{"id":737,"date":"2014-08-10T07:54:46","date_gmt":"2014-08-10T15:54:46","guid":{"rendered":"http:\/\/ariplex.com\/folia\/?p=737"},"modified":"2014-08-10T08:07:19","modified_gmt":"2014-08-10T16:07:19","slug":"arrogance-is-the-worst-and-most-dangerous-trait-a-dr-can-have-this-blog-by-georgejulian-shows-why","status":"publish","type":"post","link":"http:\/\/ariplex.com\/folia\/archives\/737.htm","title":{"rendered":"&#8220;Arrogance is the worst (and most dangerous) trait a Dr can have. This blog by @GeorgeJulian shows why&#8230;&#8221;"},"content":{"rendered":"<ul><a href=\"https:\/\/twitter.com\/drpaulmorgan\/status\/498209253099065345\">https:\/\/twitter.com\/drpaulmorgan\/status\/498209253099065345<\/a><br \/>\n[*quote*]<br \/>\n&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>\nDave Jones @WelshGasDoc<\/p>\n<p>Arrogance is the worst (and most dangerous) trait a Dr can have. This blog by @GeorgeJulian shows why&#8230;<br \/>\n<a href=\"http:\/\/georgeblogs.wordpress.com\/2014\/08\/06\/the-blackest-of-wednesdays\/\">http:\/\/georgeblogs.wordpress.com\/2014\/08\/06\/the-blackest-of-wednesdays\/<\/a><br \/>\n#TipsForNewDocs<\/p>\n<p>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>\nPaul Morgan @drpaulmorgan<\/p>\n<p>@WelshGasDoc @GeorgeJulian The failure to listen was unacceptable. Pre-judged the situation in favour of personal bias. Wrong.<br \/>\n&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>\n[*\/quote*]<\/ul>\n<p>.<\/p>\n<p><a href=\"\"><\/a><\/p>\n<p>@GeorgeJulian allowed me to quote her blog text. I copy it here, so that it will be seen by more people than if it were on only one place in the Net.  <\/p>\n<ul><a href=\"http:\/\/georgeblogs.wordpress.com\/2014\/08\/06\/the-blackest-of-wednesdays\/\">http:\/\/georgeblogs.wordpress.com\/2014\/08\/06\/the-blackest-of-wednesdays\/<\/a><br \/>\n[*quote*]<br \/>\n&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>\n<strong>The blackest of Wednesdays<\/strong><br \/>\nAugust 6, 2014 George Julian<\/p>\n<p>It was five years ago today, yet I remember nearly every bit of it as though it was yesterday. I can recall his name, his walk or rather his strut, his voice and his manner, perhaps one blessing in disguise is that I can\u2019t remember his face. It\u2019s odd that but I often wonder whether our brains are clever enough to protect us from a lifetime of searching. I can remember how insignificant this young doctor made me feel, how frustrated and unheard, how desperate and futile. He reduced me by his arrogance, his absolute refusal to listen, his lack of humility or awareness, his performance perhaps designed as much to convince himself as anyone else.<\/p>\n<p>Five years ago, Wednesday 5 August 2009 my Dad nearly died. In the end it was another 3 years, 3 months and 10 days until Dad did die, but five years ago today was our nearest miss. I don\u2019t want to focus on the specifics of Dad\u2019s situation because the reason I share it is in the hope that some learning may come of it! However, as context, Dad had been diagnosed with cholangiocarcinoma, bile duct cancer, a very rare cancer in Sept 2007. I\u2019ve written elsewhere on this blog about the amazing treatment Dad received, he was diagnosed in less than two weeks, admitted to our local hospital Torbay, and transferred for specialist treatment inPlymouth, at Derriford, as soon as possible. Dad spent months in Derriford, no exaggeration. He initially had drains fitted to drain off the build up of bile, he then had a 12 hour liver resection op in January 2008 to remove the tumour (we hoped), a month long stay as an inpatient followed with a side order of MRSA. Dad got home and started his first lot of chemo in late Spring 2008, but he quit that early so the blisters on his feet would heal in time for him to walk my little sister down the aisle that summer.