I keep underestimating how bad people can be. Here there was one resident who I thought was just bitter because of something that happened in the last couple months. Today he was in charge, without the chief there to protect the junior resident and me, and I found out, in much greater detail than I’d known before, how nasty he is. He messed with me and the resident for four hours before we managed to escape. All I can say is, thank God he hasn’t been in charge all month; and I don’t know how the junior residents are going to stay sane around him for the rest of the year.

You think this is an over-reaction. I thought maybe he was just accidentally pushing buttons, till he left the room for a minute, and the resident started cursing him out with every word in the book, and the nurses just nodded and said, “Yes, that’s exactly how we feel about him.” Later on, I was walking through a room, and heard some other random nurses cursing him. I’d  guess that if you have all the hospital employees who know you cursing you on a regular basis just because you’ve showed up for the weekend, there’s something seriously wrong. 

He’s horribly rude to the patients. He changes carefully arranged management plans just for the sake of showing that he’s in control. I’m actually a little scared that everyone who really knows the ICU patients has left for the day, and he’s alone with our handful of critically ill patients, who need their labs and mental status checked every two hours, and followed carefully. I’m hoping that 24 hours won’t be enough to seriously harm them before other team members get back tomorrow.

I was trying not to take him too personally. But then when we were rounding with the attending, he started telling the attending that I leave the hospital early every afternoon, and avoid doing any work. I didn’t mind too much (ok, I minded, but I didn’t say anything) when he just teased me like that privately; but for him to tell the attendings that destroys my reputation as a hard worker, which I do care about. So I said, as lightly as I could manage, and smiling, “I should sue you for slander.” He laughed, but immediately changed his tune, and admitted that I’d been carrying their pager and handling their calls.

It’s kind of scary to think of how much damage this guy has done in the past couple of years, and how he’s twisting the younger residents whenever there’s no one around to protect them. I am so glad to get out from under, and thankful that he has no equal in my own program. It’s too bad that he’s going to graduate and get a job; at least in the real world, people will be able to quit to get away from him.

I realized, not for the first time, the real difference between the medical drama shows and the actual hospital: In the dramas, the plot moves because everyone pours their feelings out publicly, and all conflicts are explored in depth, loudly and without reserve. In reality, we grow very stiff faces. It’s unprofessional to argue, whether for a nurse to make a dramatic objection to the doctor’s plan, or for the junior residents and interns to object to the seniors, or for any residents to disagree in more than a cursory way with the attendings. No matter what we think, we smile and nod on the outside. There’s been enough drama and plot development this last month to fuel several episodes of House or ER. But you’d never know that from listening during rounds, or during bedside discussions with the nurses. Most of it is never verbalized, and when it is, it happens in a back room between a few people who know each other.

Let’s just say that if this guy were in a TV show, he’s done so many bad things, and antagonized so many nice people, that you could predict his rapid demise or firing within a few episodes. Unfortunately, this isn’t a TV show, so he’ll be around a while longer.