Achieving Osler’s Ideal of Imperturbability

Excerpt

In 2018, as Chief of Staff at our medical center, I met with a half a dozen physicians who lost their cool in the hospital in substantial ways. Some became angry with the OR staff, a few with the floor nurses, others with administrators. To a person, each of the doctors had legitimate complaints: inadequate equipment, insufficient attention to detail, or shortcomings in operations or planning. These clinicians are skilled and recognized for their patient care. What was striking in each instance was the asymmetry between how these physicians comport themselves with clinical crises as compared to non-clinical. These same master clinicians that, with equipoise and compassion, could handle life-threatening surgical bleeding, potentially lethal heart rhythms, dying patients, or demanding families would outwardly erupt or internally seethe when faced with the seemingly lesser challenge of imperfect hospital operations. Some of these physicians faced immediate consequences as a result of their actions, including the possibility of suspension form the medical staff. Others I met with were not facing serious repercussions from the hospital but were clearly suffering from their own internal frustrations; so much so in several cases that they were now in danger of being viewed as cranks or malcontents. Their ability to exert influence in the hospital or participate in projects with their peers was significantly hampered, and administrators no longer turned to them for guidance or input. …