< meta name="DC.Date.Valid.End" content="20050825"> Amendment Nine: You don't understand Frist

Friday, May 20, 2005

You don't understand Frist

. . . unless you understand that he is a surgeon--first and always. And you don't understand surgery unless you understand that it is a carefully scripted drama, where the single actor is also the stage director and all other players are just that--players. (Not for nothing is the operating room called a "theatre" in most of the English speaking world outside the USA.) Nor do you understand surgery unless you understand that it presumes certainty at the outset--"there is a lesion or other anomaly, it must be excised or corrected, I will do it, and everybody else will assist me at my direction." And finally, you do not understand surgeons unless you understand what they will not admit but what is universally true--they carry a lifelong sense of entitlement, really a "right," to be overpaid and overly deferred to. That sense of entitlement is a direct result of medical and residency training practices that first of all inflict intense overwork (80 hours a week for four or five years is the current limit for residents--a limit that is bitterly opposed by most senior attending physicians and hospital administrators who complain that it deprives them of the cheap labor they need to make their own practices and institutions economically viable). But this overwork is accompanied by equal doses of a "pay day someday" promise of good times coming in their later practice--when fees will be high and community adulation will be profuse. More later on how to confront, resist, and defeat a surgeon who thinks he performing surgery on the body politic. (Hint: hit him where it hurts--at his sense of entitlement to respect for honesty and competence.)