Confrontational Surgeons

When I was in the peds cardiac ICU, there was a surgeon who seemed to
have particular joy in making nurses tense and everyone jump when he
came storming into to room. Even when everything was fine he was really
aggressive at getting answers met. When things were bad, he was far
worse. Imagine already having really high adrenaline levels and
sweating to do everything you can to save this child's life and then
this tall man walks in yelling at you and everyone else in the room! I
remember him standing over me literally so close that I had to crane my
neck up to maintain eye contact while he fed me 20 questions and
feeling my heart in my throat. I tried to leave the room and he
followed right behind me continuing to talk at me.

Only one nurse seemed to know how to deal with him and that was because she was
much older than him, had many more years of experience and was very, very New
York - Brooklyn even. She talked right back to him as if he was being
ridiculous, while showing she was obviously on top of the situation, "so
why was he so stressed out?" He liked it. I took notes. I was not any of
the three things she was, but I could display confidence around him and
let him know I was on top of the situation he was emoting about.

Things changed after one of my patients coded and we saved him. The infant had only
a single ventricle and had had his chest open for several days after
his heart surgery - because the pressure would have been too much to
close right away (there is a sterile dressing covering it all, but
still weird to see). They had just closed his chest earlier that day
and the surgeon went home. He went asystolic (ie flat line) and we
rushed to revive him. These children are very tenuous and when they do
code, they typically have to be placed on a mini heart and lung bypass
machine of sorts (called a ventricular assist device) to support them
for a few days. But this baby did so well after our resuscitative
efforts, that was not needed. The surgeon came in long after it was all
over and seemed amazed. He still tried to bark orders by having me
increase the dosages on some of the inotropes (medications to support
the various heart functions and blood pressure) and I would call back
"So you want this much? That means X per min." As I dialed it on the IV
pumps, he tried to be condescending by asking How do you know that?!
And I looked back at him and smirked, saying "I calculated it." He's
been nice to me ever since. Even now when I run into him in the
cafeteria, he asks why I'm not still there and tells me his patients
need me.