Today I finally made myself gossip with one of the other general surgery residents about the neurosurgery program. Turns out there was a lot I didn’t know. The program has been in turmoil the last few years. No wonder I couldn’t figure out who was senior to whom. No wonder I couldn’t figure out what their hierarchical structure was. And no wonder a couple of them are so bitter. One of the neurosurgery residents told me he wakes up every morning praying, “God, please don’t let me get fired today.” I couldn’t live with pressure like that. Resolved, to make a few more excuses for their behavior. (Although, even knowing that, and knowing that my dumb questions must be a tremendous nuisance to him, it’s still hard to work with a guy who bites your head off every time you open your mouth. Still, I’d rather ask dumb questions, than make an assumption, and hurt one of the patients.)

What he especially hates is me being reluctant to talk to family members who come asking about prognosis, and instead forcing him to talk to them, when he’s got a million other things to do. I know what everyone says, “you’re the doctor now, you do it,” but I’m honestly not competent to go and give definitive answers to people who want to know whether their father or mother is going to live or die. They’re going to decide whether to withdraw care based on what we tell them; and I don’t know enough to honestly go and tell them, this is how it is. I would be cheating them. No matter how annoying it is to the neurosurgery guys, I refuse to say that stuff.

They don’t explain enough to me, anyway. They talk in shorthand to each other (as I’m sure general surgeons do, to our med students’ annoyance). The trauma guys ask me what neurosurgery thinks of the CT scan. I can only shrug my shoulders. “They pointed out a couple of spots that were different from yesterday, and they said this scan isn’t enough to explain the clinical picture. But what the name is of what they were looking at, I couldn’t tell you. All I know is, they said the patient needs to stay in the ICU.” How am I supposed to talk to families like that?

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