Saturday, July 19, 2008

Reasons I'm Leaving Emergency Medicine (number 7)

It's not M*A*S*H

It's not even close.

I first noticed this in medical school. Don't get me wrong... there were plenty of "Hawkeyes" and "Trappers", but the medical school administration at my rather prestigious school was in the avant of the new guard, and was politically correct from their perfectly trimmed toenails to their Ivy League pedigrees, from their smaller than advertised brains, to their tiny testicles and ovaries, and from their miniscule cache of common sense to their love of 'process' and 'protocol'.

My friends and I did have a few run-ins with these automatons. We had some mandatory touchy feely stuff designed to make us behave contrary to our XX or XY nature and it was widely panned by most folks in my class.

Then we had the proposal put forth by the 'student council' that encouraged us to turn in fellow classmates that we were concerned might have a substance abuse problem. Guess what... about 80 percent of our class had, as is commonly defined, a HUGE alcohol problem. Miraculously, and with some exceptions I'm sure, that 80 percent is now, hell, 8 percent... but the idea that we could rat on each other based on a suspicion ALMOST succeeded in becoming policy.

This was the writing on the wall. Now it's 1984 all over again only the jack-booted thugs carry clipboards. They are the Dr. Frank Burns crowd. Doctors by training... mousy, scared back-stabbers by default. They have won the battle of medicine with attrition by paperwork and incessant inane drivel that is picked up by the MSM and used to scare the population shitless.

Don't eat at McDonalds... don't use your cellphone... don't drive big cars because the planet has a fever... wear your seatbelts... wear your bike helmets... don't smoke... don't tolerate people who smoke... embrace all manner of dangerous sexual practices but check that cigarette at the door mister! Gay? SUPER! Sixteen years old and want an abortion? GREAT! No, we won't tell your parents. Think you may have been raped? You probably were... let's work on your recovered memories.

Trapper is not speaking up to tell folks that, despite their best efforts, there is precious little anyone can do to ward off the scary killers of medicine. The melanomas, the ruptured intracranial bleeds, the genetically determined heart attack, the rectal carcinoma, the leukemia, the lymphoma, the auto-pedestrian facial crunch, the acute traumatic fibromyalgia etc...

Dr. Burns is in charge of most hospitals now. He no longer really practices. He has the political heirarchy wired though, and they are all his clones. Hot-lips is in charge on the nursing side, and, in the military now, God love 'em, they rotate the CO position at all their hospitals between Doctors like Dr. Burns, Nurses like Hot-lips... scratch that... more like Nurse Ratched, and Medical Service Corps types (admin). This makes for a SUPER looking bit of fairness on paper but really, why is anyone BUT a physician in charge of a hospital?

It was true in the medical corps that the good clinicians paid their time back and busted out for the civilian world (there are noteable exceptions to this). The higher you go in the military medical corps the less you practice medicine. I thought this bit of silliness would be absent in civilian land. I was wrong.

The "Pros from Dover" have been tied to a stake, bound, and gagged. Dr. Burns needs to see you in his office now... one of your charts was incorrectly corrected.


  1. The "rat on your classmates" thing was official policy at my med school. If you "suspected" a substance abuse problem, you were supposed to let the administration know. Presumably, the problem student would be shipped to a reeducation gulag or something.

  2. Dear Doc! You keep talking about quiting.. But you can't make the same kind of living doing much else bro. :)

  3. .
    I have to admit I could not see where you were going with your count down and recollection of events that happened 15 years ago and boo hoo the lady was mean to me and I can't get over it story.

    Now I get it and this is highly depresssing. I'd quit too.

    As for all the lies that the Drs. Burns tell the public, well, if we are sheep enough to believe them and have lost all common sense, we probably get what we deserve.

    Are you fantasizing about what you are going to say to Dr. Burns when you leave? Still, this has to be bittersweet for you. Don't you feel like K in The Castle (Kafka)?

  4. dear anon,

    i can make more being a medical administrator or a hooker.

  5. dear amy-65c,

    i know you and i get the kafka reference but i don't think anyone else does. for the sake of our readers, pretend i have no clue about K in the castle and tell me to what you refer... okay, i have no clue. who is K in the castle? is her hair very long and draped down the parapet? is there a dragon?

  6. No, no.
    K dies after jumping into the ocean, dissolving into foam. They have a statue of her seated on a rock, off the coast of Puerto Rico.

  7. So what are you gonna do after quiting medicine?

  8. amy65-c,

    well that's what she gets for sitting on a rock off the coast of puerto rico.


    i'm going to stay in medicine but get out of the ER. it's time for the young bucks to put their head in the furnace... too hot for me.

  9. Foreign dictators always seem to need personal physicians...

  10. Now that is thinking outside the box Dev! I applaud you.

  11. wow. I had completely forgotten about the narc policy... ahh, memories.

  12. Anon:

    There are plenty of professions that make as much as and often times more than most docs. I make more than most docs and haven't finished law school yet. Business is not a minimum wage career.

