I’ve never been the doctor who yells.  However, if you work in medicine, you’ve met him or her.  I’ll call this physician “Dr. Barkus Yellby.”  Dr. Yellby is angry.  A lot.  In the old days (and not so old days), he threw instruments in the OR when they weren’t what he wanted.  Or if the charts and labs weren’t ready for rounds, he slammed things on the desk and berated wide-eyed nurses who were holding back sobs.

As an emergency physician, I’ve talked to him any number of times on the phone.

“Did you even examine the patient?”  “Why are you calling me?’” “How is this my problem?”

I was reminded of Dr. Yellby a few months ago when I called the surgeon for an incarcerated umbilical hernia.  Silly me, I’ve been trained over the past few years to “finish the workup” and “order the CT,” so a CT I ordered.

“How long has she been there?  Did you even examine her?  Now I have to come back in, and we’ve had a delay!”

On and on the berating went.  Heck, I didn’t think surgeons did anything without a CT scan these days.  Lesson learned.

I’ve been insulted, cursed and treated like a perpetual intern, all because I either angered the on-call “real doctors” or because I dared to run my all too Appalachian mouth.  Dr. Barkus Yellby, having fussed at me, was deeply offended that I told him, “I don’t need your crap.”  Shocked, he was, and clutched his pearls in a swoon.  Before threatening to report me to the medical board.  We have since made up.  But I smile looking back.

A former partner of mine was a super guy; with a little bit of Dr. Yellby inside.  He was forever apologizing to nurses with flowers the next day.

Some time ago I saw a young man who had a significant knee injury while skiing out of state. Rather than have surgery as recommended when he was evaluated near the ski area, he came home and went to the ER.  He was concerned about costs and insurance.

I called Dr. Yellby.  (Remember, his name is Legion …)

“So he refused care.”

“Well, not really,” says I.  “He was worried about the money.”

“So he refused care.  I get it.  I’ll see him in the office tomorrow.”

He was unhappy.  He didn’t so much yell as growl.  Dr. Growlby.

Today a physician, angry at his patient, told me, “that’s the last time I’ll ever see him.   He’s yours now.”

I didn’t do anything to earn his anger, and I was just calling to update him and ask advice.  But that was that.  The patient’s family rolled their eyes in humor.

“Oh, he’s like that.  He’ll see him again.”

Dr. Yellby had clearly yelled at this family before.  Maybe they yelled back.

I sometimes wish I could be Dr. Yellby.  But as much as I wanted to, I never felt the yelling was beneficial.  Besides which, it has to be unhealthy for the “yeller.”  Unhealthy physically, emotionally, spiritually.

I guess I’ll never be that guy, that doctor. And that’s OK.  Fortunately, Dr. Yellby is rarely toxic.  In fact, when he needs something he’s sweet as honey.

“Hey Ed, how are you buddy?  Listen, can you pronounce someone dead for me?  Really? Thanks, you’re a life-saver!”

Most often, Dr. Yellby is just, well, unhappy.  In the short term because of tiring nights on call and non-stop admissions, or thanks to labyrinthine rules and satisfaction scores.  Or even in the long term thanks to bad choices, personality issues, greed, lust, or any other besetting sin.  Often because of deep wounds and loss.

I’ll never be Dr. Yellby.  Unless you’re on fire and I tell you so … loudly. Or because  of some other danger.  (“Joint Commission is here!”)  Or because of free donuts.

But as the years pass and my heart softens, as God molds me (hopefully) to be more the man I was made to be, I realize that Dr. Yellby needs my understanding maybe even more than I need him to shut up.

And that’s, oddly enough, a kind of comfort.

Edwin Leap is an emergency physician who blogs at edwinleap.com and is the author of the Practice Test and Life in Emergistan. 

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