Those of you who have been with me know that I am on a continuous healing journey from being labeled “the problem” to helping find solutions.  Please let me recount a painful lesson from my third year of residency. At 3 AM, after being up over 20 hours, I was asked to evaluate a patient with acid burns of the face, and when I said that we needed to get the patient to a shower immediately to wash off the acid, the triage nurse told me, “Our protocol does not allow an acute patient to be transported out of the ED.”

I lost it. Instead of saying, “Let’s take care of this patient’s acute needs to get the acid off his face and discuss revising the protocol in the morning,” I let her know what I thought about her protocol and took the patient to the nearest shower in the OR changing room.  When I returned with the patient, I learned that I had been reported for swearing at a nurse in front of a patient.

Caught in a “Gotcha” moment, I apologized to the nurse, her boss, the ED Director, the Chief of Surgery, and my program director, to name a few.  Through this incident, I learned that leaders need to remain calm in crises, so that team members can function at peak efficiency.  I also learned not to fight at night and told the story to all residents who would listen once I became chief resident and Assistant and Associate Professor of Surgery, hoping that they would learn from my mistake.

At the end of my residency, I presented a talk at the Society of University Surgeons, entitled “Misadventures in surgical residency: Analysis of mistakes during training” (Current Surgery 42:278-285, 1985).  It was the only talk in which I had a standing room only crowd.  As one surgeon told me, “Everyone wants to hear others admit their mistakes.” 

When asked to comment on my presentation, my program director, Dr. William McDermott, replied, “I have thought of the third year of surgical residency as the peri-menopausal year because residents are in between, no longer interns or junior residents but not yet trusted to do senior-level work.” Later, he reflected on his distinguished career in academic surgery with this wise counsel:

For all of us in healthcare, it is a privilege to be asked to serve.  It means that someone else values what we do and that we can lend a personal touch to the task which we have been assigned.  But after a while, our eagerness to please takes its toll.  We find that, like burrs, things stick to us, and we cannot get away from them without confronting people or leaving to take another job.  So, you might say that we all have the seeds of self-destruction planted within us.

Then,  he smiled at me and said:

Just because we have the seeds of self-destruction planted within us, does not mean that we need to drink Miracle-Grow.

As Thanksgiving approaches, I feel blessed to have benefited from a wonderful mentor like Dr. McDermott.  He is the principal reason that I have devoted time to teaching fellow physicians how to mentor newly hired physicians and why I was proud to write an article showing that teaching physicians to be better mentors improved physician retention significantly (The Lifelong Iterative Process of Physician Retention).

What do you think?

• Has your career benefited from others making the time to mentor you
• How have you reciprocated
• What stories can you share about the co-mentoring process, in which we learn from sharing knowledge and experiences with others

As always, I welcome your input to improve healthcare collaboration.

Kenneth H. Cohn

© 2009, all rights reserved

PS: This will be my last blog for 2009.  My son, a senior at Purdue in the Naval Reserve Officer Training Program, will begin his Naval aviator training soon.  Our focus will be on family from Thanksgiving through the end of the year.

©2012 Healthcare Collaboration. All Rights Reserved.

Collaborative Learning: Post 80 is an original post from Kenneth Cohn on Healthcare Collaboration - Improving Physician-Hospital Relations