We've got a medical student rotating on service with us, and I have grown to hate him.
Now, I don't dislike very many people. In fact, I would argue that I'm a pretty friendly guy all around. But this one, he has pushed all of my buttons.
I'm on Surgical/Trauma ICU this month, and as an emergency resident, I don't have quite the pull that the surgical residents do. Chest tubes, intubations, and other procedures somehow seem to fall in their laps a bit more often than in mine. I'm also not expected to know as much - both a relief and insulting at the same time - and my plans for patient care are often ignored on rounds, the attending turning away to flirt with the nurses while I'm talking. This is pretty frustrating, as I'm training at one of the most elite emergency medicine programs in the country, and it took a lot of percentiles to get here.
Medical Student has recognized this power dichotomy, and as such, has shown me his true colors. Unlike the surgeons that he's trying to impress, he doesn't bother to hide from me that he's incompetent, unpleasant, and lazy. He figures I'm not evaluating him at the end of his rotation. He is quite mistaken.
"Honestly, man, I can't say I'm thrilled to see patients this morning."
"You want to teach me about heart failure? Why on earth would I ever want to know about that? I'm going to be a surgeon, not a hospitalist."
"Well, you emergency guys just admit all sorts of crap anyway..."
As such, I have found a vast, previously unknown wellspring of pure malice lurking deep within my person. They say power corrupts. I never really understood until I wasn't at the bottom of the hierarchy.
Now, I don't stoop so low as to scut him out to fetch me coffee (like my surgical residents did to me as a medical student), but I have started to call him on his bullshit. When he bitched about being asked to learn something for rounds, my response turned decidedly nasty this morning.
"Maybe if you already knew it, you wouldn't need to look it up in the first place," I sneered, "but of course, it's not like ventilator management is important for your education, now is it? You're going to be a Surgeon, right? 'Course, you need to actually match into a surgery program first..."
I'm not a mean person, but I must admit I get a perverse sense of pleasure from watching him squirm on rounds. I usually pantomime answers to medical students on rounds to make them look good in front of the attending. Instead, I just smirk when he roasts on the spit under the rapidfire questions.
A big part of this is being immersed in the surgical culture. The same mean streak emerged last year when I was a general surgery intern. Being surrounded by so much poison makes it next to impossible to maintain a good attitude. I simply do not fit in with this culture of harsh, trust-nobody, work until you drop self loathing. But being submerged in it for a month, it takes its toll. It'll be a few weeks before I detox all the Surgeon out of my system and go back to being a fun, good-natured emergency doc.
In the meantime, I'm carefully crafting my end of the month evaluation for Medical Student... the bus, my friend. You're about to be thrown under it.