When we physicians don’t get our way, or don’t get the response we desire, we can be intimidating.  I have seen this play out many different ways.  I have been treated rudely by other physicians.  I was once threatened by a very prominent one, who told me (in response to the fact that I dared question his tone), ‘be careful son, you’re digging yourself a deep hole.’  I don’t know what kind of hole, or where it would have taken me, but he was certain I was digging it.  Oddly enough, I rather like digging holes.  (Very zen.)

Physicians yell at one another, or curse.  Physicians stomp and slam down charts.  I don’t like it at all.  I think it suggests immaturity.  I always tell students and residents that in the ER, especially, the physician is ‘Captain of the Ship,’ and the Captain must never lose his or her cool.

But physicians, sadly, do the same to non-physicians.  Nurses, in particular, earn their ire as they scream, curse, stomp and engage in all sorts of negative behaviors.  It also happens to paramedics, unit secretaries, dietary workers, therapists, administrators and all manner of persons.

It even happens outside the hospital.  ‘Do you know who I am?’  Used to being obeyed, physicians unleash their anger at waiters, waitresses, clerks, minor government functionaries and others who frequently don’t have the freedom to respond in kind.

I admit, it’s better than it used to be.  Back in the Olympus days (when we walked like gods on the earth), yelling and cruelty was positively standard as nurses often moved in terror of certain physicians.

I further admit that the majority of physicians do not behave this way.  But, for those who do, I’d like to suggest a guideline.

We should never treat anyone badly who is not in a position to return the favor.

That is, if I call you from the ER and you’re mad and want to raise your voice to me, go ahead.  I may not give it back, but I can if I wish.  The nurse, the secretary, the x-ray tech, is not usually in the same position.  They fear being reported, reprimanded, fired.  They fear retribution.

Doctors who want to unleash their immature anger should only do so if they can expect a healthy dose in return.

It’s simply a matter of decency, courtesy and ultimately, of chivalry.

So do unto others only if they can do unto you.  At least when it comes to rage.



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