(In this second part of a two-part series on bad behavior in the OR, we give you details about a report in the Annals of Internal Medicine as well as details from a specific incident involving an anesthetized patient who was ridiculed. In last month’s issue, we gave you an overview of the problem and provided potential solutions.)
An essay in the Annals of Internal Medicine received the attention of not just the medical community, but also the general public, when it revealed how anesthetized patients sometimes are treated with disrespect and even subject to what could be considered assault.
Titled “Our Family Secrets,” the physician author recounts incidents of misogyny, racism, and sexual assault in the operating room. In an accompanying editorial, the editors of the journal said that they debated whether to publish the sensational essay, but they said they did so to underscore that it’s important that doctors not remain silent when they witness misconduct.
The author of the essay was teaching a medical humanities course to senior medical school students. During the course, he asked the students if any of them had something happen during their medical school experience that troubled them deeply.
One student expressed regret at not standing up to a surgeon’s inappropriate behavior while a patient was under anesthesia for a vaginal hysterectomy. While the surgeon was prepping the unconscious patient’s vaginal area for the procedure, he looked at the student and said, “I bet she’s enjoying this,” accompanied with a laugh and wink.
The student called the surgeon a “dirtball” when recounting the incident, but expressed remorse that he had laughed along with the surgeon. He felt intimidated by the senior physician and didn’t know what to do other than play along with the joke.
The anonymous author also told his class of an incident that occurred when he was a third-year medical student. He had helped deliver a baby, but the mother experienced severe bleeding immediately after. The resident instructed the anesthesiologist to put the patient under and then proceeded with an internal bimanual uterine massage, which involves placing a hand inside the vagina and pressing a fist against the uterus to stop the blood flow. Once the bleeding was controlled, the doctor said “Atta girl. That’s what I like. A nice, tight uterus.” Then he raised his free hand in the air and started singing “La Cucaracha,” shuffling so it looked like he was dancing. (The patient was Latina.)
The essay author laughed and hummed along to the song until the anesthesiologist yelled at both of them to stop. (Access to the essay is available at the Annals of Internal Medicine website at http://tinyurl.com/oovn85m. The cost is $32. See story in this issue of another example of bad behavior in the OR.)
