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    Thursday, April 18, 2024

    Pride doesn't really belong in medicine

    A few years ago, I overheard a conversation a man was having as he was trash-talking his doctor. It wasn’t long before I realized that the doctor he was trash-talking was me. Of course, I eavesdropped a little closer as he said:

    “When the nurse asked my doctor a question, my doctor said, outright, ‘I do not know.’ I mean, what kind of doctor says, ‘I don’t know’ to a nurse? If he doesn’t know, he shouldn’t be a doctor. Not my doctor, anyways.” I never saw the guy again.

    My father, who to this day is still a practicing physician and remains the best doctor I have ever met, told me, after I had completed my three-year fellowship, three-year residency, chief residency, four years of medical school, and four years of college, that the most important thing I learned after all that training was how to say “I don’t know” with confidence.

    When I was a junior in college, I lived in Florence, Italy, and I remember going to a restaurant and ordering spaghetti alle vongole (spaghetti with and clams). I asked the waiter for some parmigiano cheese. He looked horrified — angry even — and said, “No!” His finger was waving in the air, a sign of something forbidden in his Italian hand-speak.

    I said, in Italian, “What do you mean, ‘No’?”

    “With fish, you never put cheese.”

    I insisted, and he again said, finger in the air, “NO!,” adamant. I got angry and insisted and said I was paying the bill, not him, and that I wanted cheese. He muttered that I was troglodito (I didn’t even know what the word meant when someone translated it into English — a “troglodyte” is an uncultured person).

    After one bite of the spaghetti with clams and parmigiano, I realized instantly that the waiter was absolutely right. The cheese completely ruined the wonderful flavor, texture and aroma of the dish. I wish I could say I had the courage to admit to the waiter that he was right, but in my pride, I pretended to love the cheese and practically licked the plate clean.

    Pride is a funny thing that doesn’t really belong in medicine. But when you formulate ideas, you tend to become proud and want to argue for them. I remember being a brand-new cardiologist in New London, perhaps overly cocky. I remember calling a (rather famous) cardiac surgeon about someone with a dilated aorta who I believed needed surgery. The surgeon didn’t think surgery was needed. I insisted surgery was indicated, and I smugly started quoting data from a medical journal article I had just read on the subject. The surgeon listened quietly, then gently said, “Well, that’s interesting because I wrote that article and, unless there is a typographical error, I think you are misquoting the data, because I have the actual data right here in front of me now ...”

    I have worked with that surgeon since that day, and I occasionally bring it up, laughing. He has been nothing but humble, gracious, and kind with his time and even with his mentorship to this very day.

    Pride seems to dominate some politicians who tend to avoid ever admitting that they are wrong or that they do not know something. These are questionable strategies given the uncertainties of a pandemic. Or when the rest of the country wants to (finally) unify to demonstrate against racial violence and injustice. So far, it doesn’t seem to be going well for them.

    Ah, but I’m no politician. I still like things like tuna melt, which I suppose makes me a troglodyte, I often make mistakes, and there’s still a heck of a lot I don’t know.

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