Medical Myth Busters
After my freshman year of college, I took a job at a large aerospace firm because, well, it should be obvious to you by now that I am a slut for money, and this particular company offered to pay me ridiculous amounts of money to play Hollywood Stock Exchange and Snood with my cubicle-mate for an entire summer (in case you’re keeping score, that’s Effeminate Loser 2, Maintaining Any Sense of Dignity 0). However, while at this job I couldn’t help but notice that the hierarchy of this company reflected the ultimate stereotype of corporate life, such that the people at the top were inconsiderate fools and everyone else did their best jobs to smooch any open orifice these fools had in order to get ahead at the expense of their collegues, sheer incompetence not really playing into who did or did not get promoted. In essence, one summer at this job taught me that Office Space was far more realistic than I could have ever imagined.
Nuts to that, I declared triumphantly (to no one in particular, prompting the tragic "Oy our son is crazy!" fiasco of 2000...don't ask) at the conclusion of that summer. After speaking with enough doctors and medical students over the next few years, I started getting the impression that such hierarchical nonsense did not really happen in medicine, because everyone was equal, all colleagues singing songs and holding hands in a valiant display of mutual respect as they circled around a campfire burning with love (and maybe some fire).
Unfortunately, I have learned that this campfire does not exist, but instead is a mirage meant to disguise a disappointing reality. Case in point, last Thursday, when I was subjected to yet another afternoon with a certain attending at an endocrinology clinic who enjoys nothing more than embarrassing me in front of patients as much as possible. I have grown accustomed to such treatment, which usually goes something like this:
Attending: And what do you think is going on here?
Me: [Another brilliant explanation]
Attending: You couldn’t be further from the truth! [Laughs at me while patting patient on the back, who also begins laughing and pointing his or her finger at me]
Fine. I’m over it. However, last Thursday we were joined in clinic by an endocrinology fellow (meaning he had completed medical school and a residency, putting him at least five years ahead of me in training) there to help out. I introduced myself to him like so:
Me: Hi, I’m the third year with you in clinic today.
Fellow: OK. Third year resident?
Me: No, medical student.
Fellow (disgusted): Oh lord.
Lovely. Clinic was moving along rather slowly, so I decided to join the fellow while he did a work-up on a new patient. There were not enough chairs in the room, so I was forced to stand in a poorly ventilated room for an hour and a half while this fellow fumbled through a history and physical, taking forever on a task that even a moronic third year medical student could have done in half the time (and me in less than an hour, tops). Yet, I kept my mouth shut and just suffered through it.
I saw the next patient on my own, finishing the workup in about 30 minutes. I presented to the attending and we saw the patient together for another 15 minutes, for a complete workup total of 45 minutes. While walking out of the room, the fellow approached me from across the hall and, under his breath, spewed out rather angrily “What the hell took you so long? You're still on that patient?” Excuse me?
Soon thereafter, we had seen all the patients in clinic. The attending began his “You can leave” speech, but the fellow interrupted him and asked a lengthy academic question that served no purpose other than to signify his fondness for the attending’s rectum, because this question directly resulted in the attending saying the magic(ally horrific) words, “Why, I have some slides on that! Let’s go to my office and I’ll give a little talk!”
Seriously, kill me now. I followed them into the office and sat through the talk, the bulk of which consisted of the attending spending almost 30 minutes trying to explain a relatively simple concept to the fellow, who was so dimwitted he simply could not get it. Again, recognizing my place in the world, I just kept my mouth shut while the attending and the fellow went back and forth trying to tease out what was clearly stated on a stupid powerpoint slide. When the fellow finally got it, the attending realized that I had been silent for a while now, which led to the following exchange:
Attending: OK, does that make sense now?
Fellow: Thank you so much for that talk, that was really great!
Attending: Well, it looks like our friend here [pointing at me] is not really interested in our intellectual conversation, how about we call it a day for him?
[Attending and fellow laugh at me]
Ladies and gentlemen, the medical world is not some fanciful place wholly different from the corporate world, the legal world, or any other economic or social construct. The same rules of success apply, whether that means sucking up, making other people look bad, or doing whatever it takes to get ahead. I was probably just a victim of being especially naïve, but I honestly believed that there was something fundamentally different to the medical hierarchy, that even though there was a totem pole, people did not have the same pressure to abuse that pole at the expense of their colleagues in real-life practical settings.
Even more so, I learned that currently I am not merely at the bottom of the totem pole. The totem pole is mercilessly beating me across the head, smashing my insides out and my outsides in, and smothering any shred of dignity that might remain after you account for those ridiculous short white coats they make us wear and the aforementioned Snood I used to play from time to time.
Being a doctor may be unlike any other job in the world, as we are privy to the private experiences, fears, and hopes people would not share with almost any other soul…but, paradoxically, being a doctor is also just like every other job in the world, and I’m embarrassed to admit that I did not appreciate this until now.
Next time, I shall ruthlessly debunk Myth #47: There is at least a minute shred of truth to the drama depicted on Grey’s Anatomy.