A surgeon is fined $5,000 after ditching a patient in the operating room for a nap

One would think so. Med students and residents are extremely goal oriented as a whole, and there is such a stupid, macho, “I can go longer shifts than you can,” not to mention the vulnerable position we were in - piss off the wrong attending, and all those years of work and sacrifice go poof! Not very many were willing to chance that. And as for mistakes, I saw many, and made a couple, but these are largely considered the cost of being in a teaching institution. And, believe it or not, when mistakes are made, the consequences frequently fell on the nurses who didn’t catch it or the senior resident who “allowed” it, but never on the upper levels who created and ran the system. It’s a fucked up system closer to fraternity hazing than academic rigor. It is somewhat better now, there are limits on how many hours can be worked, and protected sleep time is required, but there is still a strong motivator to “go above and beyond” and rack extra, off the books hours. So glad I got out of academic medicine. We still work i safely hard, stressful hours, but I know will go home after hours, sleep a reasonable nights sleep, and not have to deal with fascistic idiots every day. Of course, that is part of the problem. The ones who like that system are the ones who stay and “initiate” the next generation, while those of us who despise it leave and have pretty damn good lives while letting the system continue to eat it’s young, because we are not going back there. No way, no how, not for love nor money.


There are procedures that last longer than that.

I can see not wanting to hand off to another team in the middle of a procedure (because it’s not just the physician/surgeon, it’s the scrub nurse/tech, the circulating nurse/tech, etc.) but at some point, it is definitely in the patient’s interest to at least consider it. I’ve seen procedure teams get called into a complex case 11 hours and 30 minutes into their shift. It’s not good.


Imagine letting a guy who’s wobbling on his feet start a 10 hour surgery.


The worst I’ve seen is a tired, end-of-shift team pick up an emergency 2.5 hour case. Trust me, that’s nerve-wracking enough. I was ready to drop and I was just there as an advisor.


I’ve seen that phrase used to justify so many otherwise indefensible things, in a variety of industries. It’s sadism.


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