PROF. MICHAEL E. DEBAKEY’S ROUNDS 1980 AND BEFORE:
Prof. Michael E. DeBakey is nothing short of a legend of Medicine. He was the Head of Department of Surgery at the Baylor College of Medicine, Houston, Texas.
This write up is not meant to write his bio. He already has books written on him. These are just quiet observations of someone who worked at the Houston Methodist Hospital from 1984 to date and saw and worked with the Professor as a non surgeon and for a limited time.
Prof. DeBakey rounded Monday to Friday starting at 4 PM. He carried a patient load of roudndly 100-120 patients at a time. He was very meticulous and expected to know details on each of his patient. The resident responsible for the patients had to be on his/her feet and expected to know progress, labs, vital signs and report to the Professor. Dr. DeBakey expected all the consultants, some Chiefs of their own departments to accompany him on the rounds so that quick decisions could be made. This included the Cardiologist (sometimes more than one) the Internist, the Nephrologist, Infectious Disease Specialist, Pulmonologist and the like. The attrition rate of residents was about 20% either resigning due to stress and could not take it any more or being fired on the spot.
FONDREN ICU RESIDENT: The Cardiovascular ICU was the location for this famed rotation which all CV residents had to undertake and was one test of nerves and patience. Professor likely used this as The Test to see who could survive his training and come out a trained surgeon. First it was straight 3 months ( as related to me by Dr. Phillipe, Urologist) and later it was changed to 60 days done twice. (related to me by Dr. Hazim Safi, CV Surgeon) During this rotation, the resident LIVED in the ICU and was not allowed to leave till the rotation ended. He/she slept in the isolation room ( no attached bathroom, just a sink) and was on call 24/7. His job was to round on each and every patient in the ICU and write notes, and fill out the detailed labs on each patient to present to the Professor during rounds. In the early days there was a RED LINE which could not be crossed by the resident to go out. (more about this later). Actually less residents were fired from this rotation than on the other rotations, likely because by the time they came to this rotation they had already weathered the “storm”.
PROFESSOR DEBAKEY’S RED LINE:
A red line similar to this one once was at the entrance to the Fondren ICU at the Methodist Hospital, Houston, Texas. It represented the line that could not be crossed by the surgical resident doing his three month rotation in the Cardiovascular Intensive Care Unit. Once the resident entered the Unit he stayed there for the next 3 months, sleeping in a room, working, rounding, writing notes, doing procedures, managing ventilators, admitting and discharging patients, accompanying Prof. DeBakey on rounds once or twice or more daily. There was no timing of rounds which could start and end when all the patients had been seen. Resident ate, drank, prayed, showered, shaved and slept when he could in the Unit. He could see his family once in a while through a small window. One thing he could not do till the last day of his rotation is to cross the red line. For if he did, it would mean an end to his surgical residency and his career. He would be dismissed from the Surgical program and from the Hospital. The following true incident was quoted by a surgeon (who is now a urologist) who actually did this rotation in 1960’s.There was a Philipino resident in the group. He had done 10 weeks of the rotation with 2 weeks more to go.He was excited and out of sheer fun he went near the red line and actually crossed it and bragged to the nearby patient liaison secretary that he had only two more weeks to go and then he would be free. Alas, his excitement was not to last long. The secretary promptly picked up the old black dialer phone and called Dr. DeBakey’s secretary and told her what she had noticed. Next morning at rounds, Dr. DeBakey singled out the resident, held him by the nape of his neck, dragged him to the entrance of the ICU and physically kicked him out of the Unit. The resident was expelled from the program. The reader can make his/her own decision regarding this incident. Was it his strict discipline that he himself practiced and he expected from his students for him to take this drastic action? Was it cruelty? Of course in this day and age this type of authoritarian practice would not be possible without inviting a lawsuit for assault. In fact might be criminal. You decide…..
GlobeMedic 