I should have posted on this a long time ago. This happened in the last millennium at the C of E.
Naturally being a Centre of Excellence, the Centre of Excellence has doctors from all over the world come there to become excellent. In the late 1990s we had a surgeon from a third world middle eastern country spend a year or so to learn to do liver transplants. Now there are a lot of people who would think that most third world countries should maybe focus on things like public health, vaccinations and non-excellent things but they are not thinking excellently. As the fully qualified surgeon working as a fellow, he was given some latitude in working and was mostly working unsupervised on the memorable day.
I came in to find that as usual my list was all messed up and my first scheduled case couldn't start until the early afternoon, however in consolation, I was allowed to pick up an emergency case from our ICU. This was a liver transplant patient who had had his abdomen packed due to oozing at the end of the case. It was now time to remove the packs. I was not a liver transplant anaesthesiologist but now that he had a sort of a functioning liver I was deemed competent to anaesthetize this patient. He was still ventilated, lines in, plug and play.
After removing a number of packs our now more excellent surgeon announced he was closing. "Not so quickly", said the circulating nurse who had the count sheet from the original operation. "There is still one more pack in." "No there isn't" said our surgeon. Fine said the nurse we'll X-ray. Our surgeon left the room leaving his residents to close which they did in time. X-ray was summoned and a flat plate showed surprise, surprise, the missing sponge. Our surgeon was summoned back.
There are a number of appropriate responses to this scenario; most of them involving some expression of regret or remorse. None of these were forthcoming. Was did come was the surgeon angrily accusing the nurse of not being more forceful in insisting that he look for the sponge. I rolled my eyes; I do after all get paid by the hour.
The last time I worked with this surgeon was during the evening and I witnessed him being walked through a laparoscopic cholie by a junior resident. I decided this wasn't really appropriate and complained and he shortly returned home where I suppose he is doing liver transplants and laparoscopic cholies and might even listen to the nurses occasionally.
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I can't remember the most arrogant thing a surgeon has said. The usual self congratulatory crap at the end of case implying if not for him the patient would have died on the table. Funny, they never look at us and say "If not for you, I would have knocked this patient off." which happens more frequently than them actually snatching a lap chole from the jaws of death. One surgeon was famous for pronouncing at the end of the case "worst case of " he had ever done. He was serious, and never remembered that last case was similarly judged. One surgeon, who would be a permanent member of anger management classes if he practiced in Canada, stormed into preop furious because his line of cases was held up because the next patient had some issue, something his workup had said had to be done but he didn't order it. The RN running the 25 bed prep area had done everything to get him to verbally order the test from the OR, but he is too important to be disturbed in the OR. He wound up screaming at her for not ordering the test herself (uh scope of practice) and concluded with "It's ridiculous to expect the busiest man in this hospital to do this!" I was trying not to laugh out loud, and she and I joked about it alot.
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