Thoughts of a Dinosaur

       Dr. E. Renner

Would I be today the same naïve and inattentive resident assisting in a AAA repair, as I was 35 years ago, I would unlikely be woken by a scalpel flying my way which occurred to me then.  And this is good so – except for the fact that it painfully reminds me that I have become a dinosaur.

As a consultant these days, I have not infrequently difficulties finding the responsible house staff to talk to because he/she is not on the ward for various – and totally legitimate – reasons including being “post-call” or attending one of the (too?) many formal teaching session. When I finally find somebody to talk to, I am calmly told that he/she “just covers” and does not know the patient – and that may not be so good.

I survived the flying scalpel (and other admittedly unpleasant experiences), that would today probably be reported as harassment and physical or at least psychological abuse. I don’t think I have suffered lasting damage, but that’s up to you to judge. In fact, it never occurred to me at the time that I could have been abused. I knew what I was getting into. I wanted to learn something – my choice – and this (and many other unpleasant things) came with it.

Don’t get me wrong, I am not trying to excuse scalpel throwers, nor do I try to justify or to persuade anybody to accept such behavior. It is unprofessional and disqualifies the actor. However, developing resilience, learning to cope with the many not so pleasant situations we are all faced with in daily life is not the worst thing, is it? And sometimes this may mean just having to swallow what comes our way and stay on – or drawing the consequences and move elsewhere.

I fully recognize also that terms such as abuse and harassment have inherently a large subjective component. As beauty always lies in the eyes of the beholder, the threshold of feeling abused may vary from person to person. That said, these terms are strong and whoever uses them needs to be aware of the consequences they will have. Using them lightly is reverse harassment and reverse abuse. Could the pendulum have swung too far to the self-identified victim side? Could it have become too easy to accuse somebody of harassment or abuse? Should anybody, even a subordinate, really be able to get away with accusing somebody else, even a superior, anonymously and without having to provide any evidence, and should this really lead to a formal investigation – if not more? By doing so, do we not risk to open the door too widely to cheap revenge by denunciation?

I have recently heard many times from role model teachers that they find it harder and harder to give honest and meaningful feedback, not to speak of failing somebody in an exam or rotation, even if this would be warranted, because of the fear they may face disciplinary or even legal actions. Have we gone too far by letting “political correctness” force us on that slippery slope towards mediocrity by dropping the bar lower and lower? Granted, feedback should be constructive. This includes that whoever is deemed to underperform is given a chance to improve. The first step to improvement however is identifying and acknowledging that there is a need for it which often requires being made aware of failure. This is rarely a pleasant experience, but needs to remain possible in order to assure that those who complete our training programs are competent and able to live up to their patients’ legitimate expectation of receiving high quality care.

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