A surgeon walks into a neurocritical care unit. . . .

Actually, he rolled in. On a stretcher. After a TIA. Transported by EMS from the airport. And it was, sadly, no joke.

There are surgeons nobody hears about, even if they've been working in the same place for twenty years. There are surgeons you only ever hear good things about. Then there are surgeons like Dr. Guts, about whom the most complimentary thing I've ever heard is, "Well, he's not quite Satan."

This is a man I once saw push a chart rack (remember those? Welded wire, meant to hold eight or so charts at once? Big, heavy three-inch plastic chart binders, full of paper, each weighing more than a couple of pounds?) over on to a unit secretary because he didn't like something that had just happened. Nothing having to do with the secretary. If she hadn't jerked out of the way, I think the weight might've broken both her forearms.

And here he was, in my unit. I should mention that Dr. Guts has quite the reputation for patching up people whose lower intestines have sustained damage of one sort or another. He's particularly good at reattaching colons to anuses.

Like attracts like.

The first words out of his mouth when I walked into his room were "GODDAMMIT! Why is this goddamned hospital so fucking disorganized??" I greeted him, introduced myself, and prepared to do a neuro exam.

"I was examined" he sneered--and I'd never actually seen anybody sneer before; I thought it only happened in books-- "by a qualified physician less than four hours ago. I do not wish to repeat the exam."

"Good" I said. "That's gonna save me a lot of time the next time I have to assess one of your patients."

He looked at me.

"Because an exam by a qualified physician means that exam will stay stable, right? Now, look right here at my nose."

He hated the food. He hated our MRI suites. He kept complaining that the hospital was disorganized--a hospital he helped found--and that everything in the world was wrong. He bitched about the doctors, the night nurses, the phlebotomists from the lab.

Finally, midway through his second (and last) day on the unit, I said, "Is it possible for you to be any less of an asshole? Just for a minute?"

His wife, sitting on the couch with a book, said, "She has a point, dear."

A week later he was back on the wrong side of the bedrail, this time for a cardiac problem. Thankfully, not in my unit.