I will include a letter I wrote to my manager this morning because it describes the incident in full. Then I will go on and explain myself further. Here is the letter (with names changed to just initials):
Here is the letter. I was going to give you a point-by-point bulleting of what was said and what happened. But the truth of the matter is that I cannot leave out my personal feelings. This whole incident was about personal feelings and dehumanizing a patient. The way I felt and the emotions that were experienced need to be addressed as much as the words that were said. Quite honestly, this incident changed who I am as a person. It had a very powerful effect on me. Here is the letter:
I'm very sad to have to write this to you today. I was an unfortunate witness to some very inhumane and unprofessional treatment of a human being today. The behavior displayed by the anesthesiologist, Dr. D, was enough to make me sick to my stomach. I will start by saying that I don't think anything I say here today can be truly properly conveyed. It isn't just about the words, but about the tone, mannerisms, volume, inflections, attitude and body language which I cannot portray in a letter.
N.S.had a patient transfer to our facility this morning. This young 20-year-old woman came in because she was in labor and her baby was in a breech position. She needed a c-section. She arrived and preparations were made. Dr. D was the anesthesiologist on duty. When Dr. D arrived on the unit, she appeared very upset and was speaking very loudly. She was demanding with the staff, saying things like, "Get me the c-section paperwork!" There was no kindness and never a "please" was heard.
Once in the O.R., her behavior got grossly worse. As the patient was sitting on the edge of the table, Dr. D was speaking in the rudest manner. She was speaking in a very loud voice and quite frankly, she sounded like a mean army drill sergeant. She never once asked the patient anything, she only demanded. She would shout orders at this scared, young woman, saying things like, "Move forward more! Stick your back out towards me! No, that's not enough!" And then I witnessed her physically put her hand on the patient and shove her into the position she wanted her in, which obviously caused the patient discomfort as evidenced by the reaction on her face. The patient was scared, in pain, and crying as she repeatedly said in a sad voice, "I'm trying. I'm really trying."
At one point, the patient, through tears, said, "I don't think I can take anymore trauma." And to that Dr. D rudely said, "This isn't TRAUMA! This is what EVERY person goes through who has a c-section! You're just experiencing what everyone else does. You're fine. Just do your deep breathing! Remember to breathe so your baby gets the most oxygen!" It was obvious that she was scaring the patient further. Again, she was shouting these orders to the patient and was being very, very curt and abrupt. While she was saying this, she was applying a nasal cannula to the patient and jerked the cannula in place, causing the patient to jump. I saw that most of her hand movements were abrupt and rough.
At one point while she was attempting to put in the spinal, the patient was startled and she jerked. Dr. D was very condescending to the patient and asked her, "Are you sixteen years old? Are you sixteen?" And the patient quietly said, "No, I'm 20." And then Dr. D said, "You're NOT sixteen! You're 20. You can handle this."
When the curtain was put up, I asked if it was okay to bring the woman's husband in. The poor patient had tears streaming down her face and said, "Yes. Please." Dr. D then curtly said, "NO! Not until after the test is done! And there will only be ONE person in this O.R.!" Once it was confirmed that she was indeed numb, she simply looked at me, flicked her head, pointed her finger toward the door and said, "Now!" That was my cue that it was okay to bring in the husband.
I was shooting looks back and forth to the circulating nurse, T. I could tell she was just as angry and appalled as I was. When I walked out of the O.R. and out to the nurses station, the staff could see on my face that I was upset. I was shaking and almost hyperventilating and trying hard not fall apart in front of everyone. Later on, T and I went into a private room to debrief and I broke down and cried. I was in shock. It was inconceivable to me that in 2008, I had witnessed such horrific treatment by a physician. Neither of us could believe what we had just seen and heard. It was heart-wrenching to see this young woman dehumanized by someone who is supposed to have the patient's well-being at the forefront of her practice. Her behavior was not at all in line with the way that the nursing staff in the birth center treats their patients; nor was it in line with any of the four Franciscan values of reverence, integrity, compassion and excellence. I was embarrassed to be in her presence.
