Let’s taken it as a given that doctors are superstitious (don’t believe me? read Superstitious Doctors, Part I–then try this: ask your doctor if she has a white cloud or a black cloud and see what happens).
Well, first, the questions has to be asked–is there any basis in fact to these weird superstitious beliefs? No, seriously, is there?
Who knows? But here’s the kicker about the black cloud/white cloud superstition. Sometimes, the label is deserved. Saying someone has a black cloud can mean that this is a provider who can’t make decisions, someone who dithers, and delays until the entire emergency room is packed with bodies like cords of wood stacked against the walls. Their “luck” is actually self-fulfilling prophesy. In that situation, it is inevitable that at least one patient (or more) lying there for hours is going to go “down the tubes” as we in healthcare like to tactfully say. If you were a nurse, you would be filled with dread when you saw that doctor’s name on your schedule.
And sometimes the label is deserved, but for a different reason. If a doctor is the mensh who will always work the predictably bad days that no one else wants to work—the day after Christmas, New Year’s Eve, the Tuesday after Labor Day–then sure, it’s going to look like he has bad luck.
But, after years of watching these labels applied, and the behaviors that prompt them, I have another theory. Sometimes you actually want your doctor to be a black cloud doctor. A dermatologist who insists on examining every molecule of skin is going to get some nasty letters about “productivity” from a review board—but that’s exactly who you want to be examining you if you’ve already had one horrible skin cancer removed.
Obsessions and weird behaviors exist in our species for a reason. Sometimes they’re a good thing. I, for one, want my physician to have a little bit of obsessive-compulsive disorder. Neurotic hand-washing, a desire to control (to the point of irrationality), and a belief in rituals—well, sign me up for that surgeon. And if some of those traits spill over into a need to wear the same socks on call, fine by me.
Similarly, the black cloud doctor can be a good thing for everyone, despite all the groaning that it produces among staff. Look at it this way: Doctor A goes to see a homeless patient. The patient grunts, “Lice.” Doctor A hands out a bottle of lice medicine and whips off to the next patient, thereby exceeding his physician productivity requirements for the day. He churns through patients in the emergency room and everyone is happy.
Same situation, but this time a Doctor B goes to see the same patient. After twenty long, slow minutes, she comes out of the room into a packed waiting area and asks the nurse (in a tense whisper) to call the police, now. Turns out Doctor B, the black cloud doctor, found out that the homeless guy thinks he has lice because demons are biting him, and they do it at night, ever since someone cancelled his disability checks. On further questioning, turns out the guy wants the lice medicine, sure, but he knows in his heart the only real cure (and true sleep) is going to come after he uses the gun in his backpack. He’s heading down to at the government building, just as soon as someone gives him a bottle of lice medicine.
Too often, black cloud doctors are the ones who are calling ambulances and tackling disasters because they are the ones foolish enough to dig deeper. Sure, it’s never boring when they’re at work, but the people who work with them might start to think it’s bad luck getting assigned to the same shift that day.
What about those other superstitions, like the sitting in the call room, doing nothing? Here’s what I think. Like a lot of human oddities, maybe it started with a grain of truth. I wonder: if you’re getting a call about a patient and something great is on television, aren’t you more likely to be distracted? If you’re distracted and you don’t deal with things right as they come up, isn’t it more likely that your shift is going to spin out of control?
Maybe, if you’re the patient, having a doc who stares at the wall for hours may not be so much a sign of lunacy as you first thought.
So what’s a patient to do? Well, stay away from the emergency room (if you can) when it’s a full-moon Saturday night. Don’t always assume the worst if you see a nurse roll her eyes and huff about your doctor having a black cloud. And, for heaven’s sake, never say out loud, “Wow, it sure is quiet today, isn’t it?”