  13. The major Burns's of the world are crappy clinicians, have poor interpersonal skills, have loew self esteem and gravitate toward positions of power where they can say "no" or impose stupid rules to make themselves feel more important. In the military, the good docs got out after their 3-4 years. Those who couldnt make it in the civilian world stay and move up in rank. (generalities of course)

    In the civilian world the same thing happens and thes sniveling little ass wipes go into some sort of administration.

    It is absolutely true. It is making me depressed that it only makes number 7 on your list because these type of people are never going to go away in medicine, and particularly, hospital medicine.

  14. Thank God, 6 more to go and the dipshit is gone.

  15. Dear 911Doc,

    Hooker? Didn't you see "Midnight Cowboy?" Remember what happened to the cowboy?

    And another thing, "hooker" is out (politically incorrect). "Commercial sex worker" is the official Centers for Disease Control term.


  16. Hey, anonymous 8:21, he won't be gone from blogging. He's just changing jobs. Perhaps his new job will allow him even more time to irritate readers like you. ;)

  17. dear anonymous,

    i am calling the police as we speak. i have your IP address and i am sending help. i hope we get to you in time because it seems like someone has kidnapped you and forced you to read this blog. otherwise, you would be a first class asshole-douchebag, and dumb as shit to boot, for choosing to read something that is abhorrent to you. courage! help is on the way.

    your humble servant,


  18. I hate it when the turds float to the top

  19. Hey 911, ignore the critics, I love your series. Its not quite my upcoming "Top 10 MILFs of the 60's" but its good.

  20. 911DOC,

    There seems to be little appreciation, from anonymous, of the use of irony - that you would be following the policy of turning him in "for his own good."

    Now, if you were in the castle, wouldn't you be letting down your long mustache?

  21. frank,
    if your list does not include angie dickinson, farah fawcett, the other angels, and cheryl tiegs than you don't have a hair on your ass.

  22. 911

    Love #7. I always managed to stay 1 step ahead of the narcs by standing in front of etotheipi.


  23. You know what I've ever understood...and this is after 10 years of being an ED nurse......the utter hypocrisy of kissing ass, catering, and enabling every addict matter how abusive they are. And believe me there were nights I couldn't sit down when I got home from all the "lubeless" ass fucking I got from from my seriously I did get a lovely orbital fracture from a meth head about 2 years ago....he pulled me in the bathroom and preceded to beat the shit of me (I wasn't even the dickhead's nurse) I was then asked not to press charges but to let him go to rehab. (Didn't happen by the way)


    for nurses and doctors there is a "zero" tolerance for substance abuse with instant firing, license revoking, and public humilitation/disgrace

    Gotta love this crazy liberal Burns run world

  24. dear jennifer,

    i do not think the general public has any freaking clue what kind of shit we are forced to swallow here. behavior that would get you kicked out anywhere else in the world is hushed up and swept under the carpet for fear of bad publicity.

    i was encouraged NOT to press charges on one of these kind of patients but i did in fact press charges and the dipshit was such a pain in the ass in jail that her three month stay was extended to nine months.

    she got sent to jail for spitting in my eyes, telling me then that she had aids, and bringing one of my best male nurses to the ground by grabbing his nuts and twiting.

    this nurse had been army special forces, a real snake eater, and could easily have hurt her or killed her but he restrained himself.

    i went against advice and pressed charges because the one thing we can not have down here is a public perception that it's open season once you get to the ER.

    sorry you got hit. i hope the guy went away for a long time... but then again, he has a disease and you should just let him do whatever the fuck he wants... but i digress...

  25. I agree with you. The ER will suck out your soul. That is why I did not stay there. I can only handle the moderate abuse of being a nurse. Not the extremem abuse of working ER.

    So what now is the big question? I once dated a guy whose brother was the Doctor for the Bruins. That would not be a bad deal. Also they need Doctors on Crusie ships and they want western doctors. One of my Doctors at work only does the assists for the C-sections and the occasional delivery. He has a good position.

    And don't they need chiefs of medicine all over the place. I know at my hospital the chief of med did very little med and lots of visiting and smiling. But he was a good SH!t.

    Hey, you are reasonably entertaining. You could do seminars. I think the seminar folks make a decent coin. I know my hospital pays big bucks for Lisa Miller to come and chat with are whole staff about how not to get sued.

    So what are your plans?

  26. Cruise Ship Doc aint what its cracked up to be, back when Doc Bricker was banging Charro on "Love Boat". Free Medical Care is part of the Cruise Package along with the overcooked Buffets and Shuffleboard. And Standards have declined so much, if it wasn't for the Journey cover band you'd have a hard time tellin it from a Greyhound Bus Station.

  27. Good Lord Frank, which cruise line did you go on?

    However, the girl who did the facials told me she had to work 6 out of 7 days and had to work 12 hour shifts so that wasn't a great deal for her.

  28. here is my 3 second triage...
    when the "patient" became the "customer" all hell broke loose.

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