Learning About Surgeons From A Narcissistic Cat

   One of my most valuable fixed assets is my old cat Bob. He is actually my son’s cat. My son asked if we would watch Bob while he explored the world for a few months. That was nine years ago. Bob is a narcissist. He has all of the narcissistic personality traits. He is exploitative, grandiose, preoccupied with success, feels unique, feels entitled, seeks admiration, lacks empathy, is envious and is hypersensitive to criticism.    Bob’s behavior is often disruptive to the rest of the family pets, which have all run away at this point. There is not a thing we can do with him and my son refuses to take him back.    So why is this narcissistic cat, full of malignant self-love, such a valuable asset? I was recently appointed Chief of Surgery at our hospital and a few of the surgeons are just like Bob. Living with Bob over the past nine years has given me priceless insight in dealing with several narcissistic surgeons who behave in a disruptive manner and create chaos in the surgical service. This experience would have been a total shock if it had not been for my nasty old cat.    Bob occasionally sprays the walls to mark his territory. The surgeons mark their territory by hogging block time on the OR schedule.    Bob is merciless to creatures whom he perceives as inferior. The surgeons treat the nurses and techs like dirt and feel it is their right to do so.    Bob cannot accept correction or criticism. The surgeons fit this bill as well.    Bob is preoccupied with success and litters our doorstep with dismantled rodents. The surgeons drive sports cars and upscale SUVs.    Bob totally lacks empathy for other living creatures. Some of the surgeons are also insensitive to the problems and suffering of others.    Bob needs to be the center of attention in any group while he is ignoring everybody. The same is true for some of my surgeons.    I have given up on Bob. He is what he is. I have to keep working on the surgeons, though. When a surgeon has alienated all of the people he or she works with and all of the patients, the surgeon creates a dangerous situation for him- or herself. The surgeon won’t get away with any mistakes, complications or poor outcomes. The rest of the staff and the patients will pounce on him or her and have no mercy.    It is my job to try to change the narcissistic behavior of my surgical colleagues before they self destruct. The problem is there is no cure.    Narcissism is considered a personality disorder for which there is no treatment. Those who have it tend to be bright and competitive. It is not surprising that quite a few physicians suffer from the disorder. Actually, it is their patients, colleagues, co-workers and families who suffer the most.    I deal with these doctors by letting them know the problems they are creating and giving them a few insightful books to read. One is Complications, a Surgeon’s Notes on an Imperfect Science by Atul Gawande. Another helpful book is The Resilient Physician by Wayne M. Sotile and Mary O. Sotile.    Books will not cure the problem but some knowledge will lead to introspection on the part of the physician. Knowing the consequences of disruptive behavior gives the physician an incentive to work on the problem.    When the problem is severe and suspension of privileges is a possibility, I refer the doctor to our state physician’s health program for assessment and counseling.    The reward for me when things go well is a salvaged career and preservation of a valuable resource for the hospital. Things did not go well with a physician several years ago. He left medicine to go to law school. I wish him well and hope he settles in another state when he opens his malpractice mill.    When Bob’s behavior became intolerable, we took him to a veterinarian to be declawed and fixed. That would not be a viable option for narcissistic surgeons, although the thought has crossed my mind.    Bob is still ornery as hell and has all the narcissistic personality traits but he doesn’t spray the walls anymore and he doesn’t rip apart the furniture. I appreciate him for the preparation he has provided me for the job as Chief of Surgery. When he screws up, I lock him in a small room with a litter box, water and some dry cat food. The hospital won’t let me do that with the surgeons.    For what it is worth, the podiatric surgeons on our staff are never any trouble. Dr. McCord is a Diplomate with the American Board of Podiatric Surgery. He practices at the Centralia Medical Center in Centralia, Wash.