It's a dislike-dislike relationship. It is really rather unfortunate, but Surgery and Emergency Medicine often have poor opinions of each other. That's not to say there aren't excellent Surgeons. Same as there are many many excellent ED docs, but there are a select few that create a bad name for the entire collective group and that's it. Stereotype made.
Walk a few miles in an other's shoes. For the most part it's easy to understand the ED's annoyance with Surgery, so I do my best not to fit the stereotype and for the most part we get along just fine. As for Surgery's distaste of a certain approach exhibited by those select few in the ED, I get to stay in my own shoes to experience that one.
Had a particularly bad spoonful of it last night. Got called for a surgical consult on a patient in the ED, at that point the patient had already been in the ED for 5 hours. Within the first 5 minutes of interviewing the patient together with my Attending, it was obvious that the patient's issue was not surgical, and appropriate work-up was severely lacking. When we presented this to the ED Attending taking responsibility for the patient, he hmmms and hawwws about it for a bit and then turns to me and says, "well, just order whatever you want." Caught me off guard, passing the buck on his patient like that. Handing management of a non-surgical patient in the ED over to a surgical resident. Inappropriate, but whatever. I ordered the work-up for the patient. Even had to compromise with the CT techs to get the exact studies we want, but we finally got it ordered and everybody happy.
An hour or so later, I'm leaving the ED after a trauma and cross paths with this same attending. I'm heading down a hallway about to exit through a pair of double doors and he calls after me. "Hey! So what's going on? Why isn't that guy's CT scan done yet?" I froze, my hand on the doors to exit. I turned and stared at him. This ED doc is much taller than me. I probably come up to his shoulder. But I stepped right up to him, head back, staring him straight in the face, and flat out scolded him! I told him what was going on with his patient too, but definitely scolded. Was that inappropriate of me to speak to an Attending that way... can we just not answer that? Because honestly, either way, his general lack of caring is so thorough that he didn't even flinch, completely zero interest in taking ownership of care of his own patient. It's upsetting, so very upsetting to me!
To punctuate the whole situation, because I had been the one to order the work-up, it was I that the radiologist paged to communicate finding of a pulmonary embolism on the CT scan of the chest. It was the ED that were the ones that needed to know that information, not a random surgical resident, yet I was the one they called. So I thanked the radiologist, and then called the ED myself and relayed the message on.
There are many amazing ED docs. And whenever I come across a medical student who wants to do emergency medicine, I emphatically encourage him/her to be the best ED doc ever! And maybe one day... the stereotype will no longer hold true. But until then, it is still very much alive.
Much Love.
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