Our Scibling PhysioProf has launched the opening salvo in what may turn out to be a rather bloody flame war. In the interest of actually gaining something from this other than venting my own anger and frustration, I will beg your indulgence here as I explain why my colleague is so utterly misguided.
PhysioProf (hereafter referred to as “PP”) is a researcher at a medical school, and teaches medical students (no secrets here…I’m not outing anyone, just re-stating facts already in evidence). According to my sources who know such things, both PP, and his/her blog partner DrugMonkey, write excellent material on the process of grant writing and surviving scientific academia. I take that as a given, as it is far outside my expertise.
Where neither of them seems to have a clue is the world of clinical medicine.
PP, who we’ll focus on here, wrote about a horrible incident in which a surgeon essentially assaulted a patient (he put washable tattoos on her during surgery). I would be surprised if this were the first incident, as people who do these type of things tend to be repeat offenders. What led this particular surgeon to this inappropriate act is anyone’s guess, but I don’t see how this particular anecdote can be used to form gross generalizations.
Look, I’m an internist; internists and surgeons stereotypically hold each other in friendly contempt, which has created a whole genre of bad jokes. But at the end of the day, we are colleagues who work together to help people.
For every crappy-surgeon anecdote PP has, I have a dozen good ones. For example, during my surgery rotation in medical school, I worked with a surgeon who was a tyrant in the OR; for 2 months my name was “pull, goddamn you!”. But when talking with patients, well…
One day in his office he was doing a biopsy on an older woman. It was an office procedure done with a local anesthetic, but was still rather painful, and since it involved cancer, the patient was scared. As she stared to cry, the young medical student (me) reached out to grab her hand, but then pulled back, unsure of my boundaries. The surgeon said, “NO! It is never wrong to hold a hand and comfort a patient. It’s the most important thing. Please continue so I can finish my biopsy.”
But anecdote wars can continue all day, so are rather pointless. More important are some of PP’s other points.
As someone who spends a substantial portion of his professional time teaching medical students, I can tell you that this kind of attitude-that physicians are gods, not mere mortals, and wield power over other human beings that no one dare question-is inculcated in them from the very beginning of medical training. It is an ugly secret of our medical training system. And the more prestigious the institutions where physicians receive their training, the more overweening is this attitude.
Now admittedly, I haven’t been affiliated with every medical school in the country, but I’ve been doing this a while. I have known arrogant medical students, but I have never seen a systematic inculcation of arrogance and omniscience in medical schools or hospitals. Never. There is no dirty secret. Some doctors are unpleasant, but most are not. In fact, medicine generally attracts people with good communication and interpersonal skills, as that is what they will likely be using for the rest of their careers.
More important, as a professor at a medical school, PP has the opportunity to affect medical students, both positively and negatively. Just because physiology is not generally a clinical class does not mean that lessons about humanity cannot be taught in the way you interact with your colleagues and students. Many of my pre-clinical med school instructors were huge influences on me.
And that brings me to the most important point. PP and the rest of us have the ability to influence young doctors, but that influence does not have to be positive. You can choose to treat them as arrogant pricks who are using you for your knowledge, thereby creating the very behavior you loathe.
If a physioprof at a medical school can’t see the opportunities for real teaching, including the human interaction, and can’t see his or her students as people, rather than med students, perhaps they should spend more time in the lab, and less in the classroom.