Friday, February 02, 2007

The Towering Inferno (That Is A Surgeon's Ego)

During my last hospital visit, we were sitting in the lobby waiting for the surgeon in charge to come get us. Assorted medical personnel were walking by, and lots and lots of scrubs. After a while I noticed you could actually tell what sort of doctor they were simply by the way they walked. So I wrote a Medscape post on the subject. And then I left it there because I had other stuff to post about (things that were obviously more urgent, like Cambridge students riding whale skeletons and emergency physicians predicting we were all going to graduate to become drunken incompetents. --Editor)

Then I went back yesterday, expecting the post to have the usual smattering of comments under it, most probably from a few surgeons calling me dirty names, and I see 74 comments under the article. Many were from people voicing their support of this particular medical stereotype, and a few surgeons (and people who had worked with surgeons) speaking out against it, including Sid Schwab of Surgeonsblog fame. (There was, of course, the odd commenter calling me an idiot, one of whom misunderstood exactly who I was insulting when I said we medical students were "ridiculously well dressed", but I'm used to people calling me an idiot. In fact I think it started when, in the labour room, the gynaecologist delivering me slapped my back and said "Breathe, you idiot!" --Ed)

For the record, I have worked with many great (and very humble) surgeons, and also some downright arrogant ones. I harbour dreams of becoming a surgeon myself (though after this fiasco, there probably isn't a single surgeon out there anymore who's willing to teach me. Sigh. --Ed). Do go over and read the post for yourself, and drop a comment if you have feelings on the matter. Some of those comments have been very insightful, especially to a lecture-theatre-bred medstudent brat like me, and I will put a few up here soon. In the meantime though, I'm off to Newcastle to meet with med students who actually get to see the inside of a hospital in their first FEW WEEKS of med school. (Bastards. --Ed) I just hope my train doesn't get attacked by Red Indians.


the little medic said...

WOW!! That certainly kicked up a bit of a fuss didn't it!

I have to say I completley agree, most if not all surgeons have a huge ego. We recently had teaching from a neurosurgeon (top of the ego ladder) He actually introduced himself to us as god. And proceeded to tell us for 50 minutes about why surgeons, partiularly neurosurgeons are better than everyone else on the planet. He then spent 10 minutes telling us about brain tumours before waltzing off in a typical surgeon manner sweeping through the corridor like he owns the entire county!

I too harbour dreams of becoming a surgeon one day and if I do i'll probably develop my own ego.

Have fun in Newcastle.

Dan said...

" but I'm used to people calling me an idiot. "



Wandering Medic aka The Wanderer said...

Dude, you're far too harsh on yourself. Surgeons definetley have a swagger, regardless of how humble they are. Its not so much the consultants (they've had the strut broken by years of pounding the halls and theatres) but the middle grade registrars who think they own the place.

Case in point: I was doing a rotation in anaesthetics recently and having no surgical shoes to hand, like any good med student, "borrowed" the nearest pair to hand, which had no visible markings. Half way through the list, enter a surgeon, who pulls me out and says: "You've taken my shoes!"

Me: "Oh really? My mis-" and I begin to take them off, but before I can finish....

Surgeon: "Never take a Cardiothoracic surgeons shoes" and storms off into the distance

Me thinking: That was interesting and rolling in hysterics!

I don't have anything against arrogance, but to degrade someone is just bad manners. Regardless of if you're a Professor of Surgery or "lowly" med student, courtesy will get you everywhere.

Nancy said...

it is a well written piece and a nasty hornets nest you've opened.
It so true, as a MRI tech we are on the botton of the feeding chain, so we feel their sting often.

HospitalPhoenix said...

I haven't read all the responses to your piece (as I have MTAS to wrestle for the time being) but I'll come back and read them when my MTAS ordeal is over.

What you state is interesting, and the responses even more so.

I must tell you about my perspective on this issue at some stage... or maybe even write a post on it.

Nice photo by the way ;)

[there are photos of me on the internet but you'd have to know where to look...]

Chrysalis Angel said...

