“Look at every path closely and deliberately, then ask ourselves this crucial question: Does this path have a heart? If it does, then the path is good. If it doesn't, it is of no use.” ~Carlos Castaneda

Monday, March 26, 2007

I guess it is all about perspective

“You have your way. I have my way. As for the right way, the correct way, and the only way, it does not exist.”

~ Friedrich Nietzsche

Over the last week or so, I have been getting acquainted with a number of other bloggers. Seeing what topics are being discussed and what comments are being made. The list seemed endless. I realized that there are various other opinions, duh. These other opinions are somewhat skewed based on the person's perspective. Where they are; where they have been; and where they are going. We all have a different perspective, and of course my perspective is more right than yours, because I have more justification.

Today, I had the opportunity to speak with a physician from Uganda. He was a spine surgeon who was here to observe us, to see a few cases, and attend a course. It was a little slow in my clinic, so I asked him how things ran in his country? How was the residency run? How did his practice run? He began to discuss the basics of his hospital and what types of cases he sees. His practice was totally different than your typical American spine surgeon, all trauma and infection (mostly TB). His approach was different, usually delayed because the families had to get money for the instrumentation. He explained that the residency structure was also different. It was set up more like the UK system. After A levels, students went to medical school for 5 years, did a 1 year internship, worked for 2 years or more in local hospital, and then started residency. He explained residency was 4 years, and that there was really no supervision at night. Residents would do cases unsupervised at night, unless it was an extremely complicated case, then a staff surgeon may be called. He is amazed at some of the things we are capable if doing. He thought most of our complaints were; well, let just be thankful for what we have.

As an attending, sometimes I do forget the perils of being a residents. The money issues and abuses from the medical staff, other services, are may times forgotten. As an attending, we are kind of immune to some of the resident issues. We have more power, so we think. We have control over our time (in some respects), we have some control over the patients we will see and the number of cases we do. There is some sense of control. But, then why can't I get the insurance companies to pay? Why do I have more paperwork day in, day out? Why am stressed out over patients, cases, teaching? How can the hospital tell me what medications or instrumentation I can and can't use? Damn, I thought I was in control.

As a resident, the perception is that we are always out to get you. People are always trying to shit on you, take advantage, and abuse you. You get paid little and respected less. No one works harder than th resident, and those other residents are always getting out of work.

As a patient, the perception is that the physician makes a lot of money. "They are always drinking coffee and making me wait. " "Even if the physician is wrong, his colleagues will cover for him/her." "They like to use big words to confuse use, why can't the just use regular lay terms."

As nurse, the physicians always talk down to us. "I have been a nurse for 10 years and that resident graduated last month, what does he know?" "They don't spend anytime with the patients and don't really have the patients interest in mind." "I am the patient protector."

There are so many different perspectives. Is any one perspective more right than the other? Hmm, of course I would tell you that my perspective is ultimately the right perspective to view everything. Truth is that we are all right from our own perspective. The most important thing is that us appreciate that the difference exists. When you are complaining about how bad it may be, remember there is always something or someone worse.

“Everything that irritates us about others can lead us to an understanding of ourselves.”

~Carl Gustav Jung

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