<\/p>\n<p>Fast forward to June 2009 and Dad was in pain, it turned out that an abscess had formed under his scar. Immediate surgery followed and he was home being looked after by the District Nurses within a week. No sign of the MRSA, or any tumour activity, relief all round. July 2009 saw the emergence of swine flu, a quick google image search for \u2018swine flu newspaper\u2019 produces these gems:<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/georgeblogs.files.wordpress.com\/2014\/08\/screenshot-2014-08-06-08-53-49.png?w=595&#038;h=317\" alt=\"screenshot from 'George blogs' showing newspaper frontpages concerning swine flu\"><br \/>\nhttp:\/\/georgeblogs.files.wordpress.com\/2014\/08\/screenshot-2014-08-06-08-53-49.png?w=595&#038;h=317<br \/>\nScreenshot 2014-08-06 08.53.49<\/p>\n<p>Remember it? When Dad felt ill again in July, lethargic and generally groggy one of the first things the GP tested for was swine flu, it came back negative. Dad carried on, making no fuss, took a course of antibiotics and that was that, until a few weeks later things got worse and we called the GP first thing that Wednesday. Dad was having rigors (not as scary as they look, extreme shivers, almost like a fit and sweltering temperature), it wasn\u2019t the first time he\u2019d had them but it was often an indicator that something was seriously wrong and he was fighting infection. The GP decided the best place for Dad was hospital and he called to arrange an ambulance. The ambulance crew were brilliant, taking Mum with Dad and I followed on behind in my car. A&#038;E was busy, Dad spent about an hour or so in the corridor before a nurse ran through a checklist of symptoms and directed us to an isolation room. It was sweltering and close and stuffy that day and we were told to wait in this room, the three of us, and not prop the door open. We were so used to Dad being in isolation due to his experiences with MRSA that we didn\u2019t think anything of it. Another hour and a half passed, Dad\u2019s rigors got worse, sweat was dripping off him (and Mum and I weren\u2019t exactly comfortable) and in the end I couldn\u2019t wait any longer, you get to a point where you think you\u2019ve been forgotten (on this occasion I don\u2019t think we had, but you never know) and I couldn\u2019t watch Dad in such discomfort any more, and I could smell that he was toxic.<\/p>\n<p>I\u2019m no medic but there is a certain smell that comes hand in hand with blood poisoning or sepsis, it isn\u2019t pleasant and once you\u2019ve learned what it is, it\u2019s hard to forget. Oh and once you\u2019ve been in a room barely bigger than a bed with someone giving it off, on a very hot day, for over an hour\u2026.you definitely can smell it. I headed for the nurses station, pulse racing, feeling clammy and that low level guilt. No-one likes to complain in hospitals, you\u2019re playing russian roulette, what if you make things worse for your loved on, what if someone else needs the staff\u2019s attention more urgently etc etc. Anyway I asked if anyone would be along to see Dad soon and if I could give him a drink (answer no, until he was seen by a doctor but it shouldn\u2019t be too much longer).<\/p>\n<p>Twenty minutes later, Dr Strut (*not his real name) walked in. He was about my age, obviously delighted to introduce himself as a Senior House Officer, not the best bedside manner really. Talked to Dad, ignored Mum (and me, but that would have been ok if he\u2019d acknowledged Mum). Dad at this stage was barely awake,which worried me even more, and Dr Strut just kept directing questions at him. Dad did his best to answer and Mum chipped in, he shot her that wary look (he didn\u2019t, but a roll of the eyes wouldn\u2019t have been out of character). I could see us in his eyes immediately, pushy daughter, neurotic wife and clammy patient who doesn\u2019t seem too bothered either way. Dr Strut deigned to allow Mum to answer for and with Dad, he listened to her explanation of what had happened, cutting her short to ask the questions on his checklist (and yes he actually had a clipboard with it on)\u2026.have you felt dizzy? Any difficulty breathing? Temperature? He went on and sure enough lots of Dad\u2019s symptoms were similar to swine flu.<\/p>\n<p>He immediately pronounces that Dad must be taken home, with a course of antibiotics and given TLC. Yup, he actually prescribed \u2018TLC \u2013 tender loving bloody care\u2019. How rude and how arrogant. What the hell did he think we\u2019d been doing for the last two years? Our tender loving care wasn\u2019t fixing his cancer and it wasn\u2019t going to cure Swine Flu either. At this point I couldn\u2019t stay quiet any longer, \u2018Excuse me Dr Strut but Dad has already tested negative for Swine Flu, you can check with the GP, it should be in his notes. I\u2019m really worried that this is something else, he had surgery for an abscess last month. I\u2019m sorry but we can\u2019t take him home like this\u2019.