Showing posts with label our causes. Show all posts
Showing posts with label our causes. Show all posts

Monday, February 2, 2015

"You're full of it"

I have read countless articles about how medical trainees have been berated and belittled, yelled at or pushed. I have never in my years of training felt that way or been treated that way. Yes, I’ve been questioned strongly. Yes, with lines of questioning sometimes called “pimping.” I have felt like I needed to study for 40 more hours and have gone into the bathroom afterward to cry, but I’ve never been berated. I’ve never been pushed. I never even thought of what I would say or do in those situations. I have heard my share of racist and sexist remarks and have found ways of addressing it directly and highlighting to the team why it’s unacceptable. But what would I do if someone directly belittled or disrespected me? Would I cry? Would my knees buckle? Would I yell?

Well, that all ended when a Pediatric Surgery Attending told me, “You’re full of it” in front of my staff while I was working in the Pediatric Intensive Care Unit. This particular Surgeon has a history of yelling at Resident Physicians that I learned of after the incident. That night, I was caring for a postoperative patient who had just left the operating room. During interdisciplinary sign out I asked for clarification of a medication dose as I was preparing to enter routine orders such as for PCA-administered pain medicine. The Surgeon turned and said, “No, we will enter the orders” meaning the Surgery Residents. I told him that in my experience PICU Residents enter the orders and manage the PICU patients. He said, “No, who trained you, this is my patient?”  I looked around and of course, everyone was staring at their feet. I was in my second month of PICU service and had heard countless times how our unit was a “closed unit” and that we managed our own patients, but this gruff, aggressively self-confident, tall male Attending with salt and pepper hair and a fresh tan was staring me down. I said, “You will need to speak with my Attending because this is not what I have been trained to do.” He turned, stomped away, and snuck in a low, yet completely audible, “You’re full of it.”

I stopped in my tracks and said more audibly, “Excuse me, but you just said ‘You’re full of it.’”I paused, collected myself and continued: “I feel very uncomfortable, and that was disrespectful. It is not appropriate to speak to trainees that way. I only want to provide excellent patient care.” He froze. When he turned around he had a look of utter contempt and disbelief; it was like no one had ever told him he cannot speak to people that way. His eyebrows furrowed and he spit out, “Well, I’m sorry,” and turned around. At that moment, my Attending arrived and my Fellow said, “Well, I’m glad you said it because I was about to.” I quickly excused myself as my hands began to shake and the pounding in my ears began to dull everything else out. I exited the unit, and sank onto the bathroom floor and cried. Big crocodile tears as my grandmother would say. I was anxious and nervous, but I was damned proud of sticking up for myself.

My PICU Attending found me later and asked me what had happened. I explained the facts and he shrugged and said, “I’ve heard worse,” and told me something about how that Peds Surgeon had cursed at him during his Residency. I told him that I hadn’t heard worse and had never experienced that type of behavior but that I thought it was unacceptable to speak to any member of the team that way. He shrugged and said he would address it with the Surgeon later. As I entered the Unit, the Nurses individually applauded me for speaking up the way that I had. I asked a trusted Nurse mentor if she thought I handled it well and she said I nailed it, and my Fellow echoed the sentiment. I didn’t get emotional, I said what I needed to say, and kept it focused on the patient. One of the Peds Surgery Chiefs came up to me later and had heard about it and gave me a quiet nod of support. She agreed that Surgery Residents who did not spend the night in the hospital should be consulted but they shouldn’t be the ones putting in orders since the PICU Residents are the ones who stay in house overnight. It’s a patient safety issue.

Many thanks to a different fabulous PICU Attending who a week earlier coached us on working in uncomfortable situations. She told us to use words such as “uncomfortable” and “unsafe” and keep things focused on the patient. Without her words, I probably would have shut down, my knees buckled and I wouldn’t have been able to say things in a way that would have gotten any response from that Peds Surgery Attending. I still believe, “You’re full of it” has no place when we are caring for patients.

I spoke on a panel earlier this year sponsored by the Student National Medical Association. They asked a group of underrepresented minority Attendings and Residents to discuss discrimination in medicine. I shuddered as I listened to the horror stories the Black and Latino Attending Physicians recounted. I think I would have quit if I had to endure the downright hostile environments they practiced in in their early careers. I don’t discount the real experiences highlighted by other trainees around the country and applaud them for their candor in sharing. I hope that we all are continuing to work so that abuse and disrespect are not allowed, and when they do occur can be apologized for and learned from.

