Doctors Behaving Badly
As odd as this might sound, my mother was upset when I declared my intention to go to medical school.
It wasn’t the mountain of debt I was sure to incur since I’d already figured out how to get Uncle Sam to pick up the bill (a small deal that put me in a military uniform for a decade). It wasn’t the fact that medical school would delay the litter of bouncing grandbabies she wanted to fawn over. And it certainly wasn’t because she’d miss me—she’d already seen too much of me and my dirty laundry on weekends during college.
No, my mother was legitimately disappointed in me for choosing to enter the medical profession simply because she had a deep-seated disdain for doctors. I could almost envision her sad disgrace as she chatted with the neighbors during my final year as a resident in brain surgery:
Mom: “What’s little Festus up to these days?”
Neighbor 1: “Oh he’s doin’ real good. He’s got himself a carwash business up in Magna that pulls in a couple hundred a week. Lookin’ to buy a bass boat for him and the misses.”
Mom: “And Cletus?”
Neighbor 2: “Almost done with his ten years up at the state pen in Bluffdale. Won an award for license plate stampin’. Trixie and the boys are real proud of him.”
Neighbor 1: “And what’s Eric doing?”
Mom: “He’s still not married.”
My mother never told me why she disliked doctors so much. I’m left to assume that she’d had a number of bad interactions with them over the years, but she never bothered to back up her expressions of disapproval with any sort of details. It took several years for my mother to warm up to the idea that I had not turned to the dark side by becoming a doctor. I think a lot of it had to do with inertia—by the time she finally decided to express any acknowledgement of my career decision, two more of us boys were in medical school and I supposed she realized she couldn’t be disappointed in all of us.
Now that I’ve been in practice a number of years I’ve finally learned what it was that so intensely turned my mother off about doctors: they can be arrogant, condescending and impolite. Of course, many of my readers are at this moment wondering if I’m also going to reveal other mysteries such as “birds fly” and “dogs bark.”
I had a roommate in medical school who was a great guy. He studied hard, didn’t party too much, and always managed to put the toilet paper on the right way (rolling out from the top down, in case you were wondering). Years after we graduated and had gone our separate ways I had a phone conversation with a physician assistant who’d gone to work for my old roommate. “It must be great working for Dr. X,” I added. A pause on the phone. “No,” he said slowly, “he’s a total jerk. Everybody hates him.”
I have two theories. One is that all medical students believe they will go on to become an Albert Schweizer in their field—kind, self-sacrificing, benevolent—but somewhere along the way a certain fraction of them let the glory of their career go to their heads and begin to treat patients and underlings like chewing gum on a movie theater floor. What constitutes that percentage is in the eye of the beholder. For my mother it was some where around the 98% mark. I’m a little more generous—I’ll say 20%.
My second theory is that all doctors believe themselves to be noble, kind, and beloved by all. Rarely do I come across an arrogant doctor who recognizes him- or herself as such. Rather, almost all of us think we’re appropriately mannered. And we are . . . most of the time.
The rubber hits the road, though, when job-related stress enters the picture. A physician who ends up an hour behind in a busy clinic can become snappy at his nurses and receptionists. A surgeon who is elbow-deep in a case gone awry will turn her anger toward the anesthesiologist and scrub techs. In both cases, the doctors in question feel they were simply reacting appropriately to the situation: “Of course I yelled at my nurse. Doesn’t she realize she is making me later than I already am?” or “Of course I hurled the Metzenbaums across the room. Am I the only one in the OR who cares what happens to this patient?!”
As any nurse will tell you, the true measure of a doctor’s demeanor is not how he or she acts during times of ease. Instead, the nature of a physician’s soul is uncovered precisely during those times when he or she has the most right to explode in a volcano of vulgarities and instrument-throwing. A doctor who can keep cool while juggling 3 phone calls, a clinic filled with patients, and a patient exsanguinating on the operating table is both rare and worthy of high esteem.
In fellowship I had the misfortune to work under a cardiologist described by all other fellows thus: “She’s fun socially but awful to work with.” This proved to be true: at a staff party she was great to have around, but when faced with the challenge of rounding on 15 patients in a two-hour period she transformed into Medusa. Yet, I’m sure, if asked, she would maintain that she is polite, kind, and patient—as long as the situation doesn’t demand otherwise. The problem is that her definition of “situation” was pretty much every day at work.
