Originally published at: A surgeon is fined $5,000 after ditching a patient in the operating room for a nap | Boing Boing
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Question: why is only that one surgeon facing discipline - years after the fact - when it’s actually the entire medical career field that quite literally hazes its own people like this as a regular & expected part of training?
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I would like to go on record that if my surgeon is so tired he will fall asleep while eating in a car I would not like him to perform surgery on me until he has napped.
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The patient died, but the operation was a success.
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With proper communication, this would not have been an issue. Instead of disappearing to his car, the doctor should have cited fatigue and asked the other surgeon to take the case from the start.
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The very best surgeon I know saved my mother’s life. I also know from talking to nurses that for years, he has started surgeries at 2am and ended at 10pm every Monday and Thursday. That’s 20 hour days, spent either on his feet in the operating room, in an on-site office reviewing test results, doing rounds of his hospitalized patients, or seeing families in the waiting to explain how a surgery has gone. And he still pulls at least a weekday and half in his own office, each week. It’s a brutal, high-stress job I do not envy, and I will certainly not begrudge him a mid-day nap.
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Considering how rife with toxic masculinity the field of surgery is, I wouldn’t be surprised if he didn’t feel comfortable doing that, and thought he could grab a quick 10mins of shuteye that accidentally turned into 8 hours.
Communication-based solutions only work in environments where people feel safe doing so. Toxic masculinity causes industrial accidents, medical errors, airplane crashes, and other calamities- all because a workplace has been created where people don’t feel safe admitting fault or weakness.
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Can a surgeon pull back from these hours or does he do this at the hospital’s demand? He’s literally doing work of 2 people.
This is normal and expected in american medicine.
Not wanting to work all the time and have no life is perceived as weakness or a moral failing, or a lack of ambition.
“Don’t you want to be the best orthopedic surgeon in America? Well then you better be doing surgeries every moment you can. You gotta keep those numbers up.”
When a surgeon tells you he’s done a procedure a million times, he’s not really exaggerating all that much.
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In the hospital I worked at, residents pulled 24+ hour shifts while senior staff went home. All part of the plan.
The chief of orthopedic surgery also had a habit of chewing on coffee beans “for energy”.
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The AMA changed its policies on how long residents are allowed to work in one shift, but I’m not sure the new rules are being followed. Many of the people resisting the changes commented “I had to go through it and I survived!”, If you can’t think straight through exhaustion you’re useless as a doctor.”, and so on. No wonder amphetamine abuse is rampant hospitals.
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“We can overlook negligence and endangering a patient, hey, we’ve all been there, but dammit, you made us look bad.”
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Vividly recall 36 and 48 hour shifts where by the end I could not do simple math, nor form coherent sentences. It never made sense to make people try to perform intricate, life-and-death procedures while mentally and physically exhausted. It still doesn’t. Other than “I did it, so now you have to as well” which is what you usually hear, there is no rational explanation. It does not help anyone prepare to be a physician, just puts people in danger. I hate it.
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This is what happens when you take a short break in your car to “eat” a fifth of vodka.
This is not unusual though.
Whether human or veterinary medicine, shifts can be ridiculously long and exhausting.
I’ve known many people to pull an “Alaskan fisherman” (i.e. you find a quiet part of the hospital to go crash for a 15 min nap. It helps tremendously… at least for the next hour or two…). As senior student on clinics, it wasn’t unusual to get 3 hours of “proper” sleep a night, then make up enough sleep to remain partly functional by grabbing quick naps if there was a cancellation, or during a lunch break, etc…
I’m betting this guy was so fried that he was going to take a 15-30min nap while the patient was prepped for surgery, and was so zonked that he slept through whatever alarms he had set.
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In the hospital I worked at, there were sleeping rooms specifically for this, but not many residents were able to take advantage even if they wanted to.
Those rooms were also black holes for medical records docs had checked out of the records department the night before a patient’s surgery.
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I bet if one class-year of med students refused to be exploited this way and quit, we’d have less wildly abusive practices.
Frankly I don’t understand how liability insurance hasn’t put a stop to this shit.
We know for a fact that working for longer than about 4 hours has diminishing returns.
We also know that working tired reliably produces mistakes.
In medicine a mistake could mean a big expensive lawsuit.
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Not to mention injury or death to the patients.
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Insurers don’t care about anyone living or dying except in the context of whether it can cost them money.
For example, health insurance companies would be perfectly happy for everyone to die painfully in their homes and never recieve medical care. In fact that’d be their ideal scenario. Healthcare is a major problem for health insurers’ bottom line. They’d much rather nobody ever go to the doctor.
This is why I will say for profit medicine is immoral and disgusting.
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