BehindTheMedspeak: The anesthesia resident who got down on his knees to pray with his patient

Once upon a time, in an academic anesthesia program far, far away in both time and space where I happened to be a junior faculty member, a sparkling fresh class of incoming residents arrived on July 1 to begin their training.

It was the early 80s in Los Angeles at UCLA Medical Center.

Among the new residents was a really nice red-haired freckle-faced guy whose name I remember but will omit here. 

The intense close mentoring that happens in July in anesthesia residencies — as a rule, one faculty member is assigned to two anesthesia residents for a two week period in the same OR every day, so as to be able to deliver a consistent message and get a feel for the strengths and weaknesses of the newbies — happened, and we moved on to August, when the new residents are gradually worked into the rotation of cases and work with all the members of the teaching faculty.

In July, I tended to go to visit patients preoperatively with my new residents, pretty much just sitting quietly while they did their preop workup and then chatting with them at the nursing station about what things mattered and what didn't in terms of our job: in brief, bringing the patient to the recovery room no worse off than when they entered the OR.

Anesthesiology's a peculiar specialty in that respect: No one expects you to make the patient better — as long as you keep someone in the condition you encounter them in, you're doing your job the way it's supposed to be done.

But I digress.

Come August, the new residents go to to see their preoperative inpatients on their own just like the more experienced ones.

One day, getting organized in the anesthesia prep area along with all the other faculty and residents, someone mentioned that the cheerful red-haired resident had been fired the previous day.

That got our attention.

Long story short: After the resident had performed his pre-op history and physical, the patient, apprehensive and lonely and scared as people tend to be the night before a major surgical procedure, asked the resident if he would pray with him for a good outcome.

The resident said yes, he would, then apparently got down on his knees at the hospital bedside and proceeded to do so.

Remember, this is all hearsay AND it happened 30 or so years ago, so the fine details may not be literally correct, but the gist of the story is true: our chairman called a meeting after that day's cases were over for all residents and faculty and explained what had happened and told us he felt that the resident had behaved outside the boundaries of appropriate physician behavior and that such action could not be considered acceptable in our department.

At the time, I remember thinking a lot of things: First, how weird the whole thing was; second, how it was a shame that that particular guy was the one because he was a nice person and a good resident; finally, that I totally agreed that doing something like praying with a patient at UCLA Medical Center was inappropriate and probably merited dismissal.

Now I'm not so sure.

Anyhow, the story has a nice ending: a couple years later someone brought up the resident's name while we were sitting around talking, and someone said he'd ended up going across town to the University of Southern California School of Medicine's Department of Anesthesiology — which was having all manner of problems, with its chairman under investigation for stealing money and residents fleeing like rats off a sinking ship — which happily took him on, seeing as his negatives were a whole lot less than those of the general run of their residents at the time.

He excelled there and became chief resident in his final year.

I hope he went on to have a fine and fulfilling career and life.

What do you think?

Should we have fired him?

How about today?

You make the call.