When you hear the name “Jerry Springer”, the first thought that pops to mind is probably of a handful of outlandish guests from his television show yelling and screaming at each other, fists flying, clothing being torn off to the incessant chant of “Jerry! Jerry!”
Me, I tend to focus more on “Jerry’s Final Thought”. This was the last segment of the show and it was where Jerry tried to tie everything together. This part was so memorable to me because I found it to be at such odds with the entire show. Jerry had just spent 55 minutes exploiting a few hapless people who were more than likely just looking for their 15 minutes of fame. He then would spend the last 5 minutes taking a break from his circus to instead focus on a thoughtful and heartfelt monologue which he would always wrap up with the line “Until next time, take care of yourselves and each other.” No matter how many circles of hell Jerry travelled down into in the first 55 minutes of the show, he would always come back up at the end trying to make sense of it all and, if you were paying attention, give you a life lesson to learn from the tragic experiences of his guests.
In medicine, we could stand to learn a few lessons from The Ringmaster. (And no, I don’t mean learning not to pay for a prostitute with a personal check.) A few weeks ago, I was working in the hospital and I happened to witness an incident. Someone was supposed to do something that was of moderate importance and it did not get done. It wasn’t bad enough that heads needed to roll, but this incident did need to be reported. We are all human and we all make mistakes, so while I was unhappy about the situation, I certainly didn’t think badly of this individual. However, I was taken aback by some of the information that I was receiving during my investigation of the event*.
The person in error was being openly disparaged by one of his/her colleagues directly to me as I was trying to find out more information about what did or did not happen. I wasn’t even talking to this individual about the case. But that didn’t stop them from offering up rather mean-spirited comments about the person in question. Saying things like “[That person] is really a scatterbrain”, “I’m not surprised that [this person] did this”, and “This is the kind of thing that [this person] does all of the the time.”
I was flabbergasted. I couldn’t believe that someone would be so willing to turn on a colleague at the drop of a hat like that, especially to the attending physician. I hadn’t even asked this individual their opinion of the person in question or the event that had occurred. It was like they were trying to distance this person from the rest of the group so that this person’s mistake would not taint my view of the group as a whole. In my opinion, this event wasn’t even bad enough that it would necessitate such a “fight or flight”/”every man for themselves” kind of reaction. It was shocking to experience such a lack of support for a colleague.
For those of you who are non-medical professionals, you may be thinking that “watching out for one another” is one of the problems with the world of medicine. Doctors covering for other doctors. Protecting each other like some kind of twisted brotherhood where we don’t rat on each other and cover over each other’s mistakes with the patient and her family none-the-wiser. I have been on the other end of that situations many times before.
As a resident at an excellent referral children’s hospital such Riley, I would often admit patients to the hospital whose families were at their wits end. No other doctor had been able to figure out what was wrong with their child and so they would come to the beacon of hope in the big city. I would get a lot of “Those doctors at [fill-in-the-blank] County Hospital don’t know what they are doing!” Sometimes the families would try to draw me in and get me to confirm their frustrations with the doctors that previously took care of their child. It would be easy to do. I could build some rapport with the family by letting a snide remark or two slip out or confirm that “Yes, those other doctors were morons, but here we know what we know what we are doing.” (Outside Hospital has inspired many a doctor and patient to be frustrated.)
But in the end, I always refrained and I always encourage others to do the same. The fact of the matter is that medicine is not easy and the story of a sick patient is always evolving. While 3 hours or 12 hours or 24 hours later the diagnosis may look easy, the fact is that most difficult cases present in subtle ways and only fully declare themselves at a later time. What I am seeing now is probably much different that what the first doctor saw. So, I never question what another doctor or medical professional has done in front of a patient or a family. Afterwards, I might have a discussion with a referring doctor to try and figure out what they were seeing or thinking at the time and try to educate them on what had developed since then. This way we can all benefit from the case. But never in front of a family. There is a difference between covering for each other and supporting each other.
Plus, you never know when you might actually be wrong. That was the kicker in the case that I was a part of a few weeks ago. In the end, the person in question did do the right thing and the patient was appropriately taken care of. But by that time, it was too late. The damage was done to someone’s reputation. Not the person who’s actions had been in question, but the individual who was so quick to speak ill of a colleague.
For doctors, nurses, physical therapists, pharmacists and so many other medical professionals, our jobs are difficult enough without being at each others throats, throwing each other under the bus at the slightest sign of weakness. In the end, we could all stand to remember the ultimate advice from The Ringmaster himself. “Until next time, take care of yourselves and each other.”
* I am not sure how many residents or nurses or faculty or other colleagues read this blog. But in just in case there are some, I can promise you that this is not about you or any one you know or work with. So don’t worry. I had never met or worked with either the person in question or the individual with the loose lips before or since. I may never seen either of them again. But I certainly will never forget either of them and I hope you won’t either.