<\/p>\n<p>So what did Dr Strut do? Check Dad\u2019s surgery site, nope. Check his notes, nope. Call the GP, nope. He summoned all his patient skills training, touched me on my arm (not a welcome invasion of personal space at this point I might add) and said \u2018With all due respect, your father is an infection risk and he doesn\u2019t need to be here\u2019.<\/p>\n<p>Arrrggggggh, he hadn\u2019t heard me, he didn\u2019t listen. I don\u2019t think I\u2019ve ever really heard the phrase \u2018with all due respect\u2019 since without thinking of how readily it\u2019s used as cover for \u2018with absolutely no respect I\u2019m right and you\u2019re wrong\u2019. Nothing I\u2019d said had made an impression, he was so intent on getting us out of A&#038;E that I could have been talking to myself. After very disturbed sleep at Mum and Dad\u2019s the night before, a frustrating and ultimately pointless morning, I did what all sleep deprived, un-heard, patronised people would do in that situation and promptly burst into tears.<\/p>\n<p>This flummoxed Dr Strut a little. So he somehow attempts to make it better with \u2018I\u2019m sure it must be very difficult for you with your father\u2019s illness, very draining, but I can assure you he doesn\u2019t need to be here\u2019. Again, made it worse, he had no idea how difficult it was or wasn\u2019t for me, he hadn\u2019t engaged with anything I\u2019d said, just rolled off some meaningless assurance, his opinion and what he wanted, us out of there.<\/p>\n<p>He dismissed himself with a cheery \u2018Good Day\u2019, told us to collect the prescription on our way out and reiterated the need for the room. At this point I was beaten, Mum was also close to tears, Dad just wanted the fuss over and didn\u2019t want me upset, so Mum asked me to go get my car. I left the room a dishevelled mess and was half way to the car park when my mobile started ringing and it was Mum. I felt sick all over, what now, what had happened. She told me not to worry, not to get the car but to come back. When I got back to the room in A&#038;E, the door was propped open, Mum had a glass of water, Dad was sat up in bed, clammy and ashen looking but smiling for the first time that day. A female doctor was with them, turns out she\u2019d seen me leave in a state and had asked someone at the nurses\u2019s station who was in the room. She\u2019d then taken it upon herself to look at Dad\u2019s notes and pop her head around and ask Mum if everything was ok. Mum had said we were worried but had been told to take Dad home, she said she\u2019d give him the once over to check if that would reassure us.<\/p>\n<p>As I walked in she looked me in the eye, said that she was going to look after Dad and immediately said \u2018you were right, I suspect your Dad is septic\u2019. Mum had told her what I\u2019d said. What followed was an hour of the best A&#038;E treatment we could have hoped for. Super doctor checked Dad over, actually looked at him and his belly where the abscess had been and checked his original scar, she ordered bloods and put him on a saline drip. She asked a nurse to bring in another chair so I could sit down for the first time that morning, and when she went out to see another patient, as we were waiting for the bloods to come back, she re-emerged with a fan. This woman was amazing, like a perfect antidote to Dr Strut.<\/p>\n<p>Dad was admitted onto a ward from A&#038;E that day, he was kept in for two weeks of intravenous antibiotics, treating blood poisoning caused by an MRSA infection. As the porter arrived to take Dad to the ward, Dr Amazing graciously accepted our thanks (we must have looked quite manic at this point, no food, little sleep the night before, four hours in A&#038;E, all the anxiety and emotion, and then someone literally saving the day), she said she\u2019d have a word with Dr Strut later and she touched me on my arm (which didn\u2019t in any way feel like an invasion of personal space), looked me in the eye, and said \u2018You did what any daughter would have done today, and you must keep doing it. We do our bests but we need people to speak up. Thank you\u2019.