Saturday, December 22, 2012

A Pause...

I have today (Friday) off from my clinic, in preparation of Babygirl's first birthday party tomorrow and Christmas in general, but I came to work anyways, to drop off Christmas presents for the nurses and office staff. I was feeling pretty good until the NPR commentator announced, "...let us now pause to take a moment of silence to pause in honor of those exactly one week ago. Remember that it was at this time of the morning last Friday December fourteenth that twenty elementary schoolchildren and six teachers were gunned down at a Connecticut elementary school...."

I cried last Friday when I first saw the headlines about this shooting, and I cried again as I was driving in. Every day, I think about those families, and wonder we can do for them.

I can't help but pause for a moment to think about them, and then to be thankful for my own little family, our two beautiful kids, our hectic workaday lives, every day full of small and large joys.

I want to help them. There are things that I can do as a human being, a parent, and a physician, to offer some help to those families... There are things we can all do.

Since last week, I have signed two petitions appealing to our politicians for stricter gun laws, including a ban on all military-style assault weapons. The most effective of these is on the We The People website, an open-access petition site: anyone can start a petition to the government, and any petition that gathers more than 25,000 signatures is guaranteed a response from the White House. In the hours after the Newtown shooting, user David G. started a petition asking for stricter gun control legislation; this gun control legislation petition has now gathered over 190,000 signtaures, in a week, and has received alot of attention as the most popular petition to ever appear on the We The People site.

Guns are a public health issue, and need legislation around them protecting citizens from risk of harm, similar to cars. Try replacing the saying "Guns don't kill people, people kill people" with "Cars don't kill people, people kill people". Hello? Not everyone can have a driver's license- they need to pass a test first. They need to be checked to make sure their previous license was not revoked. We have seat belt laws, we have drunk driving laws, we have speed limits, we have traffic laws, and our driving is regularly monitored by cops on the road.*

Why, for God's sake, do we not have even a fraction of the same legislation and monitoring of guns? We don't shrug and say, " Oh well, no need for laws around car safety, we just need to work on our substance abuse and mental health care system!"*

*I take this analogy - though it is a common one- from Nicholas Kristof's brilliant New York Times Op-Ed piece Do We Have The Courage To Stop This, published after the Newtown shooting, and I recommend it to everyone.

These are my personal thoughts and opinions, as a doctor and a mother... and a rational human being.

Wednesday, April 1, 2009

Vote for a future colleague! Vote for love!

Mothers in Medicine, our help is needed. Kirby is a MS3 who is a dedicated reader of this blog. She and her fiancee are finalists for a free wedding...but needs votes to win! You can read about their story and vote on the right sidebar for "Kirby and David" at the website. It takes only a minute to vote but could mean making the dreams come true for a future mother in medicine. Voting ends the morning of Sunday, April 5.

I just voted. It took me all of 0.2 seconds.

Good luck, Kirby and David! You'll have to promise to post pictures of the wedding here if you win.

Wednesday, October 1, 2008

The Mothers in Medicine Challenge: Giving back to public schools

Getting into medical school is competitive. We're hoping that competitive streak in you will help us in our goal to raise money for a great cause: our public schools. Many public schools, particularly those in poorer school districts, can't afford the materials they need.

Have you heard of DonorsChoose.org? It was started by a former teacher as an experiment and now is an alternative funding source for teachers nationwide. Teachers upload projects they want sponsored such as Biology Lab basic equipment for a Mississippi high school where students have never had an exposure to a real laboratory ($818). Donors can contribute as little as $5. DonorsChoose purchases the supplies and ships it to the classrooms, along with a disposible camera. Donors receive thank you notes from the children, as well as photos.

According to Fortune magazine, "Donorschoose.org has raised $24 million to get support to 1.4 million students in 50 states. Nearly 60,000 projects have been funded."

Now, to the competition.

Starting October 1st, bloggers around the country will be competing to see who can generate the most donations to DonorsChoose classroom projects. Last year, blog readers donated $420,000 toward books, art supplies, technology, and other resources, reaching 75,000 students in low-income communities.

Mothers in Medicine in joining in and we're hoping that we can show the internet who wears the pants. Please visit our giving page and see what projects we've selected to raise funds for. You can also get to our giving page via that nifty widget in our sidebar. After donating, you can leave a message for the students you are helping. Since the giving account is under Mothers in Medicine, leave your name, if you wish, in your message and where you are from.

Give if you can!