God Complex in Doctors by Muhammad Akbar Baig (guest writer)

“What the hell are you doing doctor, are you insane?” shouted the consultant at his trainee who was presenting a case, while standing in the resuscitation bay of the Emergency Department (ED), surrounded by nurses, patients and their family members. I was shocked and intimidated while observing this man scold a trainee doctor. He was tall, dressed formally in a red tie and a pristinely white starched lab coat. One look at him and anybody would have quickly noticed that he exuded authority. The poor trainee, visibly shaken, was trying to hold on to the medical files and other instruments from slipping out of his hands. He was also trying dearly to hold on to his wits, I could tell.

The ED is a dynamic place that sees several consultants at any one time, called there for expert opinion on patients. But the ones that catch my attention the most tend to be the crankiest and meanest of the lot. How they cope with their lives outside of the hospital mystifies me.

Being the ED supervisor at that time, I followed this particular attending as he went up to another patient on whom he was consulted. There I observed an unexpected dynamic. The patient who had presented with respiratory distress, was in a terminal stage of irreversible lung disease secondary to excessive smoking. Now the poor soul could do nothing other than visiting the ED every few weeks whenever his breathing problems exacerbated. I leaned over the nearby nursing counter in order to listen to what the attending had to say after his evaluation.

“I think you would have saved us a lot of trouble if you did not do this to yourself. You are too sick for us to save now.”

Silence crept over his team, the kind which overshadows whenever tragic news is broken within the hospital.  I cannot even claim what the patient and his family must have felt after hearing those words. The attending consultant grabbed the patient’s file from the resident’s hand, hurriedly wrote in it, and then rushed away as if he had some emergency to attend. The patient’s family was left behind in the lurch, with several questions still etched on their faces. It took a while for this to sink in, followed by pandemonium! They were rightly enraged with what the consultant had said to them. But the sad part is they took out their anger and frustration on the patient’s nurse, the area doctor and administrative staff. They screamed at the top of their lungs, demanding another professional who would at least have the courtesy to speak politely and explain to them what could be done for their patient, instead of being told that there was no hope.

“Is he even human?” asked the area nurses appalled at the consultant’s rude behavior. I wondered if they were right. No human I knew of would be able to pull this off. He seemed like he was used to this. His trainees had nothing different to say. It was routine for them to bear witness to such occurrences when his admitting week would start.

While standing there, I pondered for explanations for the consultant’s behavior. Maybe it’s the tenure of the tough life that doctors choose for themselves that makes a few believe that they are more enlightened vs. others. It is probably presumed power over life and death that feeds their ego and paves the way for a vicious cycle of unending grandiosity. Maybe it’s the life as resident trainee during residency with its brunt of overwhelming responsibilities, without sufficient appreciation, that creates the ‘monster consultant’? The sad reality of witnessing unresolved inter- and intra-departmental politics enslaving one to work only with utter disregard of resident wellbeing might be an important factor. Such a life can turn any good person into a bitter and frustrated physician. What could also be blameworthy: idolizing the wrong type of consultant, eventually following the same path of overambitious and narcissistic madness? Or it could be the stress many consultants in their lifelong careers have to deal with while treating critically ill patients. The intensity of such an environment with its fear of even minor discrepancy leading to permanent injury and death of the patient can turn trainees into the prickliest and most demanding of physicians. 

Nevertheless, after coming out of my train of thoughts, I felt that this was a very real and growing concern in today’s physicians. For a doctor, this can cause turmoil throughout his or her career. For a patient, it is even worse - having to deal with a physician who thinks he/she is in absolute control while losing sight of the patient’s basic requirements of empathy and compassion. For now I can only hope to spread the word through my narratives, so my colleagues, junior or senior, can understand and relate in a professional manner.   

[from Narrative Medicine]

CREDITS:

About the Author: Dr. Muhammad Akbar Baig, is Instructor, Dept. of Emergency Medicine, AKU. 

Editorial Note: This is from a 'phase II' continuation of Narrative Medicine at AKU - what started as a Workshop-based initiative on January 20^th, 2016. The editorial work was performed by the Writers’ Guild, an interest group at AKU, with the purpose to promote love of reflective reading and writing, within and outside of  AKU. 

     

DISCLAIMER: Copyright belongs to the author. This blog cannot be held responsible for events bearing overt resemblance to any actual occurrences.