The time I almost got fired for saving a young woman’s life

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I was a fourth-year surgery resident, on the transplant team. It was a difficult rotation, because the doctor who ran it was sexist and got along better with you if you flirted with him. He made innumerable sexual wisecracks in the OR while we were working, and preferred to round with his arm around me as he made further innuendoes.

I wasn’t doing particularly well on the rotation, because while I am very good at flirting, it offended me that that was required to get a good review. I had made it clear to him early in the month that I had no intention of playing along.

I was lucky in my later residency years to have an exceptional mentor — a senior surgeon who was semi-retired and had time to spend with me. He assured me he had my back if things got ugly. Thank God, because I needed it more than once.

It was a Saturday afternoon, and I was the senior in-house resident on call. A young woman in her 20s came into the bubble — the higher intensity area of the ER — where I was seeing a consult for transplant.

She was spitting blood everywhere. Her mother reported that she had had a tonsillectomy the day before with one of the ear nose and throat surgeons — a service we no longer covered for emergencies. While I was standing at the bedside of the patient next to her, I heard most of the story.

Then she began to bleed in earnest — bright red, pumping blood from her nose and throat. The nurses grabbed me and asked for my help. Thinking quickly, I got a wad of gauze and stuck it down her throat, putting pressure on the exposed tonsillar artery. This artery is connected to the carotid, and a woman her size and age could bleed out and die in minutes if the bleeding wasn’t stopped. In fact, it happened to one of my pulmonologist friends years later — he bled out at home from his tonsillectomy site and was dead before the ambulance arrived.

Now I was stuck, because I couldn’t take my hand off the artery. It would not stop until it was oversewn in the operating room. Someone brought the phone to me and I spoke to the ENT doctor, urging him to come as soon as possible. He told me he was already in the car. Then we called the OR and told them we had an emergency coming down immediately.

To get to the OR, we had to go down the elevator to the basement level. I climbed up on the stretcher, straddling the frightened woman, and off we went. Somewhere along the way, they outfitted me with a hat, mask and gown as best they could.

Dr. J arrived just as we were rolling into the OR. They scrubbed my arm right into the case and intubated her nasally. Once everyone was ready to go, the patient was asleep, and we were as sterile as possible, I took my hand out of her throat. Dr. J. jumped right in and oversewed the artery. Life saved!

During this entire episode, my pager was going off like crazy, but I couldn’t get to it. I was sure it was my attending — the doctor I was working for that weekend.

As soon as the bleeding was under control and my hand stopped being numb from holding pressure for so long, I called him back.

He wouldn’t even let me explain where I was or what I was doing. He let me have it — how could I be so irresponsible? How could I just not answer my pager for nearly an hour? What happened to that consult in the ER?  He told me in no uncertain terms to report for duty immediately. My heart still beating from the adrenaline rush of saving a life, I slogged off to the transplant unit to meet my fate.

Even when I did explain what had happened, he was still angry. It wasn’t my responsibility to cover the ENT service, it was my responsibility to cover his service.  Why couldn’t I at least have had someone call him to let him know?

Truthfully, because when your heart’s beating so loud in your ears that you can’t think straight, the last thing you do is call your attending to tell him you’re missing rounds. It’s true, I forgot about him. I was focused on the task at hand.

He wrote me up, and on Monday I was told not to bother reporting for transplant: I was relieved of my chief duties.

I was called down to the surgery chairman’s office to account for myself. It’s a very big charge to abandon your duties while on call. The transplant team wanted me fired. I brought my mentor with me. I brought the letter from Dr. J commending me for my fast thinking and for saving his patient’s life. I had the business card of a reporter for the local newspaper — just in case whistle-blowing became my only defense.

I won’t lie about it, I felt pretty angry. When did rote obedience become more important than patient care? In what world should a vindictive sexist surgeon get to bully and harass a female resident and win? I shouldn’t have needed that much ammunition.

In the end, I was not fired. I had to return to the transplant team with instructions to keep records of any harassing behavior. I didn’t get a very good review from them.

I won’t say I didn’t learn something from the whole incident. I will never tell you that I was some great resident whose only issue was how I was treated in residency. I had no idea at that time how to be assertive without aggression. It was back down and be walked on, or stand up and fight. There wasn’t much in between. My motives in those days weren’t always pure.

But I see a world where doctors love their jobs again. Resident and medical student abuse can never be tolerated. This job is hard enough without that.

I remember, years ago, when I went for an interview for a surgery residency and the interviewer asked me if I was aware that surgeons eat their young. I had no idea how true it was.

Carolyn Messere is a surgeon and can be reached on her self-titled site, Soul Deep Wellness.

Image credit: Shutterstock.com

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