The Virginia Board of Medicine committee members must not have a sense of humor. How else to explain the $1,500 fine they levied against orthopedic surgeon Benjamin Allen, MD, for stapling a surgical nurse's forearm while playing around in an OR at Culpeper (Va.) Regional Hospital?

In board documents, Dr. Allen says he only meant to tack the sleeve of the nurse's scrub jacket while testing a malfunctioning staple gun. Surgical staffers who saw the incident, however, describe Dr. Allen's actions as part of a "joke."

That incident was one of many that caught the ire of the state department of health.

At a gathering of hospital surgical leaders, Dr. Allen once berated several podiatrists, telling them to "leave surgery to the real doctors." The self-described practical joker also told the surgical staff to schedule a fake revision surgery for a knee replacement patient 2 days after the original procedure. Problem was, the staff (who prepared the OR for surgery), the patient (who was upset about being placed on the OR table for a second time) and another surgeon (who couldn't get into the room to perform an actual surgery) weren't in on the joke.

During one of his not-so-funny moments, Dr. Allen got into a shouting match with an anesthesiologist in front of a conscious patient waiting for hip surgery. Other staffers had to separate the two. The patient waiting for surgery experienced a hypotensive event during anesthesia induction and had her procedure cancelled.

The anesthesiologist who refused to work with Dr. Allen after the argument reportedly spoke in his defense at the health department hearing, stating many factors contributed to the dispute. He called Dr. Allen an "exemplary figure" in his leadership roles at the hospital and a "great surgeon" that his patients love.

Leadership at Culpeper Regional have monitored Dr. Allen's behavior for the past 2 years, subjecting him to a zero-tolerance policy and requiring he attend an anger management course at the University of Virginia. H. Lee Kirk Jr., president and CEO of Culpeper Regional, says Dr. Allen's professional conduct and decorum have improved, and he's been incident-free for the past 6 months.

Dr. Allen told the board he's sorry for his previous behavior and embarrassed by it. He pledges to be mindful of his actions and what he says, and is now more aware that he's part of a team.

He didn't immediately respond to a request for comment, but did issue a statement: "This has been a humbling journey for me. Today, I'm even more committed to providing excellent orthopedic care with extreme compassion for my patients at all times and in all places."

He hopes his road to apparent redemption helps others understand that surgeons are human. "Perhaps we don't always put our best foot forward when working with staff members in stressful situations; however, we, doctors, can learn the impact this has on others and improve our methods of interpersonal communications to improve our healthcare system overall."

Daniel Cook