I haven't read the post yet. I'll check it out after I leave this for you. You cracked me up with this quote. "In fact I think it started when, in the labour room, the gynaecologist delivering me slapped my back and said "Breathe, you idiot!" --Ed) Remember to always be humble. No matter what specialty you chose. It's always good to keep in mind how human we are. Never loose the ability to look across at someone and realize that could be you someday. How would you like them to treat you?

Calavera said...

I know what you mean.

The worst are definitely orth pods. No doubt about that.

HospitalPhoenix said...

I know some lovely orthopods. And most general surgeons are lovely too. Vascular surgeons are changeable and unpredictable, cardiothoracic surgeons are nicer than you think they'd be, paediatric surgeons are really lovely, plastic surgeons are nice people with a slightly autistic affect, ENT surgeons keep themselves to themselves, and urologists are scary. Who've I missed out? Maxfax. They're dentists.

HospitalPhoenix said...

I fucking hate stereotypes. They earn their reputation, and the worst offenders are those who enter a specialty as a normal person, and morph into the stereotype they promised they'd never become.

Like psychiatrists. All fucking nutcases. But back when they were SHOs, they were normal people. They should have escaped whilst their sanity was intact.

Is the peer pressure so great that all surgeons morph into arrogant arseholes and all psychiatrists go crazy? Or were they pre-programmed that way all along? Is it possible to resist the seductive pull of 'fitting in' or is the final destination of specialists unavoidable?

I wish I knew, because if I ever become an arrogant twat I'll rip my own head off.

zewt said...

when you're a surgeon... make sure you keep your ego level under control then... wouldnt want others to call you an arrogant bastatd, no?

by the way... what's the different between an attending, a resident and an intern. I am more interested in the difference between an attending and a resident. yeah... i watched too much grey's anatomy.

Spirit of 1976 said...

This annoys me. I've always liked scrubs, because nobody can tell if you're a HCA or the consultant neurosurgeon. And now you're saying I have to get the walk right?

Damn. I'm going have to spend ages practicing the walk in my bedroom so next time I'm wearing scrubs I can enjoy my fantasy that passers-by are thinking, "Oooh, that's probably a really dashing and clever surgeon going past. I should do him in a cleaning cupboard."

Not that they let us wear them much, being in mental health. The only psych unit I know of that wears scrubs are the neuropsychiatry unit, and that's just because the staff complained about their clothes getting covered in assorted body fluids.

Spirit of 1976 said...

Oh, and is it just me, or did some of the comments on that post of yours simply reek of "ARE YOU SAYING I CAN'T TAKE A JOKE? DON'T TELL ME I CAN'T TAKE A JOKE! I HAVEN'T WORKED AND STUDIED FOR TWENTY BLOODY YEARS TO BE TOLD I CAN'T TAKE A JOKE! I'M A SURGEON, YOU KNOW!"

HospitalPhoenix said...

Uh... spirit of 1976... I always thought you were a girl. Oops.

the little medic said...

Hospitalpheonix's summary of surgical specialties seems to be pretty accurate. Most of the surgeons i've met fit into his categories. I hope they sterotypes too though!

What about neurosurgeons HP?

Spirit of 1976 said...

Uh... spirit of 1976... I always thought you were a girl. Oops.

Cos I'm a nurse?

Ha! Stereotyping! :p

Bohemian Road Nurse... said...


HospitalPhoenix said...

Yes, doncha know, all nurses are girls and all surgeons are boys.

Neurosurgeons? I know two consultants, and they're both really nice quiet chaps. Their SpRs on the other hand have egos the size of the Empire State building. I'll never forget a neurosurgical SpR repeatedly refusing to review a patient on our ward. I ended up calling the Consultant at home, who came in immediately and bollocked his SpR. Ha.

