Thursday, December 30, 2010

Medicine: Very Superstitious

You always hear about athletes and their superstitions.  Doesn't matter what sport, there's someone in that sport who has superstitions.  I remember when I used to play goaltender in hockey I had my own superstitions.  When I got suited up - league game, pick-up game - it was the same routine: down then up, left then right.  Cup, shorts, left knee pad then right.  Stockings.  Left skate then right; tied the left then the right.  Left goalie pad then right.  Chest protector then neck protector.  Jersey.  Helmet.  Left glove (blocker) and right glove.  Goalstick.  Ready to go!  As I idolized Patrick Roy, so did I imitate him: the head jostles and talking to the goal posts.  Why?  Well, why not?  It seemed perfectly reasonable at the time.  Saint Patrick did it!

I never really paid attention to it, but I'm superstitious as a physician.  I think we all are ... to some degree.  I first realized this idea of superstition in medicine from a Scrubs episode: Dr. Cox had 27 patients in the ICU and hoped for a perfect game where no one died on his watch.  (To those who don't follow baseball, the perfect game in baseball is 27 straight outs without giving up a hit or walk.)  Dr. Cox gave a speech and walked away.  Eliot calls out to him and she's quickly hushed by the rest of the staff.  They basically tell her the following: You never talk to a pitcher when he's on a roll. 

Nowadays, superstition doesn't influence how I get dressed.  As long as my fly is zipped and no toilet paper's stuck to me, then it's a victory for me.  I don't have daily superstitions, like I did when I played hockey.  With hockey, you always dressed the same way, approached the net the same way.  None of that as a physician.  I certainly don't approach the hospital the same way, mostly due to Atlanta's el nino type traffic patterns.  But what I have noticed is that I'm situationally superstitious.  Example: How many times have you been doing something, in a certain spot and in a certain situation, and realize how long you haven't been interrupted (or in the case of doctors, paged)?  And how many times have you remained in that certain spot and certain situation hoping the trend continues?  I'm guessing I'm not the only one guilty of this.  

Or how about this, specifically to the doctors out there: Anyone seem to notice that your probability of getting paged seems to quadruple when you use the bathroom?  I don't quite understand this phenomenon.  (One of my nurse friends tells me this phenomenon happens to them too.)  So yes, you can imagine what I've done.  If not using the bathroom has correlated with a long period without pages or admissions, then I will gladly hold my urine until nearly incontinent.  Why?  As simple as superstition.  

One of the most unusual rituals I performed was during intern year on my first month of overnight call at Grady Memorial Hospital.  I remember on my first night trying to get rest in one of the 14th floor call rooms.  What transpired was a night of numerous codes (cardiopulmonary arrests).  I can't sleep in there again, I thought.  On my next overnight call, I went to one of the floor work areas, found three chairs of roughly the same height - one for the head, one for the butt, and one for the feet - and slept.  What ensued was a night of uninterrupted sleep.  Mind you, two hours of uninterrupted sleep in a hospital is considered a good night.  You can imagine how I approached each call that month.  And, at least, from what I can vaguely recall, the pattern held.  

How amusing that even medical minds, who tend to ground their practice on science and evidence-based practice, still resort to ritualistic behaviors.  Or maybe it's just me.  But I doubt it.  It might just be that superstitions are, at their core, coping mechanisms.  That being said, I still avoid using bathrooms in hospitals.  Too many interruptions.

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