Behind Closed Doors: I'd Rather Go to the DMV

If you’re thinking of getting a Real ID or an enhanced ID when you renew your driver’s license, you’ll want to make your stay at the DMV as pleasant — and as short — as possible. Yeah, right.

Give yourself plenty of time. Like, take a half-day of PTO just to be safe. Pack your patience, a snack and a Trapper Keeper to hold all the documents you’ll need to prove that you are who you say you are: passport, birth certificate, photo work ID, Social Security card, utility bill or phone bill, paycheck stub, W-2 form and the badges from the last 3 surgical conferences you attended.

We’re kidding about the badges, but you get the picture. And if your name isn’t exactly the same on all the pieces of required documentation — if you’ve been divorced and remarried and your name has changed, or if your middle name or initial appears on some but not all of your documents — you’ll need a government-issued document that you probably don’t have as proof of your full legal name.

After standing in line for hours on back-to-back days, I finally got my enhanced license. On my drive home, I made a list of 6 things we sometimes endure in surgery that can make an afternoon (or 2) at the DMV feel like a day at the spa.

• Staff meetings. Sometimes they go on and on about what we’re doing wrong and what we’re going to change. These marathon meetings have a way of shutting down your brain.
• In-services. After weeks of struggling to get the (new and improved?) item to function the way the literature reads, the industry rep excitedly tells us which magic buttons to push. By this point, I’m numb to the fact that it will ever be of use to me.
• Long and winding consents. Ever work with a surgeon who puts every conceivable procedure on the consent? Take the GYN who scheduled the case as a laparoscopic tubal ligation, but listed every conceivable procedure: diagnostic laparoscopy, tubal ligation, possible oophorectomy, possible laparotomy, possible lysis of adhesions, hysteroscopy, myomectomy, dilatation and curettage, endometrial ablation, removal of diseased or damaged tissue and cystoscopy.

I can’t make this up. Does he have any idea all the equipment we’ll need in that room? He doesn’t. Nor does he care. Oh, and he’s an hour late.

• Nail cases. Fingernail and toenail cases can make the blood run cold and the skin turn clammy. Some shudder at the sight of a Freer Elevator being dug under the nail. Others have to look away when a nylon suture goes through the tip of the toe and into the nail bed.
• Long skin closures. Don’t you just love the new RNFA or PA who takes For-Ev-Er to close the skin, settling for nothing less than a perfect stitch. “Now, how long has the patient been asleep?”
• Know-it-all surgeons. Sometimes we can’t get out of the way of our own egos. Take the rookie surgeon who was struggling mightily to get the femoral head out during a total knee case. No matter how hard she pulled, it wouldn’t give. Staff members offered to help, but the surgeon uttered the S-words: Shut up and stop trying to help me. Double ouch. She broke scrub and phoned a friend for help. Her veteran colleague gave her the same advice that her team was trying to. Doubt she’ll recover from shooting herself in the foot. Do they issue enhanced medical licenses? OSM