Working in a hospital as a doctor is an interesting experience because while you are working on a team, you are often the only doctor on the floor, especially if it is overnight and you are on call.
The responsibility of being the only doctor feels HUGE the first few nights any resident does call by themselves, and it never really goes away as staff physicians often tell me. Once in awhile, a physician from a different specialty will work on the floor with you as a part of a “buddy system” to be an extra pair of hands on the floor, which is always greatly appreciated. The downside of being that “off specialty” doc is that they are often othered by the team, seen as less competent, and treated as such as well.
I was having yet another overnight shift at the ED where my staff happened to be this off specialty doc. However, he had been working as a ED physician for many years and considered himself (perhaps accurately) a specialist in the area. Unfortunately, the night went very poorly for him. Several resuscitation cases came in that he could not manage on his own – he had to call the help of another ED doc but alas, it was not enough to save the patients. I was not involved in those cases so I did not know of the details of what happened in that resuscitation room.
The rest of the night marched on with a heavy mood. I could hear whispers from all corners of the hospital talking about how these cases did not go as they should have, that another physician would have been able to save them. It was hard to control myself from not thinking what they were thinking. Would the outcomes have been different had it been a different doctor? Someone who was trained in ED from residency?
When it came time to review some of the patients with this physician, I could see the worn and defeated look on his face. As soon as I started presenting, he abruptly cut me off and without giving me a chance to finish, he started to ask basic questions, insinuating that I basically did not know what I was doing. When I showed him my documentation proving that the information was all there, he LOUDLY told me that residents are not to be trusted and that because of this, I must follow a way of presenting as per his preferred style to demonstrate that I “am not making stuff up”. I was dumbfounded by this experience. Immediately my mind went to what I was going to put on this supervisor’s evaluation for treating his residents this way. Then, the goddess whispered in my ear, “no, Embrace the Other”.
He was alone in this entire ED, managing a highly acute floor by himself in a truly difficult night. He was further othered by the staff here due to the failed resuscitation cases. I imagined what I would have felt in his shoes, and my heart immediately broke for him. The thing is many resuscitation cases are not “salvageable” when they come into the hospital. Patients often have the wrong idea of what a resuscitation is like from TV shows – miraculous recovery is extremely rare. Even if a person’s heart is to start beating again, the chance of them regaining much of their baseline level of functioning is even smaller. With his years of experience working at the ED, I am sure he knew this too, and so did the rest of the ED team who were judging him. However, amidst all this background information, his identity as the “other” is what shifted their view into judgement and criticism instead of understanding and empathy. His harsh criticism of my work, increasing his voice so that everyone else could hear, was probably an unconscious effort on his part to re-exert his power and sense of control on this floor. Yes, it came at my expense, but what I had to endure was far less than his suffering.
Gritting my teeth and controlling my breath, I told him “Thank you so much for teaching me this, it is very helpful.” He nodded and sent me on my way to see more patients. At the end of the night, when he was doing my evaluation, he said “I was so glad you were here, it would have been a rotten night without you”. It was in this moment when the teaching of the goddess became apparent. Had I not shown understanding and patience in that moment, I would have pushed him further into the darkness. In choosing to set my ego aside to embrace the Other when nobody would, I accompanied another physician, another human being, in his journey from darkness back to the world of light.