schadenfreude

i have a confession. i've realized something about myself. and perhaps, something about doctors in general. but nevermind everyone else- i should claim this vice as my own. so here it is: i do so love to feel intelligent and, dare i say, superior. oftentimes, however, this feeling comes at the expense of my medical colleagues' ineptitude... unabashed schadenfreude. ok maybe it's not so much deriving joy from others' suffering, but it's the closest word/concept i could think of. anyhoo, let me elaborate...

i first thought about this when i was catching up on some recorded private practice episodes one free afternoon. the poor writers- they mean well, but gosh they get a lot of the medical stuff wrong. i mean, it's a glorified soap opera- am i really expecting clinical realism?! i catch myself thinking about how incompetent addison & her colleagues are... "like, puhleeze, you need to diagnose Crohn's disease with a camera swallow study?! like, hello, you could have just asked the patient if she has diarrhea?! how about checking for some extraintestinal stigmata??!" and for a moment, i sit there, warm in my little pocket of smugness and superiority over TV fake doctors- because let's face it, i'll never be as telegenic as they are. ;)

but it doesn't stop there. it's an unpleasant reality that as we physicans choose specialties, we somewhat inevitably tend to devalue others that we did not choose. perhaps devalue isn't the right word, but there's definitely a reason why i chose my particular field over others. in psychology terms, i guess it's an example of an ego-defensive attitude- we adapt our attitudes to confirm the decisions we have already made, or would make. for example, surgeons can't imagine who would willingly choose the interminable rounds of medicine, medicine docs turn up their noses at the crude butchery of surgery, everyone dumps on the family docs, etc...

so here's how it plays out in real life- when i was on surgery, the surgery team (myself included) would bash the poor UrgiCenter docs (a hodgepodge of family & internal medicine docs & moonlighting fellows) with every "stupid" consult that came in. we'd ruthlessly snicker at the mismanagement of a patient at the hands of the one OBGYN surgeon at the hospital. at the med center, with so many specialties in play, it's a veritable smorgasbord of options for evil delight. pity the ED docs who get slammed by everyone unlucky enough to be called to consult or admit a patient. just last week, my team shook our heads in disbelief at the orthopods and general surgeons who had initially misdiagnosed a substantial leg/knee abscess as a "sterile collection of fluid secondary to pseudogout" on a patient. even amongst our own colleagues, one tends to figure out pretty quickly who knows something and who isn't quite up to snuff... and of course, i know that it's a two-way street. i'm sure i'm providing lots of laughs at my own expense.

i honestly don't know how much of it is medicine in general, or just my attitudes overlying it all. i'm a perfectionist, and i can be pretty darn supercritical of others as well as myself. i guess the sad thing is that i'm figuring out that the criticism is sortof an ego defense... if i can say, "dood, i TOTALLY wouldn't have done that", or "i TOTALLY would have caught that abscess" , or... well, you get it... if i can say that, or think that... i'm momentarily reassured, in my own head, that i'm somewhat competent- or at the very least, more competent than the poor saps i'm skewering. because not only would it be very damaging to my ego to be incompetent- patients' lives potentially hang in the balance. not now, of course- as an intern, i kinda get a free pass with lots of supervision... but in the future. scary.

this neurotic monologue has actually been quite therapeutic, i have to say. ;) here's hoping that i'll take the guilt that has fueled this entry and sublimate it into a more accepting, open, nonjudgmental and less snarky attitude towards.... well, life.