Matt McCarthy: The Real Doctor Will See You Shortly
Selected Excerpts
“Carl Gladstone was on a blood thinner for a clot in his leg. When he fell and hit his head in his classroom,” Sothscott continued, barely able to contain himself, “he started bleeding in his brain.”
I closed my eyes.
“And I know you know he fell because you documented the abrasion on his scalp.”
“Oh...no,” I said softly and turned away from Baio.
“Oh, yes. And when you saw him, Dr. McCarthy, the blood was flooding his brain and starting to impinge on his cranial nerves.”
I couldn’t breathe.
“Yet your note does not reflect that. Your note is completely misleading. And it does a shocking disservice to—”
“I…”
“How much time was wasted?” he demanded.
“I am so sorry.” I wanted to hide. I wanted to disappear. I wanted to run, but there was nowhere to go. I was terrified to think of what I had done to Carl Gladstone. It had been more than a day since the Badass had said to scan his head. Was he bleeding the whole time until he reached Sothscott? That kind of time could have killed him. My knees buckled and I crouched toward the tiled floor, gasping for air as my eyes welled up.” (pg. 46-47)
Discussion Questions
A patient tells Dr McCarthy that he seems like he’s always in a rush. Do you find yourself identifying more with the patient or doctor in this scene? If you were Dr McCarthy, how would process this feedback?
Dr McCarthy didn’t recognize that a patient had a brain bleed. His supervising doctors intensely criticize him. How do you cope with making mistakes? How might the other doctors have responded differently to Dr McCarthy’s mistake?
Reflections from #MedHumChat
“I have the luxury of lengthy visits with my patients, and my life runs at a calmer pace now. I notice the rushed trainees much easier than before- the ones that fidget and interject “uh huh” between every word I speak. I wish I could do more for them. This feedback would have crushed me, to be honest. It’s one thing to feel like you’re falling apart internally, but a whole different thing when you realize others can tell too”—@PalliDad
[In response to @PalliDad:] “This is powerful. Showing our vulnerability and weaknesses is a very human -- albeit difficult -- thing to do though. Is there inherent risk in being human and vulnerable with our patients? -- @WillBynumMD
“I identified more with the patient’s perspective, I felt like t echoed my experience as a Med student. Often the team is so busy and the work is so much that you feel very much lost in that shuffle of papers, lists, and discharge summaries. The residents and attendings who prioritized their time with patients and worked tirelessly to make that the focus of their day instead of getting swept away by task lists were my best teachers and definitely what I hope to try to model next year.”—@CarlySokach
“Intern year, my senior destroyed me during morning sign outs., just laid into me for not knowing something about a patient...I wanted to do all those things in the quote, but instead, I apologized, finished sign outs and cried in my car all the way home… I'll never forget how I felt that day, it's a memory so livid I can feel it now while typing this...looking back on it now, it's amazing how a power difference can allow you to feel so much less than how truly amazing you are for doing the work you do.”—@ndyG83
“I think most trainees initial response is shame and embarrassment. In my intern year, I didn't want to learn from those mistakes, but pretended they didn't happen(like in this story). It took teaching/modeling from great attendings to be okay admitting failures.”—@Ndouthit
About this #MedHumChat
The Real Doctor Will See You Shortly was paired with Singular Intimacies, a book by Dr. Danielle Ofri for a #MedHumChat discussion May 15, 2019 exploring the Internship Experience.
We were honored to be joined by special guests Dr. Matt McCarthy, MD (@DrMattMcCarthy) and Dr. William Bynum, MD (@WillBynumMD) for this #MedHumChat. Dr. Bynum is an associate program director of the Duke Family Medicine Residency Program with a research focus on how medical learners and providers experience the emotion of shame.
The pieces for this chat, along with the discussion questions, were selected by Colleen Farrell.
About the Author
Dr. Mat McCarthy, MD (@DrMattMcCarthy) is an author of two national bestsellers, Assistant Professor of Medicine at Weill Cornell, and staff physician at New York-Presbyterian Hospital, where he serves on the ethics committee. You can learn more about him here.