Wednesday, October 12, 2005


I'm returned from a long vacation, much enjoyed, and, to my mind, much deserved. And so I resume my trumpeting into this great silence-with-promise.

Being away from this place, in a place where there were no great demands on my time, only reinforced the madness of my daily life as a surgical resident. Why is it that this job seems to feel it appropriate to maintain a tradition of indentured servitude? How is it that one of the most modern, advanced professions in the world still holds to the feudal premise of serfdom. The truth, I think, is pathetically pecuniary: this is the way that attending doctors insure a high income...if there were enough residents to make a resident's life easy, or even reasonable, there would be too many doctors. This is changing, slowly, as mid-level practioners -- nurse practioners and physician assistants -- who can write prescriptions and handle basic problems, but won't threaten to dilute the patient base, are made more common. Now that we are, in principle (though very rarely in fact) limited to 80 hours per week of work, these folks are much more common. But only enough to keep us right at, or over, the line.

Welcome back.