Elimination Kinetics

If my nephew is smart, he won’t show my rants to his medical school classmates, or at the very least, won’t admit to knowing me.  I told him when he was contemplating this odd profession that all – ALL – physicians are screwed up.  Only I didn’t say “screwed.”  

I used the word,“the big one! The Queen Mother of all dirty words.The F-dash-dash-dash word,” with all props and nods to “A Christmas Story” for ripping them off. 

Doctors are self-selected odd birds, whose first day of formal training includes cutting on dead bodies.  We are egotistical, cocky, insecure, introverted, extroverted, affable, jerks, big hearts wrapped in angry scowls, charming facades over numbed souls, and any other attributes you want to add.  I graduated in the bottom third of a very talented medical school class, and there were classmates so brilliant as to effortlessly wipe the floor with me on exams, who were so goofy I wouldn’t let them watch my dog over the weekend, because somehow it would get accidentally set on fire (looking your way, Harvard grads).   But if you add up all the long hard years, from undergrad to being up at 3AM in the ICU while staring at 60, one thing is pretty common:  none of us ended up here by accident.  No one ever tripped down the steps after a long night of partying and landed in a pile of passing board scores, and woke up not knowing how that medical license ended up in your wallet/purse.  And virtually every one of us got severely pissed off more than once along the way.

I only came close to actual blows with a colleague once (so far), who was unhinged and creating a very bad scene in the hospital.  Fortunately, I was able to defuse him, but it was close, and neither of us would have come out unsullied.  And that was in the days before MIPS, EHR’s, MOC’s, and blah blah, etc.  Any of us from residency on can see how things could get testy. 

It got that way in Ohio earlier this month: “A heart doctor told police it started after he sent a text message to Dr. Daniel Barton, asking why he stopped giving a patient medication that he prescribed to the patient. He said Barton is a kidney doctor.” 

The cardiologist “said he later followed up with Barton, who he said accused him of sneaking behind his back to continue the medication. He added that Barton told him that he should try answering his phone as he tried calling him about the patient that he f***ed up.”  Sorry, but I laughed out loud when I read this line.  Thankfully there is no word that the patient suffered any adverse consequence, but the absurdity over two highly trained professionals sneaking (or not) behind each other is kinda funny.  Funnier still, the cardiologist warned the nephrologist not to raise his voice, and the latter shoved him, corroborated by staff witnesses.  The cardiologist said he thought the nephrologist would’ve punched him but for the intervention of bystanders.

Barton was arrested and booked on an assault charge; he has subsequently pled not guilty, and is allowed to still practice at that hospital provided he stays away from the cardiologist. 

I wish I could find more details.  Is the cardiologist elderly and frail, or just overly sensitive in preferring charges?  I’m not excusing laying hands on another, but did a single shove really merit being booked?  Did both of them to forget to blame the primary care doc?  If dueling was legal, would they use their nurse practitioners as proxies, or mere seconds?  As long as no blood is drawn and there are no witnesses, it’s probably easier to shake hands later and buy the other doc a beer – provided he isn’t in the program.

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