Yesterday afternoon, with that last patient, something happened in the OR after Dr. Ashley left. It was my fault; I didn’t think it was a big deal. I think the intern glanced at it and agreed it wasn’t a big deal.

This morning on rounds, with just me and Bob present, Dr. Ashley found out about it, and was furious. He wanted to have been told last night the minute it happened (although that was after he had rushed away to a meeting; but that’s no excuse). I knew it was my fault that it happened, and it was wrong for me not to think to tell him about it sooner. So I said that, and apologized as much as I could.

He got furiouser as we went over to the office. He called the intern and asked him about it. I didn’t hear the conversation, but he came back and demanded from me whether the intern had looked at the problem or not, and who had made the decision what to do about it, and not to call him. As soon as I knew that he was trying to get from me whether the intern had looked at it, and decided not to do anything, or had failed to look at it at all, I couldn’t think straight to say anything. The only way to keep all the blame on myself would be to say the intern had no idea what had happened. Which was just plain not true, and the intern had already admitted to knowing something about it. So whether I said he’d glanced at it and not looked, or looked and decided not to call, he was in trouble, in addition to me.

So I said I couldn’t remember, and Dr. Ashley got even angrier. “You’re in medical school, and you can’t remember what happened last night? You’re not an idiot; this is a cover-up!” Of course by that point I couldn’t even remember in truth whether he had looked or not, and I didn’t dare say one way or the other, possibly contradicting what he might say later, and contributing to him being in trouble, when I wasn’t sure. All I could do was apologize and claim to be as responsible as possible; but he didn’t want me to be responsible – it was the intern’s fault.

We proceeded through the morning office appointments. Bob as well as a internal medicine resident were there – enough people to be cumbersome on the best of days, let alone with palpable tension radiating from Dr. Ashley in my direction. I think it was the third patient who took one look at the three of us trailing in behind Dr. Ashley, and exclaimed, “You look just like Dr. House! You know, with his three students: two guys and a girl, even. I hope you have a better temper than Dr. House, though.” And Dr. Ashley had to laugh and say, “Not today!”

I spent the morning totally not listening to the patients, just trying to figure out what I could do to make things better. I’d already apologized for every bit of it three times, so it wouldn’t help to repeat that; but I didn’t want to leave for the weekend without saying anything at all.

Finally, when the last patient was gone, Dr. Ashley talked to me again. He was much calmer, and said it wasn’t my responsibility, and I should just learn the lesson, always to tell the attending about things right away. So it’s fine as far as I’m concerned. But as we left the office, he was paging the intern to come up to the office to talk. So even worse than about having caused a problem for the patient, or Dr. Ashley being angry at me, I feel horrible for getting the intern in trouble, after he already had a bad day yesterday, and was trying to be nice to the students.

I need to remember this next year. Not just to keep out of trouble by passing the buck at every opportunity, but: this is the second time I’ve gotten an intern in trouble. I’m sure a couple of medical students will do this to me next year. So I need to take it as turn-about, and not blame them for being troublesome.

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