Dr. Slapstick

I mentioned one of the CT surgeons at my hospital in past posts. I thought I would elaborate.

Now, CT surgeons by breed tend to be a little "off" in my experience. Whether they suffer from grandiose delusions or are just odd little men, the sheer amount of schooling/residency/fellowship required to become a competent CT surgeon tends to emphasize a certain margin of the population.

Dr. Slapstick is no exception. He truly is a strange little man.

He creeps out some of the female nurses because of his over-friendly manner. Among the chosen few is my fellow friend intern, Ash. She's managed to attract his attention, and he's so slimy about it he makes both of our skin crawl when he's around her. It's not hard to decipher his intentions.

He's on his 3rd wife, and she truly is a trophy wife this time around by all intents and purposes. She is much younger than him, is legendary for her "good" looks, and apparently previously made her living at various fine gentlemen's establishments.

Not that there's anything wrong with that...

Did I mention he's the medical director for our unit?

But that's not the real issue, however scandalous it may be.

I call him Dr. Slapstick because of his technique. And I don't mean the way he woos the ladies. His surgical technique. CT surgery is a sport to him. Each case is a race to him--I've seen him finish a CABG in under an hour. While that does wonders for productivity, it leaves much to be desired in patient outcomes.

Dr. Slapstick's post op orders regularly include keeping the patient's MAP between 50 and 60 mmHg. He claims this is to protect the new grafts, but it is common knowledge that it's actually to prevent his slapstick grafts from bleeding. He is adamant about the pressure, and will often watch his previous case in the ICU on the monitor while he's working on his second or third case in the OR. If your pressure begins to even think about straying north of 60, we'll get a phone call from him, from the OR suite. For the uninitiated, a MAP of at least 65 mmHg is required to adequately perfume the kidneys, in a healthy patient.

Remember the patient that tamponaded and coded that I mentioned in my last post?

A Dr. Slapstick patient.

Ash (her patient) and I couldn't figure out why nobody would call a spade a spade and actually label it tamponade. It was textbook as it comes--agitation, brief spike in BP, then falling BP, narrowing pulse pressures in the art line, dampened art line wave form, PAD and CVP equalized. Not to mention when Ash manipulated the mediastinal chest tubes, they were clotted and then dumped 300 mls. But nobody was willing to chart that the patient had tamponaded, let alone was bleeding. After asking our educator what we were missing, she let us know that Dr. Slapstick was being looked into by the board. Apparently he has one of the highest return-to-OR rates in the country...

Not sure how I feel about my coworkers trying to cover for him...