In the South, we love words.  Even if others think our language common or vulgar, the truth is that it’s partly because we don’t throw things away; even words we don’t need anymore.  We love the words our ancestors left us as much as we love their memory.  We still say, ‘over yonder,’ or ‘on yon ridge.’  Some still occasionally call a bag a ‘poke,’ we still ‘reckon’ a thing is true.  A sentence may include the word ‘verily,’ to support its truth.  And we know that trespasses are sins.  We think metaphorically.  I think part of it is because many of us were raised on the King James Bible.  We understand an older form of English, and the poetry inherent in it.

consulting physician throws fit

consulting physician throws fit

Which brings me to ‘fits.’  Do you know what a fit is?  It’s like a spell.  Both are sudden episodes of unpleasant behavior.  But as near as I can reckon, a fit is more voluntary, whereas a spell is an episode in which on is ‘seized by outside forces,’ whether they be cardiac, neurologic or even spiritual.  Fits are often thrown by children.  Fits are sometimes thrown by physicians.

It occured to me while working recently.  I realized that, while I was trying to decide whether or not to admit a potentially ill older patient, I was hesitant  because I knew that the admitting physician had already thrown ‘a fit.’  He had yelled, stomped, been sarcastic, huffed and all the rest.  He was admittedly rather overwhelmed  by a sudden typhoon of admissions.  But it was still a fit.

Others do it.  I have a friend who sometimes throws fits when I consult him.  He gets very angry on the phone;  not at me, just at life.  He works hard, and he is excellent at his profession.  I’d trust him with any of my family in a heart-beat.  But often, I try not to call.  I don’t want to induce the fit.

Another physician I know, a general surgeon, does the same.  He’s sarcastic, terse, annoyed.  ‘I guess I’ll see hyour patient, but I have eight elective cases ahead, so it may be hours, fine.’  Click goes the phone.  Fit thrown.  I’ll do almost anything to avoid calling him lest he throw another fit.  (Lest, as in unless…more of the South!)

I started wondering, ‘is this a fit or spell?  Is it voluntary or involuntary?’  Because frankly, if it’s vountary, it’s working right well.  (See how I slipped in the Southernism?).  These fits disuade me from bothering the specialist, and make me want to figure out the problem on my own…for better or worse.

How often does this happen?  Divided as we are into specialty tribes, we constantly try to protect ourselves from extra work.  How often do we leave the other specialist alone to avoid the fit, the snide remark, the ‘why didn’t you finish the work-up,’ comments.

How many patients, who would benefit from someone’s expertise, don’t receive it because we don’t want to cause the fit?

Too many.  And you know what, it’s not a spell.  It’s a fit.  It’s intentional.  Pity, like the parent of a spoiled child, I still respond to it as predicted, attempting to make peace and keep everyone happy.

Daggum it.

Edwin

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