Anesthesia Shzt List

I read an interesting post on Great Zs blog.

I have only once said I would refuse to work with a surgeon. It was at the centre of excellence when a thoracic surgeon could not be located after his resident got into some significant bleeding and we had to find another thoracic surgeon. I wrote a letter to my chief. This lead to a staff meeting that turned into a lynch mob, the surgeon was disciplined by adminstration, but continued to work for a couple of years after before going on "leave" from which he has never returned. I did work with him about six months later and he was quite cordial.

There are lots of surgeons who I prefer not to work with; if for example I am asked if I will stay late to do their emergency, I generally decline. For some surgeons late is any time after 1200.

In a community hospital where I used to work we all knew that certain anaesthetists hated certain surgeons and vice versa so whoever was assigning the list didn't assign them in the same room unless he was feeling particularily evil.

We all of course have surgeons we would like never again to have to work with:

Dr. Tardy

He not only is late for his first case but is late for every case of the day. This means you either stay until 1800 to finish his list or his last case (and he always books his longest case last) is cancelled which means you go home at 1300 losing income and quite often witnessing a nasty scene between him and the nurses. Dr Tardy has not figured this out.

The teacher

He loves to teach. This means he lets his residents or even medical students do much of his cases. This "teaching" consists of mostly of him leaving early to presumably do something else while his resident closes. He never compensates for this in his booked times. This means his list usually runs late (see Dr. Tardy). The teacher's enthusiasm for teaching rarely extends to anaesthesia residents. Plus one can only take so much teaching, after a while it becomes repetitive and you realise that The Teacher doesn't really know that much, he just repeats what he does know over and over.

Dr. Pottymouth.

I am not one of those people who is easily put off by swearing. I swear a lot, I actually enjoy swearing. As my scout master told me, it is not the word but how you use it. We had a cardiac surgeon at the CofE who went into what people called F-Tach. It took two anger management courses forced on him to cure him of this affliction.

Dr. Angry

Lets say a surgeon has two OR days a week and is angry for both of them. He works for 30 or years so think of the number of days in his life he is angry. Is there anything that makes him happy? If what I trained 5-6 extra years for made me angry, I might reconsider things or perhaps it just might make me more angry.

Dr. Whiny

A slightly more benign and passive-aggressive version of Dr. Angry. He just whines all day. Nothing is right with him.

Dr. Nightowl

This guy loves to operate after hours. Nuff said. You wonder why you are always up all night with him and not with the other surgeons who presumably see the same emergency patients. It may be something to do with afterhours premiums. In case emergency doesn't supply him with work, Dr. Nightowl usually gets patients on his wait list to show up in emergency so he doesn't have to waste time on activities like spending time with his family while on call.

Dr. Perfect.

Every thing about this guy's professional and personal life is beyond reproach as you will hear for the entire day. Of course you are screwing up his perfect case just by being there. In addition to the platitudes you will hear him reciting to everybody who has no choice but to listen, you will of course hear about his perfect children, his perfect car and his perfect vacation.

Dr. Fingerpointer

A cousin to Dr. Perfect. Every complication is someone else's fault usually yours and he will point that out in ways ranging from conversions in the doctor's lounge that you overhear, and that are told back to you, to sneaky progress notes that of course you never read but are part of the chart forever. He occasionally will confront you personally and quite often will write a letter to your chief. Dr. Fingerpointer is quite often a vascular, thoracic or urologist; all specialties that by the nature of their work or patient population get bad results. They have not accepted that.

Dr. Slowhand

Some surgeons are slow because they are meticulous. Most of us don't mind because we hope we or our family get such good care. For the bulk of slow surgeons the old slogan "First you get good, then you get fast" comes to mind. This of course usually results in the cancellation of Dr. Slowhand's last case (see above). Quite often Dr. Slowhand is not the most punctual person.

Dr. Knowitall

Dr. Knowitall is an expert on everything. This includes anaesthesia, and Dr. K is always ready to give you helpful advice on how you should be conducting your anaesthetic. Dr. K. will also hold forth on just about any non-medical topic, as well as medical topics outside his narrow area of specialty. Woe to you if you actually try to challenge Dr. Knowitall.

Dr. Powderkeg

At least Dr. Angry is angry all the time and Dr. Whiny whines all the time. With Dr. Powderkeg you can see it building up all day and you are just wondering when the shit is going to hit the fan and who is going to be on the opposite site of that fan.