Trauma has been relatively painless thus far. This week proving to be a bit of a challenge logistically speaking. The American College of Surgeons Clinical Congress is in San Francisco this week, so nigh half of our co-residents are in attendance. I had originally anticipated being able to attend myself, until I caught wind of how many others anticipated the same. Put a quick end to any idea I had about going. Someone’s got to hold down the fort back home. So each of us on the team have three calls each in a weeks span to cover. And on top of that our dentist rotator had decided to take this week... of all weeks, to go to Vermont on vacation. But we’re getting by.
As trauma chief, I try to make the best of my position. Use it to exercise how I will want to manage my own patients in the future. I make my decisions, recognizing that my Attending has the right of veto or alteration if he sees fit. Ultimately correcting me where I am wrong and ideally instructing me in what is good and correct in terms of patient management.
Last night, on call, I had a frustrating experience. Truth be told, the whole day had been frustrating, it just dragged on into the evening and early morning. Frustrating for multiple reasons, one of which was the difficulty we were having coming to a disposition for multiple patients, the longest taking a full 12 hours to put together a complete plan. The one I am going to refer to did not take 12 hours, but it wasn’t much better. Looking at the patients traumatic injuries, her clinical presentation, and family’s wishes for goals of care I finally put together my own plan for what would be the safest dispo. My attending questioned me about it, I defended it, he agreed and the plan was put in place. A few hours later I had just gotten out of the OR and saw my Attending and my co-resident down the hallway. Quickening my pace I drew nearer in time to hear my Attending mocking my decision concerning that patient. Making my presence known, I immediately called him out on his inconsistency. Thankfully, I have a good working relationship with this Attending, so I did it with a smile and we both laughed at the fact that I had caught him. Plus, I’m not naive. It’s not the first time I’ve been thrown under the bus, and it definitely won’t be the last either. Unfortunately, it’s how certain Attendings work.
The interaction was clarifying for me in a way.
I work hard, as a resident, to learn what is safe and optimal in hopes to be able to make the right decision when it comes to my patients. I am starting to understand that the vast majority of the time, there is no one optimally correct or right decision. There is only YOUR decision. Following that you can either then decide to own your decision, or not to own your decision. This will strongly impact what kind of surgeon you are.
I will never stop trying to discern what is correct and safe, and I pray that if there is a right decision, that I can make it. But I also pray that I can have the strength to always at least own my decision, whatever it may be.
Much Love.
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