Wednesday, September 07, 2011

The Flywheel

(With apologies to Harry Chapin)
"Welcome to BA Cardiology Associates, young doctor, we're thrilled you've decided to join us. As you recall, we guarantee your salary for the first several years then when you're practice is established, your salary will be proportional to your productivity. Oh, and if you need anything, just let us know."

A child arrived just the other day. He came to the world in the usual way...
"I had the most amazing case today! His heart rate was so slow..."

"Doctor, we're impressed at how things are going."

He learned to walk while I was away...
"Thanks for helping out when we were short-staffed..."

There were planes to catch and bills to pay, he learned to walk while I was away.
"You've had a good month. You should see your bonus with your next paycheck."

He was talking before I knew it...
"We're thinking about opening a new lab at our other hospital. We'd like you to help us with the design..."

My son turned ten just the other day...
"Just a little longer, honey, I've got to finish this talk..."

He said, "Thanks for the ball, Dad, come on let's play...
"I'll try and make it, but today's schedule looks horrible."

Can you teach me to throw, I said "Not today... I got a lot to do."
"Doctor, your next available new-patient appointment is in two months. You have no open appointments. Should we double-book her?"

Well, he came home from college just the other day...
"Your privileges may be suspended if you don't complete your two chart deficiencies."

"We need someone to teach EKGs to third year medical students."

Son, I'm proud of you, can you sit for a while?
"Another good month. Your top-box scores are better, too."

What I'd really like, Dad, is to borrow the car keys. See you later, can I have them, please?
"Congrats on your pregnancy, Ms. Wonder Nurse! Don't worry about a thing, we've needed to cross-train our other staff anyway..."

I called him up just the other day...
"Doctor Frigamafratz's daughter needs an appointment before going back to college..."

I said, "I'd like to see you if you don't mind."
"Are you on call again this weekend?"

He said, "I'd love to, Dad, if I can find the time."
"When you get done with clinic, I was wondering if you could see two consults at Hospital OverThere? Oh, and don't forget the 7 am meeting tomorrow."

And as I hung up the phone it occurred to me, my boy was just like me.

P.S.: The inspiration for this post.


Dr. Dean Brandon said...

Unfortunately,Too True.

Tim Hulsey, MD said...

I wonder what the call schedule was like for those residents. I'll bet it wasn't like the qod call schedule we had as surgery residents for 14 out of our first 24 months (uphill- both ways- men were men- ships were made of wood, etc)! Were we stressed? Were we tired? Hell yes! How else do you get prepared for the schedule you just outlined? If you've never been up for a couple of days as a resident, how would you know how to cope during an on call week in private practice or in a real disaster?
Dr. Tom Brittingham, who oversaw the medical residents at Vanderbilt said that the only thing wrong with an every-other-night call schedule was that you missed half the good patients! Even when our butt was draggin', we were learning. I thank God every day for my General Surgery training, and so do about a half dozen people who are alive today because of what I learned, dog-ass tired and under stress– things that have nothing to do with Plastic Surgery: thirty-second tracheostomies, emergency thoracotomies, examining the WHOLE trauma patient even though 2 other doctors have done it already. During my 8 years of residency, only one Surgery intern washed out, but he made it to the end of the year and became an Anesthesia resident. So, I was only one of many tired, but highly competent surgery residents! Am I swaggerin' a little bit? You betcha!
If a disaster strikes, I hope these 40-hour-a-week residents will be able to man-up! And I don't want to hear any whining, either! As Tom Hanks said, "There's no whining in Medicine!"