Monday, August 31, 2009

Bill

I wrote this entry about a week ago about a former resident colleague of mine named Bill. I hesitated to post it because I don't kid myself that the internet is completely anonymous and there's enough information here that Bill might be able to identify himself. But then I thought to myself: would that be so awful? I respect Bill, but I also wished I could tell him personally some of the things I wrote here, but I didn't have the courage. Sometimes it's hard to see things from the other person's perspective. For all I know, he's writing about ME in his "Men In Medicine" blog.

(And maybe next week, if I work up the nerve, I'll tell a story in which roles were reversed and I was the "evil" resident.)

So here it is:

I met Bill as a med student both rotating at the same hospital. He always struck me as a really upstanding, solid, reliable person. He was the kind of med student that any residency program would be lucky to get, not so much because he looked good on paper, but because he actually WAS good.

When Bill and I matched at the same residency, I learned that I was absolutely right in my initial assessment. Bill was a hard worker, reliable, and knowledgeable. He also had a staunch sense of what was fair. Therein arose the conflict.

I became pregnant during my first year of residency. Among other minor difficulties this caused, one that was a frequent annoyance for me was the rule that a physician had to hold the heads of certain patients getting flexion-extension spine films. On the spinal cord injury service, this problem came up maybe twice a month on my service.

The first attending I worked with immediately offered to go down with the patients and take the brunt of the radiation. Unfortunately, the second attending refused to do this. "I don't understand," she said to me. "Why can't you just wear lead?"

(I won't get into a discussion of the safety of radiation during pregnancy and how some radiology techs wear lead counters, etc etc. All I have to say is I think it was reasonable for me not to want to be in the way of X-ray beams while pregnant if at all avoidable.)

Anyway, I was forced to find another resident to help me out. I was actually the only female resident on service and most of my male colleagues would immediately agree to go down to radiology for me. The whole thing took maybe 15 minutes tops. There was one guy who would sometimes call me and ask if I needed him for any radiation-intensive activities.

Bill wasn't like that though. I remember there were two occasions when I asked him to do this favor for me. Once he outright refused and the other time, he replied, "What will you do for me?" He wasn't smiling or teasing. He meant it.

Bill had a strong sense of fairness, as I said. He was married, but had decided not to have children. He was the kind of resident who rarely called in sick. And I understand that he didn't want to feel like a sucker who was doing everyone else's work. However, I didn't keep a scorecard. Even when I was well into my pregnancy and my work for the day was done, I would stay late helping other residents. I remember a specific situation several weeks earlier with one of Bill's patients, when the orthotists needed one of his patients' heads held by a physician while they adjusted a brace within the room... I told them not to bother paging Bill and since I was on the ward, I would hold the patient.

So yes, it frustrated me when Bill pulled out the "eye for an eye" card with me, especially when he knew I was desperate. I think that in residency, you help the people who need to be helped. And if they don't help you back, then they help someone else who needs help, and then that person will help someone else, and so forth. I finally felt redeemed for my maternity leave (two years later) when I covered two services at once for a month and a half for another resident taking family leave. It was a lot of work, but it felt good to help out.

This wasn't my only run-in with Bill. When he became chief resident, he instituted a rule that if anyone was late to our weekly morning lecture, even once, they would get one extra call. There would be no excuses. Bill said to me, "I don't care if you're in labor, if you're in a car accident... if you're late, you'll get an extra call." Again, he wasn't joking.

I was furious about this. I had the best lecture attendance of anyone in my class, other than perhaps Bill. But I was also a mother and things could come up. What if my nanny was late? "What's the difference?" Bill said. "It's just one night of call." (Those of us who have done residency can roll our eyes at that statement.)

After arguing back and forth with Bill and stressing over it for days, I finally had to take the matter to the program director, who said that the rule was directed at people who were chronically late, and I wouldn't be penalized if I had an emergency come up.

I was right about Bill that he ended up being a great resident. In so many ways, he was exactly the kind of person any program director would want to fill their residency with. And I considered him a friend. Yet it's hard for me to praise him without feeling hurt by all the times when I wished he had shown a little more compassion.

13 comments:

  1. I am not a program director, but if I were, I would put together a team. Bill does not sound like a team player. Thus, I wouldn't give him the props you do!

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  2. I'm not a psychiatrist, but Bill has obvious psychiatric problems. Just be grateful he's decided not to have children.
    I think you give him too much credit for being a good resident.

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  3. Bill sounds like a total jerk =/

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  4. Agree with above. I would not want "Bill" taking care of anyone in my family. No way.

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  5. I think it's good for everyone that Bill decided not to have kids. Anyone that inflexible is in for real trouble with children. Of course, it might be amusing to see him try to juggle his nieces and nephews for a week or two in the summer while he is a resident. Wait, that's mean, isn't it?

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  7. I guess you guys are right. Another resident who was pregnant during his chief year really despised him for his rigidity... oddly enough, a male resident who had a baby that same year thought he was awesomely helpful.

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  8. Oooh, I've met Bills. They are usually on a bit of a low-self-esteem power trip. And pretty sexist as well. Don't you recognize what he'll be like in 40 years? Those old guys who really truly believe that women shouldn't be in medicine in the first place because they're just kind of unreliable?

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  9. Bill lacks empathy. He would have to be a miracle healer to make up for that shortcoming. Bill's kind of doctor is only great on TV.

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  10. I was trying to think of the best word to describe Bill, but I think your other readers pretty much summed it up. I guess what strikes me as the most sad is that his behavior is still viewed as 'the ideal' by many people. People like him make me cringe.

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  11. Bill was definitely beloved by the attendings. He was the ideal resident for them, in many ways.

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  12. Give me generosity over fairness any day.

    Besides, from what you have said so far, Bill's sense of fairness was most active when he thought he might get the short end of the stick. Lack of compassion is a good phrase. Crap happens in life, and not just because of crappy choices, and it sounds as if Bill had no recognition of this fact. Nor any sense of making the punishment fit the crime...

    I'm afraid I am now fantasizing about inoculating Bill's morning pancakes with rotavirus. I'm glad for your sake you are more generous than he.

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