Dan said...

ego boost for you:

A fellow walked into a doctor's office and the receptionist asked him what he had.
He said, "Shingles."
So she took down his name, address, medical insurance number and told him to have a seat.
A few minutes later a nurse's aid came out and asked him what he had.
He said, "Shingles."
So she took down his height, weight, a complete medical history and told him to wait in the examining room.
Ten minutes later a nurse came in and asked him what he had.
He said, "Shingles."
So she gave him a blood test, a blood pressure test, an electrocardiogram, told him to take off all his clothes and wait for the doctor.
Fifteen minutes later the doctor came in and asked him what he had.
He said, "Shingles."
The doctor said, "Where?"
He said, "Outside in the truck. Where do you want them?"

Dr. Deborah Serani said...

From a psychological point of view, the "dissociative" qualities necessary for performing surgery require one to lack other tender attributes. Being narcissistic may be a necessary calling card for such individuals. Great medscape post!

Tunku Halim said...

Surgeons wield scalpels. Writers wield words. Both have big egos. Angry medic - you going to wield both and become a Super Ego?

HospitalPhoenix said...

Ouch! I'd beg to disagree, dr deborah serani.

It's a bad surgeon who dissociates himself from his patient's pain and suffering.

A good surgeon maintains composure, completes his commitments, exercises his 'tender attributes' by reassuring his patient and everyone else, then deals with the pain in his own way.

Some might try to numb their pain with drink, drugs, or psychologically blocking it out.

I personally prefer a nice cup of tea and a good honest debrief with a colleague, friend, or even the nurses. But hell, apparently I'm not emotionally robust enough to be a surgeon. So just ignore me.

Anonymous said...

fuh. patrick teoh commented on ur site! go aaron! our very own celebrity!


The Angry Medic said...

Little Medic: Good Lord, man, that needs to be in a blog post. Reminds me of something out of Scrubs. Though I must say, I can actually see it happening, with some of the surgeons I've met...

(To the potential assassins reading this: I said SOME.)

Dan: Ha. Har har. The first one was very funny, Dan. The second one was actually really quite funny :)

Wandering Medic: Well said, dude. That's what I was trying to get at in the article, but I think some people mistook what I was saying.

And that attending! What the...?! He sounds like he'd fit right in with the rest of these absent-minded professors over here.

HospitalPhoenix: Heh. Thanks for the low-down on the specialties. I'd put that in a blog post, but Calavera appears to have beaten me to it.

Thanks also for the photo compliment. Bear in mind, Medscape wanted a goofy-looking pic to keep with my image as the resident clown. I'm far more handsome in real life.

And nice one on the nurse gender stereotyping :)

Nancy: Aw, thanks for stopping by again. Yep, I can imagine what MRI techs must go through at the hands of the more arrogant surgeons sometimes. There are some very nice ones though (both surgeons AND MRI techs. The first one I ever met was a lovely Irish woman. Too bad she was already married :P)

The Angry Medic said...

Zewt: Who me, arrogant? Heck no. Not a humble little medic like me, oh no. And right now I'm not even sure I'm gonna LIVE long enough to become a surgeon in the first place :P

Ooh good question. Resident = not-so-big doctor who's passed houseman years. Attending = bigshot doctor who's passed a few more exams. Like you, my only knowledge of this is from Grey's Anatomy :P

Chrysalis Angel: Aww, glad you liked it. And no, I have no plans to become (borrowing HospitalPhoenix's term) an "arrogant twat" anytime soon. That is, of course, if I even LIVE long enough to graduate. Which will be quit a feat at the rate I'm pissing people off :P

Will reply your email soon, btw :)

Bohemian: Aw, thanks! My life's just so unlucky it's naturally funny :P

Dr Deborah Serani: Once again I'm honoured that you dropped by my little corner of cyberspace. Insightful little nugget you left there...I can see how that could be true though. Grey's Anatomy certainly does a good job of showing us. Everyone needs a little clinical detachment once in a while :P

Thanks for the kudos, too! High praise coming from you :)

Tunku Halim: What, a nice little humble guy like me? Nahhh. *halo appears above head*

(Okay, the surgeon bit, maybe. Just maybe.)

(Especially if I get to wear a long white coat and stride around in a hospital with lots of cute nurses. And conveniently located storage cupboards.)

