A failure to communicate ....

“To effectively communicate, we must realize that we are all different in the way we perceive the world and use this understanding as a guide to our communication with others.”
~Anthony Robbins

So the other day, I had an anesthesiologist decide a patient I had scheduled was too unstable for transport to the OR and the procedure should be done in the ICU with the ICU team providing sedation. Now, it had been 3 days since the initial injury and the patient had been stable and transported for several studies without event. For some reason, this person thought the the patient was too "unstable." So, I went to the family and discussed the recommendations. I spoke with the ICU attending about it. The ICU attending the proceeded to ask me questions about why it couldn't be done in the OR, yada yada yada. I informed him it was not my decision. He then spoke with this anesthesiologist. In the end, anesthesia came and provided sedation and everything was fine. Days later, another case, same anesthesiologist, I hear that the anesthesiologist is trying to do the same thing. This time it was dealt with without confrontation or actual communication. This person just avoided me and passed it off to someone else. Hmmm, I thought that was strange. The avoidance of communication makes it all better.

Last week, we help out with a procedure with a patient in a halo. My team had explained to me that the patient needed a PEG tube and the person doing it said that the front had to come off. He spoke with my brace person, my chief resident, and the nurse in the OR. I heard the needs, but the kid is in a Halo for a reason. We can only do so much as far as providing space for the PEG tube. They informed me that he was adamant that he needed the whole front of the abdomen free. They actually said he was a bit of an A_ _, but that is hearsay because I did not witness it. So, at the time of placement of the PEG tube, we were all there. I was watching the neck and supervising the adjustments to the Halo. You know he did not say one thing to me. Hmmm, go figure. Yesterday, I was walking down the hall and I see the same physician. As you do, I looked up, we made eye contact, and I say, "morning, how are you?" He keeps walking and says nothing. Now, I was pretty sure that he wouldn't say anything because he never does. But, I keep trying. (With hands up in the air screaming to the sky) We are all on the same team.

Today, I am going to a faculty meeting. I am getting off of the elevator. The door opens, and a team (I assume surgical) is standing 1 foot from the door. I try to get out as the team rushed to get in and a medical student, in his short coat, bumps me. Not a little bump, a full shoulder to shoulder hit. I say, "excuse me." Again, nothing in return. Now, I thought, "OK, I am not in my white coat, but come on this is common courtesy. We don't live in New York City." (No slight to my NYC fans) This got me thinking. Do we create these people believe that they are better than the next person because they may have a little more knowledge? Why is it that in medicine we lose our ability to effectively communicate to one another? Does it have to do with the inherent hierarchy of the medical field or does it have to do with the god complex that some people develop? Why can't we just be civil? Ok, that was way too many questions. Just some thoughts I wanted to put out there to see if anyone else has any answers.

“The single biggest problem in communication is the illusion that it has taken place.”

~George Bernard Shaw