When the Bully Is a Doctor

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Toward the end of my surgery rotation, I scrubbed in on a patient undergoing coronary artery bypass surgery, an intricate procedure in which the heart is actually halted from its inexorable beating for a time as the surgeon attaches new vessels supplying it with blood. The cardiac surgeon had spent the majority of the case berating me for my inadequacies, from how I held a retractor to the way I was standing or had tied my surgical cap. Eventually, he called me over to his side of the operating table.

“I want you to hold this heart for me with your hands,” he said.

Ever so gingerly, I eased my hands underneath the patient’s heart, cradling it as delicately as if it were a Fabergé egg.

“Jesus Christ!” he shouted at me. “What the hell are you doing? You almost tore it out of this man’s chest when I just fixed the damn thing! Get out of here!”

I sheepishly left the O.R., and any passing thoughts I had of a career in surgery.

But the consequences of bullying, as we all know, can be even more dire, leading to anxiety, depression, burnout, drug abuse and worse.

In a recent essay in the New England Journal of Medicine, Dr. Michael Weinstein, a trauma surgeon, opens up about his own spiral into depression and burnout, after silently enduring feelings of inadequacy for years while working in a culture that wouldn’t allow him to share those feelings. He recounts how, during his residency, he was “rewarded” for having been on call for 24 hours with being allowed to scrub in to the operating room post-call, extending his shift to 36 hours. He reflects on how he considered a colleague “weak” because he took a leave of absence for a nervous breakdown. He eventually plots his own suicide, and it is only at his wife’s urging that he finally gets the help he needs.

How many others have been driven to such despondency with the mixture of sick or dying patients, whom we sometimes can’t fix, and an unforgiving work environment?

It is a cruel irony that doctors and nurses are drawn to medicine to care for others, yet the majority have been bullied by their colleagues and superiors. We should all be able to turn to one another for support, to be able to admit that we are hurting, and to ask for a system that allows for missing work in the event of illness, without suffering castigation for being weak.

It’s in our patients’ best interests, and in ours.

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