Common courtesy is becoming uncommon. Holding doors, carrying packages, tipping the hat, escorting vulnerable people was commonly the responsibility of men. Men took pride in being chivalrous or being known as a ‘courtly gentleman.’ Even now, if you are wanting to pull out into traffic, it is far more common for a man (and an older one at that) to let you in than a woman.
This isn’t sexism; it is just the consequence of which sex has historically been tasked with public courtesy. Saying please, thank you, yes sir, yes ma’am and not interrupting others were lessons taught to both sexes. Nowadays, it seems everyone has flunked kindergarten, the traditional place where such behaviors are taught.
Doctors are not immune and I sometimes wonder whether medical school requires that one submit to surgical removal of their humility before getting a medical degree. While most, if not all, of us were driven by compassion, it also takes a hunk of ego to submit to the rigors of medical training. The mind numbing studying, the incredible hours, the self-denial while all one’s friends are out having fun.
For me it was four years of medical school beyond my four years of college; then five years of surgical specialty training. Perhaps it is understandable, if not fully forgivable, that a newly minted physician has a bit of smug self-satisfaction. I know I did. Looking back, I don’t like that me.
Certainly there are the arguments that doctors must hold themselves aloof from the misery of disease, to protect their objectivity. I think there is some validity to this. One reason I would not have gone into pediatrics was that I lacked the courage and could not divorce myself from the tragedy of a sick child and frightened parents. To my colleagues who are pediatricians, my hat is off.
Can doctors change and become gentler? Yes, as we become more comfortable in our professional skin, we can allow for increasing levels of humanity. First, we have to identify the arrogance. It can occur by zip code. Big city doctors tend to look down on small town and rural doctors. Graduates from, for example, the Ivy league medical schools, will carry their arrogance wherever they go, as though someone who dies in an Ivy league hospital is somehow more profoundly dead than someone who dies in a small town hospital.
Sometimes, the arrogance is individual. This is the doctor who likes being the guy in the elevator with the most education. He looks down on patients and other healthcare providers. He befriends only those other physicians who he deems equal to his own status in medical nobility.
I think compassion and courtesy can be learned. I did it. Becoming a man of faith certainly helped. I pray with my patients, laugh with them, and, if it comes to me, cry. I am in no way diminished in either my own eyes or theirs.
Everyone behaves in a special manner around people whom they deem important. Actors behave slavishly around Directors and Producers. Young folks behave adoringly around athletes. How do you think your behavior would change once you realized that the people you meet are children of God and beloved of Him? Would you get the look of distaste off your face if you knew the dirty unkempt person in front of you would someday occupy a respected position in Heaven?
How do you think this has impacted my perception of my patients? On a somewhat more mercenary note, scripture makes clear that, in heaven, there is no sickness, death, or disease. If so, that means that, in heaven, I will be out of a job. Picture me standing on the streets of gold with a tin cup in my hand, panhandling the saints.
In my particular case, I have also been influenced by my brother, Lucky. My larger-than-life brother and my hero for as long as I can remember, Lucky took to medicine like a stallion. Equipped with the legacy of compassion from both our parents, Lucky hit the speed bump of medical arrogance and charged right over it. He will tell you that he was taught by his patients and I believe him. A man of faith, a man of peace, a man of medicine. You should all be so fortunate to have such a mentor or role model to emulate.
For the terminally arrogant doctor, non-physician health care folks have some tactics guaranteed to humble. Nurses can be famously passive aggressive when dealing with the kind of doctor who kisses the mirror every morning. The best I saw was when I was in training. An Ivy League graduate came to our surgical training program, infected with elitism. He was a jerk. But they knew how to get to him.
He scrubbed in on a ruptured appendix, a ‘dirty case’ (one in which infection is already present). At the end of the case, everyone in the room took off their scrub pants and scrub shirts, revealing an additional set beneath. This doctor was astonished when they said, ‘okay doc, hand ‘em over. This is a dirty case and the scrubs stay in the room so we don’t inoculate the hallway. He shouted that he had no second set of scrubs on. They kept straight faces and demanded he ‘follow the rules.’ Turns out he wasn’t wearing underwear. A long walk naked down the hall ended his haughty demeanor. I suspect he was still a jerk internally, but he was on notice about what the nurses could do to him if he tried to broadcast it.
I think every doctor needs to examine his spirit in all humility and realize that the human body upon which he works is the product of a Creator who loves His children beyond all understanding. Failing that, he needs to walk naked down an O.R. hallway.
– Dennis Garvin
