For a while there I thought I was being exceptionally stupid, because one of the senior neurosurgery residents has been giving me a pretty hard time. Not bad, really, just lots of comments and jokes. Today I finally figured it out: he despises all general surgeons, not just me. He phrased it as “what you need to learn from this rotation,” but asking me questions that second year medical students ought to know the answers to, and acting surprised when I knew them, was not purely instructional.

I’ll be the first to admit that surgeons can look down their noses at most of the rest of the hospital. ER, internal medicine, the subspecialists that we consult less frequently. . . We get to feeling superior, just because maybe we’re better at putting in central lines (not me, the others!), or aren’t as worried by abdominal pain as everyone else is. Not that we’re really any better, we just have different areas of expertise.

I guess it’s good for us to be despised by someone.

These neurosurgery residents make me so nervous. Now that I’ve grasped what they’re really saying, there’s a pretty constant level of sniping from some of them. I never know whether they’re making a straightforward statement, or trying to trip me up somehow. I really want to remember and not do this to other people. No doubt a similar atmosphere from some of us is what makes some medicine residents nervous about consulting us. Too bad there’s absolutely no one who ranks higher than the neurosurgeons. They are unquestionably smarter than all the rest of us – and they know it.

If this resident explains to me one more time (asking wouldn’t be so bad) about the anatomic location of the dura, arachnoid, and pia mater, or the difference between an epidural and a subdural and an arachnoid hemorrhage, I think I’m going to give up on being quiet, and saying something sharp. Like: yeah, I think someone mentioned that to me back in first-year anatomy. Not that it will help, because I could never beat him at the sarcasm game.

Two of our patients are getting sicker and sicker, and nothing we’re doing seems to make much difference. They’re both relatively young, with a very acute illness. Their families are devastated, and even the senior residents are worried about them. How many times can I say that I hate this? God, I don’t want them to die. . .

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