| Stuff |
[Jan. 22nd, 2011|01:19 am]
Scott
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After several days of low-grade panic, I finally had my clinic with Mr. S. But Heaven was kind: Mary Harney, Ireland's unpopular health minister, resigned Wednesday night. The atmosphere in the hospital was that of a party, as all of the consultants predicted the rebirth of the Irish health system and wished a horrible and disease-laden retirement on the outgoing politician. "I hope," said one radiologist out loud at the official radiology conference "that she comes down with one of those horrible degenerative nervous conditions, one of the incurable ones, and she has her private insurance canceled so she has to get treated in one of the public beds". This started a brief argument over whether that would be more or less suitable than a different sort of wasting condition, with everyone finally agreeing that being thrown in prison would be a good start.
The upshot was that Mr. S was in such a good mood that nothing I said or did could possibly have pierced the aura of happiness and goodwill toward all mankind that surrounded him throughout the day. So I got to stand around and absorb his genius (he even looks a little like Dr. House) without fearing for my life.
This genius presented itself in some very interesting ways. I relate an incident that occurred during a surgery today. An intern came in bearing a message from hospital administration: resources were low, there were no theaters available, and the hospital was out of beds. Would it be okay to cancel Mr. S's operations on Monday?
Mr S. told the intern to relay the following message: "I understand the situation. Thank you."
The intern returned a few minutes later, again with a message from administration. "Right, so you understand we've got to cancel the operations on Monday?"
Mr. S. again sent the intern with a message: "I appreciate the situation."
At this point, Mr. S. explained this little ritual to myself and the other students. It seems that administration cancels surgeries whenever they feel like it, and the surgeons themselves have no say in the matter. But if they merely suggest that they have to cancel the surgery, and it is the surgeon who utters some variant of the word "okay", then they can write down "Operation cancelled by surgeon" on their forms. And in that case, if the patient dies because the operation was delayed, and the patient's family sues the hospital, then the hospital can bring out the forms and say "Look, we didn't cancel your operation; it was the surgeon's decision. Sue him instead!".
And so the only safe response to "We're going to cancel your operation next week, okay?" is some form of "I understand that you are doing this."
The whole event played out something like a scene from one of those old myths. Three times the administrator sent a messenger to Mr. S bearing the same question, and three times Mr. S would not be provoked to answer, and at last the administrator slunk away into the darkness defeated, only to begin the ritual again the next day.
There is something a little scary about a system in which this sort of behavior makes sense. |
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