I've worked in health care for 18 years, 10 of those as a registered nurse. I've seen my fair share of negative situations and rude behavior but nothing compares to what I was unfortunate enough to witness this morning. I would appreciate receiving some confirmation that Dr. D has been spoken to regarding this incident. I will not work alongside a person who dehumanizes another human being and displays such callous disregard for the human spirit.
It is known that women remember their birth experiences for the rest of their lives. I hope and pray that when this patient looks back at her birth experience, which occurred in a very different manner than she had planned, that she will be able to remember the beauty and joy of her miracle and that she will be able to overlook the disgusting behavior displayed by one in the operating room.
I’d like to expand on the above thoughts a bit here.
While I was standing in the operating room this morning, I listened and observed. Unfortunately, that’s all I did. I was appalled and sickened, and yet I did nothing to stop the behavior. I stood back and held my tongue, trapped in the belief that it was best not to “create waves”. After the whole incident was over, the other nurse and I had a talk about what had happened. We both agreed that we were shocked that nobody, including ourselves, called that doctor out and made her answer, right then and there for her behaviors. Ever since then, I have been thinking about this and it’s been weighing quite heavily on my mind.
How does this happen? How is it that a whole room full of people can stand idly by and watch a young woman become dehumanized by someone else in the room? How is it that physicians have somehow been put on pedestals in society? What makes them “better” than anyone else? Why are nurses so afraid to speak up against doctors? I can guarantee that if it had been an O.R. technician who was speaking to the patient that way, every nurse in the room would have said something. But somehow, we think we are immune to speaking up to doctors. At the time that the incident was occurring, standing back and remaining quiet seemed like an okay thing to do. However, looking back on it in hindsight, I am ridiculously ashamed that I allowed myself to be bullied and that I gave up the courage to stand up for another human being.
Standing up for someone is a gamble. If you get lucky, the others around you might step in and join forces with you. But if you aren’t lucky, you’ll be left alone, open and vulnerable if no one else agrees with you or if they aren’t willing to stand up and take a stand. But how is it that we place so much importance on that… more importance than standing up for a human being who is being victimized?
As I write this I am reminded of a talk that Elder Joseph B. Wirthlin of the Quorum of the Twelve Apostles gave at this month’s General Conference. His talk was titled Concern For the One. He related the following story from his own childhood:
I remember when I was young, there was an older boy who was physically and mentally disabled. He had a speech impediment and walked with difficulty. The boys used to make fun of him. They teased and taunted him until sometimes he would cry.
I can still hear his voice: “You’re not kind to me,” he said. And still they would ridicule him, push him, and make jokes about him.
One day I could bear it no longer. Although I was only seven years old, the Lord gave me the courage to stand up to my friends.
“Don’t touch him,” I said to them. “Stop teasing him. Be kind. He is a child of God!”
My friends stepped back and turned away.
I wondered at the time if my boldness would jeopardize my relationship with them. But the opposite happened. From that day onward, my friends and I became closer. They showed increased compassion for the boy. They became better human beings. To my knowledge, they never taunted him again.
I think this is an amazing story because I believe it illustrates the way we should be acting at all times.
If we are not willing to stand up to those who abuse position and power in the small ways, how are we to stand up to the Goliaths? We must practice standing tall in small ways. The bigger ways come with time.
I am also reminded of an experience I had while walking through the Trader Joe's a couple of years ago. The boys were very small, probably 3 and 4 years old. They were being their normal, rowdy, toddler selves and I was getting impatient with them, having to peel them off the shelves every few minutes. My voice was getting louder and more impatient. Without any warning, a woman looked at me and smiled. She was probably in her 60s. She touched my arm and said, "Just love 'em honey. Just love 'em. I lost my little girl when she was very small and I'd give anything to have her back. Just love 'em." Oh my... my heart stung, but I was so grateful for that experience, even in the moment. It took no small amount of bravery for her to walk up to a complete stranger and call me out on my behavior. How was she to know how I would react? How was she to know that I wouldn't lash out at her? She didn't. I'd like to think she was led by the Spirit to speak to me. And I was corrected and humbled and doused myself in patience that day.
My heart aches for the experience that the young mother went through this morning. But I will take that experience and learn from it and hopefully improve my life accordingly.