Friday, March 23, 2012

1 in 100

Doctors, we need to have a serious talk. This is a story from back before I was a patient, when I worked security at Barnes Hospital (BJC). They had just put in one of those new card-swipe key-systems, so all the doctors had to get new IDs. I was part of the security team that would ask the doctors to come in, pose for their picture, verify some basic information, and then give them their new ID badge. We would run folks through in batches of one hundred, because that's how many cards the machine could process at once. And I know this is purely anecdotal, but only one in one hundred doctors was actually nice to me.

Now, I hear the legions of the AMA screaming in protest, "But we have to be that arrogant to do our highly dangerous jobs. You have to have that arrogance, that confidence, to deal with things like cutting on the human body! It's only appropriate that doctors be arrogant!" But let me offer an example of men and women who have much more difficult jobs, and do it with a humility that is amazing.

You know that the deadliest job, even more deadly than military service, is that of the fishermen in the Bearing Straight. They have the show Deadliest Catch. But even more amazing than their job, is the job of the U.S. Coast Guard. These are the men and women who fly into the storm to rescue the fishermen in distress. These are the saviors of the people who do one of the most dangerous jobs in the world. Think you've got it bad at your job? Try doing it in gale force winds and sub-freezing temperatures.

Commercial fishing has long been considered one of the most dangerous jobs in America. In 2006, the Bureau of Labor Statistics ranked commercial fishing as the job occupation with the highest fatality rate with 141.7 per 100,000, almost 75% higher than the fatality rate of pilots, flight engineers, and loggers, the next most hazardous occupations.[8] However, Alaskan king crab fishing is considered even more dangerous than the average commercial fishing job, due to the conditions of the Bering Sea during the seasons they fish for crab. According to the pilot episode, the death rate during the main crab seasons averages out to nearly one fisherman per week, while the injury rate for crews on most crab boats in the fleet is nearly 100% due to the severe weather conditions (frigid gales, rogue waves, ice formations on and around the boat) and the danger of working with such heavy machinery on a constantly rolling boat deck. Alaskan king crab fishing reported over 300 fatalities per 100,000 as of 2005,[9] with over 80% of those deaths caused by drowning or hypothermia.[10] (Wikipedia - Deadliest Catch - Dangers of commercial fishing)

There is one group of medical professionals I will tip my hat to, and that is combat medical services. I had a favorite RN at the University of Washington ER. He was a Navy Combat Medic, and he could remain calm no matter how many top level traumas he was dealing with. I asked him once what his secret was. He replied, slightly stunned by my show of ignorance: "Nobody is shooting at me." That put things into perspective.

Only one in one hundred was nice to me. Ninety-nine though that their degree (and this was especially bad among new graduates) entitled them in some way to think themselves better than basic human kindness. There is something very wrong with that being the attitude of someone who is supposed to minister to the sick and weak. You're asking someone whom you've trained to be arrogant to then turn around and be sympathetic. The two are enemies! And we wonder why patients are complaining... It is really any surprise?


  1. And what makes one think that this arrogance transcended to patients as well?

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  3. Oh, I don't know... the half a dozen doctors who looked at me, declared me fine, *before* any actual results. Because you can't second-guess a doctor; that's seen as being a "problem patient." And it sure as hell happens in the operating room, according to this NYT article.