We doctors have chosen professions that are inherently filled with stress, deadlines, and treading in deep emotional waters. None of that grants us a free pass to behave like spoiled toddlers. As I see it, doctors should always follow 2 simple rules:
Rule #1: It is simply not allowable to be impolite, mean, nasty or snippy with staff or patients even when you are in a stressful situation.
Rule #2: Whatever is stressing you is probably stressing those around you as much or more. Under those circumstances you have to go out of your way to be kinder and more understanding. As a doctor, you control the mood in the clinic and operating room even if you can’t control the situation.
I freely admit I am unable to always adhere to these rules but I at least recognize them and intend to spend the rest of my career trying to do better. My mother passed away many years ago but I’m hoping that somewhere up there she can look down and see that I didn’t turn out to be so terrible after all.
I had the privelege of meeting DR. van de Graaf after a trip to the hospital via rescue squad. These people really saved my life.I was near death and Dr van de Graff helped preform a miracle for me.I haved been exposed to many medical people over the past 80+ years and I will critisize few of them - - but Dr van de Graff is truly a special person - as well as Dr.
I find that my patients say the same thing about other doctors as your mother. Certainly many have let this career go to their head. I have many techniques to control my anger and frustration when things are going bad in the operating room. It's hard but a must. I find myself hanging out with doctors who are like myself. Laid back and don't take life too serious. The rest are hard to get along with. Patients feel the same.
I am a retired respiratory therapist, my father was a pharmacist who owned his own pharmacy and I have 3 cousins and an uncle who are physicians. I say that because I want you to know that I have been around physicians all of my life. All that being said I would come a lot closer to your mother's 98%(probably around95%) than your generous 20%. That would include my uncle. To find a physician who is both a good dr and a good person is rare indeed. For decades I had to endure tamtrum throwing doctors. Now we have added millions of doctors from middle eastern countries who have NO respect for women, zero manners and have such thick accents the poor little old people have no clue what the physician just said, let alone who he actually was(no name, no specialty, no time for questions, no business card). My opinion has been for years that if you can't keep your cool under stressful conditions then you need to be a plumber. Anyone who doesn't think that every level of healthcare is extremely stressful-think again. Yelling at people who have done no wrong only makes them more nervous and more likely to really make a mistake. Yep, a plumber. You can make as much money(perhaps more). You can make your own hours. No insurance companies to deal with. Think about it. Some people make everyone happy by entering a room...and others by leaving.
I have to say, your mother raised you right! Its not everyone that knows the correct way to put the toliet paper on! Your attitude is refreshing and you make your profession proud! Your well written article should be a reminder to everyone that we should all treat those around us with dignity and respect.
My mother also had the same attitude towards physicians. However, my mother took everything in stride and always voiced her opinion. A few times she would bluntly express to the physician/nurse when they were not very nice and did not answer her questions. It was interesting to see the look on the physician/nurse's faces; it is evident that they were not aware how they come across to their patients at any given time. Sometimes it is up to the patient to express to their care provider how they are treating the patient. I saw first handed how their attitudes changed each time my mother came into the clinic for the chemo/radiation treatments. I would advise others to ask the provider/nurse how is your day going, it is amazing how their attitude can fall into a positive manner when someone shows interest in them as a person not just a physician/nurse. Thanks for sharing your story Dr. V.
Treat other how you would expect to be treated, and all will be well.
It's refreshing to read Dr. Van De Graaff post. I have worked with many Dr. and nurses in my time in the medical field. Sometime you get the nice fun loving Dr. / nurse or sometimes they are possessed, as a clinic worker it’s my job ( and I take pride in it) to not let it get so bad in the clinic and if it does everyone better start doing their best to make the situation the best they can. I don’t think that there is a day that goes by we aren’t laughing even when we are all a little crazy. It's nice to know that when you behave badly you know you shouldn't....
Bedside manner I was with my mom when her doctor told her she had Stage IV pancreatic cancer. After learning my mom had 6-months to live, I remember walking out of Good Sam in Kearney and running into my high school friend who was a nurse there. My friend greeted me with a smile because she had not seen me in years. I told her the devastating news and how awful the doctor was to my mom. She told me he was one of the best oncologists around. If he was the best round, I would have hated to see their worst. Thank you for your post.