Sunday, October 25, 2009

Anesthesia Shit List

Sorry if the title sounds so crude, but that is a pretty succinct description of the list of surgeons who have angered me so much that I refuse to work with them. Luckily our group is large enough that I don't have to work with these people ever again if I don't want to. Some of these surgeons have such bad reputations that only a select few anesthesiologists will even step into their OR. And we're all grateful to them for walking into the lion's den every day.

Why do surgeons like the ones on my ASL continue to hold positions at the hospital? Despite all the lecturing by Human Resources about how we all should treat each other with respect, some individuals seem to be above the law, untouchable and unimpeachable by all. They either bring a lot of well paying patients to the hospital. Or they have a special skill set that would be hard to replace if they went to a different facility. Or they have support from higher ups in the hospital system.

I'll always remember one of my early cases with one surgeon. He was about to do a thoracoscopic procedure. After I intubated the patient and positioned the double lumen tube, I turned away from the patient to draw up some drugs from my cart. When I turned back, the surgon had lifted the patient's torso and turned him lateral, with NOBODY supporting the head. The head was just dangling in midair, flopping around while that carefully placed double lumen tube was in danger of falling out of position, if not out of the patient entirely. He obviously had no respect for the patient, me, or my job. So he was the first surgeon on the ASL.

Through the years, I've had many opportunities to work with mean or bad surgeons. There was the surgeon who screamed "Get the F*** out of my OR!" when he started manipulating a broken extremity and the patient moved about ten seconds after I had placed an LMA into a patient. He of course thought it was my fault the patient moved before the patient was completely under. A**hole. Automatic ASL. Another surgeon arrived forty-five minutes late for his first case of the day. When asked why he was late, he response was "I'm calling the anesthesia director. I want another anesthesiologist NOW!" ASL. Another surgeon, thinking that I was his anesthesiologist even though the OR schedule had changed overnight, physically grabbed me by the arm and said "Let me introduce you to your next patient" even though I had just finished seeing my real patient. When I told him I was not his anesthesiologist, he got verbally abusive. That's one of the few times I yelled back at another physician colleague. I let him know very loudly, and I'm sure within earshot of his patient sitting in preop, that I thought he was a sh***y surgeon and nobody f***ing likes him in the OR. He said he never wanted to work with me again and I said I'm glad the feeling's mutual. ASL.

There are some surgeons who are just marginally on the ASL. But I'm sure with more exposure to them, they will become full fledged members of the list. Maybe that's when I'll know when to retire, when every surgeon in the hospital is on the ASL, then I'll know it's time to go.

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