<\/p>\n<p>I carried her words with me into every A&#038;E admittance over the three years that followed. Mum and I often reminisced about it, Dad also in his final weeks referenced it a couple of times, as \u2018the time I\u2019d have died if you\u2019d not said something\u2019. A false praise really, it wasn\u2019t my saying something that made the difference, it was my defeated retreat that Dr Amazing happened to notice. Still, I like to think I\u2019d have refused to take Dad home that day.<\/p>\n<p>It was the weekend as I recounted our experience to a friend of mine that he asked what day of the week it was. Wednesday said I, a knowing chuckle, \u2018ahhh Black Wednesday, that\u2019s killing season alright\u2019. I had no idea what he was talking about at the time, but turns out the first Wednesday of August is the day in which all the new junior doctors take up their post, and others rotate. Dr Strut wasn\u2019t a junior doctor, but I strongly suspect now that he was Day One of being a SHO, giddy on the excitement of no longer being at the bottom of the pile, proud as punch of his superiority and damn determined that everyone would give him the respect he deserved.<\/p>\n<p>I hope that he took something away from his interaction with us, I hope that as he went home that night he stopped and reflected on what his mistake could have cost us. It\u2019s five years later and it\u2019s coming up to two years since Dad died, and still his words and manner haunt me. Still the fear of what could have been. If you have the privilege of working as a doctor in A&#038;E, if you ever find yourself with a checklist in one hand and a distraught family member in front of you, just suspend your own agenda for a minute or two, please, you never know they may have something useful to say!<\/p>\n<p>NB I must end by pointing out this was the exception, not the norm, of the treatment we received throughout Dad\u2019s illness. We were supported and looked after by amazing caring doctors, nurses and HCAs. I have blogged lots about this wonderful treatment, and I don\u2019t offer today\u2019s post to detract from that, more as something to reflect on and maybe learn from.<br \/>\n&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>\n[*\/quote*]<\/ul>\n<p>.<br \/>\nIt was a narrow escape. George&#8217;s dad was lucky. But how many each day are not&#8230;?<\/p>\n<p>.<br \/>\nA place to read, this is George&#8217;s blog:<br \/>\n<a href=\"http:\/\/georgeblogs.wordpress.com\">http:\/\/georgeblogs.wordpress.com<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>https:\/\/twitter.com\/drpaulmorgan\/status\/498209253099065345 [*quote*] &#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211; Dave Jones @WelshGasDoc Arrogance is the worst (and most dangerous) trait a Dr can have. This blog by @GeorgeJulian shows why&#8230; http:\/\/georgeblogs.wordpress.com\/2014\/08\/06\/the-blackest-of-wednesdays\/ #TipsForNewDocs &#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211; Paul Morgan @drpaulmorgan @WelshGasDoc @GeorgeJulian The failure to listen was unacceptable. Pre-judged the situation in favour of personal bias. Wrong. &#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211; [*\/quote*] . @GeorgeJulian allowed me to quote [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,10],"tags":[],"class_list":["post-737","post","type-post","status-publish","format-standard","hentry","category-raumschiff-erde-touristenklasse","category-zweinull"],"_links":{"self":[{"href":"http:\/\/ariplex.com\/folia\/wp-json\/wp\/v2\/posts\/737","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/ariplex.com\/folia\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/ariplex.com\/folia\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/ariplex.com\/folia\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"http:\/\/ariplex.com\/folia\/wp-json\/wp\/v2\/comments?post=737"}],"version-history":[{"count":5,"href":"http:\/\/ariplex.com\/folia\/wp-json\/wp\/v2\/posts\/737\/revisions"}],"predecessor-version":[{"id":742,"href":"http:\/\/ariplex.com\/folia\/wp-json\/wp\/v2\/posts\/737\/revisions\/742"}],"wp:attachment":[{"href":"http:\/\/ariplex.com\/folia\/wp-json\/wp\/v2\/media?parent=737"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/ariplex.com\/folia\/wp-json\/wp\/v2\/categories?post=737"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/ariplex.com\/folia\/wp-json\/wp\/v2\/tags?post=737"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}