The Mentor
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last month of my Internal Medicine residency was a T hememorable one, thanks to Mr. Perini . He had had an 1
anterior myocardial infarction complicated by malignant arrythmias, and in the days before electrophysiology mapping and cardiac ablation, stopping them had proved impossible. Without a continuous lidocaine infusion, Mr. Perini rapidly developed ventricular fibrillation and cardiac arrest. We were at a loss. The day the new interns arrived, my attending, Dr. Benedict, called me aside. “I’ll be out of town for a few days, but Dr. Furstmann has agreed to cover for me. You know, he’s an authority on arrhythmias. Maybe he can help us figure out what to do for Mr. Perini”. My heart sank. Karl O. Furstmann, MD, DPhil(Ox), MACP, AAP, FACC, FAHA was the most feared attending physician at University Hospital. Not only was he demanding and abusive, but he was possessed of an arrogant conviction that he was always right, and reputedly used his powerful political influence to punish those who dared to suggest that he was not. I had managed to avoid him throughout my entire residency—until now. The sound of angry shouting greeted me as I arrived on the ward the next morning. “Did you not go to medical school? Are you totally ignorant about how to manage ventricular arrhythmias? You obviously are, or you would never have let this happen!” Dr. Furstmann stood ranting outside Mr. Perini’s room, my intern cowering before him in tears, while inside, the code team was furiously trying to resuscitate Mr. Perini and replace his occluded central line. I rushed forward to defend my intern, explaining that maintaining IV access had been a recurring problem, but Dr. Furstmann cut me short. “Are you in control of this ward or not? This patient could have died! I was told that you were a good resident, but instead I’m afraid you’re a big disappointment.” A wave of righteous anger welled up in my gut, not so much from his impugning my clinical skills but from his unjustified, vicious attack on my inexperienced intern. “Well,” Furstmann demanded impatiently. “What do you have to say for yourself?” 1 The identities of the patient and physicians in this story have been changed. Resemblance to any individuals, living or deceased, is coincidental.
Published online August 6, 2013
The wave crested. In dealing with the Gods, the Greek myths warn how such moments can seal one’s fate. “Dr. Furstmann, I was told you were an expert who could help us. But instead, with no idea of what’s been going on, you just show up and yell at my intern for something that’s not her fault. Dr. Furstmann, you’re a big disappointment, too.” Furstmann worked his jaw, but no words came out of his mouth. I turned away to attend to Mr. Perini and console my intern. That evening, Furstmann left a long note in the chart, but he did not appear for rounds the next day. Dr. Benedict returned, and the whole unpleasant episode was soon behind us—or so I thought. I moved on to my fellowship, and 3 years later, I was made an Instructor with the promise that if I continued to
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