Wednesday 3 October 2012

You're fired!

I got fired.

Yes, it's possible for a doctor, even a trauma surgeon, to get fired. But I never had...until a few days ago. Fortunately there were other trauma surgeons who were available to care for this patient...wait, let me take a step back and explain. Before you get worried, don't. It has a happy ending. Sorry if I just spoiled it.

A 40-something year old guy was brought to me after he rolled his car over several times. He was clearly intoxicated, but also clearly in a lot of pain. After an exhaustive workup, he had a collapsed lung and several broken ribs. I inserted a tube into his chest to re-expand his lung, and I admitted him to intensive care.

The next few days were rough for him - rib fractures hurt like hell, or so I'm told. About three days later his lung remained expanded, so it was finally time to take the tube out. He was sitting in his chair in the ICU when I came to see him, so to avoid bothering the nurse, I helped him back to the bed and removed the tube without any difficulty.

When I went to his room the next day, his wife ushered me back out.

"We want to see Dr. W" (not his real name) "instead of you from now on."

She must not have seen the flabbergasted look on my face, because she didn't explain. I haltingly told her ok, but I had never been fired before. Without a word, she gave me an awkward half smile and went back into his room. I started to walk away...

No. No! I've never been fired before. What the hell did I do wrong?? I had to know.

I steeled myself, turned back around, and went back to his room.

"I understand what you're saying, and I'll ask Dr. W to see you," I told them. "But if I need to know what I did wrong. If I leave here today having not learned anything, then I can't improve myself."

She explained that they were very upset about how I hadn't gotten the nurse's help the day before, and from their viewpoint that had made removing the tube more difficult and more uncomfortable. I explained that I try to be self-sufficient and not bother the already-overworked nurses. I then thanked them and left, feeling very unsettled. But at least I knew why.

Dr. W called me the next day - he went to see the patient, but he and his wife now wanted me BACK as their doctor. Apparently they were so impressed with how professionally I handled the adverse situation that they instantly felt at ease with me, and their trust and faith in me had been completely restored.

I'll never understand the human mind. This is why it's called "the art of medicine." There's so much more to it than just fixing holes and removing dead stuff.

But every day I learn something new is NOT a wasted day.


  1. Personally, I'd have been impressed as hell. I've had doctors act like they can only touch you if you're under and on the operating table, and that nurses have to do absolutely everything else...he was probably uncomfortable after the tube came out and obviously if you had had a nurse help you it would've felt like unicorns blowing rainbows up his bum...I'm impressed though- they changed their minds in the end and thought about things! Some days you wonder if people are still capable

  2. I've fired a few doctors, but I usually have a better reason than that. Who does not expect a tube removal to hurt like all hell?

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  4. At least, the couple wanted you back, DocBastard. Did you? Good thing they realized your importance. :) How was the 40-something year old guy, by the way? I hope he's doing better now.

    Sherlock Best

    1. He did just fine. He came back to my office for his follow-up appointment about a week later, and he was well on his way to recovery.

  5. I can honestly say I've only felt the need once to "fire" a doctor. I had complications from a simple gallbladder removal, and was rehospitalized less than a week after the initial surgery due to an upper GI bleed (my home instructions did not say anything about the DO NOT TAKE IBUPROFEN) and I ended up having an inflammed liver from all the antibiotics. (holy crap was I jaundiced.) My surgeon gave strict instructions that I was to be removed from all medications while in the hospital, while they performed all kinds of tests to figure out where the GI bleed was. My surgeon went home in the morning with the assurance that he'd be back on Saturday. (It was thursday.)
    Not only did the on call doctor ignore his instructions, he told the nurse to give me Lovenox. And then he got upset with me for questioning the high doses of antibiotics & blood thinners. (I straight up refused the blood thinners. I know I'm not a doctor, but if I already have unexplained bleeding, wouldn't it make it worse??) I guess the nurse may have called my surgeon, because within the hour, I got a phone call from my surgeon asking what was happening. I explained to him that I didn't understand why I was still on the antibiotics and why I was being given blood thinners. He said he honestly wasn't sure either. I came back from my (whatever that radioactive test is called) to my surgeon in my room talking with the hubby.
    He told me in no uncertain terms I was to be removed from all medications, and most definitely not given blood thinners. (It was also during this conversation that I had revealed I hadn't been taking the narcotics and using over the counter ibuprofen, which pretty much explained the bleeding. Did not know that!) Well the doctor came in after surgeon made sure the nurse had removed all antibiotics, and tried to tell me I'll get a serious infection unless I continue with the antibiotics. I told him to get the hell out of my room. He was pretty flipping agitated, and continued trying to listen to my heartbeat, but I stand by my decision. My surgeon was amazing, that doctor? eh.... nope.
    Fire a doctor because you think he may kill you. Don't fire someone just cuz you had some pain. :/


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