how I should talk to attendings and made me apologize! So much for ER doctors being guys with a sense of humor! He actually said "I'm the doctor. I know the answer. You don't know as much as you think you do." He doesn't even know me...prick.

 

[WholeLottaGame7]

In the ED I saw an attending teaching a resident using a Wikipedia article, and I jokingly said "Wikipedia? Seriously?" He took me aside for a "talking to" about how I should talk to attendings and made me apologize! So much for ER doctors being guys with a sense of humor! He actually said "I'm the doctor. I know the answer. You don't know as much as you think you do." He doesn't even know me...prick.

Dude, how long have you been in medicine? It is Cardinal Sin No. 1 to call out someone higher up than you, especially with observers around. I would say that you are relatively lucky you got off as easy as you did. If you want to see a malignant attending, try something like that in front of a surgeon. Just make sure you wear your asbestos-lined white coat...

As for the latter comment, that's a fair assessment for most people in training. You either disagreed because A) you already realize that, or B) you don't already realize that, in which case it's even more pertinent for your situation.