Ash: Who, me, celebrity? Nah. Just a bigmouth whom even famous people find hilariously unlucky. (And who's sometimes lucky enough to have them grace my blog. Like Tunku Halim up there - although his sexual preferences are a tad, um, disturbing. Cough).

zewt said...

looks like grey's anatomy does teach us something besides the fuck-first-talk-later concept.

Sid Schwab said...

Huh. When I wrote my comment over there, it seemed it never posted -- timed out or some such thing, so I assumed it was gone. Re-reading it, it wasnt as bad as I'd thought (my comment.) I guess, finally, I don't know where the truth lies. (Truth, lies?) There are certainly a lot of hard feelings about surgeons, and a willingness broadly to stereotype, and I imagine it's not just made up. On the other hand, the surgeons I know for the most part are quite different from the characterizations here and over there at your other post. As I said over there, I think the most arrogant tend to populate and breed at academic centers, for the reason I mentioned, among others. The need to "dissociate," as one commenter here put it, simply is a wrong-headed concept. No doctor is immune from the desire, at some level, not to take their patients' suffering home with them. But we all (theoretically) understand the need for and value of empathy. Even surgeons.

Michelle said...

Good stuff! I totally agree. The surgeons I know hustle around here like they are about to go change into their super suit and go save the world from the impending doom, but not so fast they look conspicuous. Hehe. They are Gods around here, its kinda ridiculous.

Anyhoo, thanks for the blog roll and the nice comments, much appreciated. Woo! I made it 'cross the Atlantic!

Prof Scrub said...

Dear medical profiler,

This stereotyping is very dangerous. Such profiles of medical specialities can lead to prejudice and favouritism.

If I was in control of the NHS, I would send all psychiatrists to the gas chamber. The surgeons would work in my concentration camps.

Your fascist Prof,
Prof Scrub

The Anonymous Medical Student said...

Surgeons can be jerks and can also not be jerks.

You are now linked.

The Angry Medic said...

Dr Schwab: I liked your comment over there. I think it rings true. A lot of people mistook my post for surgeon-bashing. It wasn't. Every profession has a few crappers around who make the rest of the hadworking average Joes look bad.

I find it weird though that you disagree with the need to dissociate. I didn't think only surgeons needed clinical detachment, or else they wouldn't be pumping us with all those Communications Skills classes :P

Michelle: Thanks! And hey, you made it across the Atlantic long ago, dear. Lurkers don't post comments, that's all :)

Prof Scrub: You're alive! And suddenly talking about fascism and concentration camps.

You...weren't kidnapped and put into a camp of any sort, were you? Stripped naked and thrown into a pit or something (willingly or not)?

Cos, uh, I wouldn't put it past you. Especially if Patricia Hewitt were in said pit.

Anonymous MedStudent: And that, my friend, is about as succinct a summary of the whole thing as I can find. Thanks for the link.

HospitalPhoenix said...

Indeed, anonymousstudentofmedicine

I'm a surgeon
I can be a jerk
And I can be not a jerk

Therefore you speak the truth!

Sid Schwab said...

I wasn't disagreeing with the need at some level to dissociate. I was trying (unsuccessfully) to point out that all docs face the issue; it's not that surgeons in particular dissociate from patients and that makes them assholes.

Sid Schwab said...
This comment has been removed by the author.
HospitalPhoenix said...


Here in England we refer to arseholes not assholes.

It's pronounced with a long aaaaah.


Sid Schwab said...

HP: Said with a British accent, everything sounds good.

The Angry Medic said...

Dr Schwab: Uhm...I was going to say something coherent in reply to your comments, but the whole accent thing with HospitalPhoenix made me laugh out loud and forget everything.

Great. I JUST got all the coffee out of my keyboard from the last time I snorted it out my nose.

HospitalPhoenix: Calavera's right about HAVE grown funnier!

Anonymous said...

You med students are better than medicine. I just read your comments, laugh and laugh, and my ulcers are *ka-pisch!* all gone!

Maybe you should just remain tortured students - that way ya'll never become arseholes or assholes (the first sounds ruder, what) - and you heal a lot more folk.


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