Paradigms

Life should be simple, and it indeed will often be simple, if only we permit it to be so. Let us take the example of resident doctors in training. Some of them do things in ways that are beyond sound logical explanation. The other day I found a patient was receiving oxygen by face mask in the postoperative ward. I asked them why she was receiving oxygen, thinking there must be some serious problem. The resident promptly turned off the oxygen flow and remocved the face mask. Poor woman must have cursed me for stopping her oxygen supply if she was enjoying it. On the other hand she may have blessed me for getting that mask removed from her face, because it is not an enjoyable experience, and oxygen is anyway odorless and not necessarily pleasant to breathe. I was not satisfied with the act, and expressed desire to know why she was being given oxygen. They wouldn't tell me, but finally told my associate professor who is kindly, sympathetic and motherly. It turned out that she had undergone a cesarean section early morning, and it was their practice to give oxygen postoperatively to all women. I asked if it was done under general anesthesia. It wasn't. She had received spinal anesthesia. I asked if she had a cardiac or respiratory disorder causing hypoxia. She didn't have any such disorder. So I asked the rationale behind oxygenating all women postoperatively. They again mumbled something into the Associate Professor's ear, who informed me that they gave it as a safety precaution, since there was no recovery room as such, and patients who underwent operations under general anesthesia might become hypoxic if taken out of the operation theater before full recovery took place. Somewhere down the line, the minimal rationality of this action was lost. Now they did it because that was the way things were done around there. It was a paradigm shift. If only they had bothered to ask us if they should do so, and what was the reason for doing so or not doing so, as the case may be. But they prefer to do what residents one or two years senior to them tell them to do, who in turn have picked up that wisdom from residents a couple of years senior to them. The reason why they don't ask the boss could be any of the following. 1. They are afraid of the boss. 2. They believe it is not worth the bother. 3. They believe the boss is unlikely to know. 4. They believe the resident advising them is more knowledgeable than the boss. 5. They believe it must one of the management guidelines of the institute. 6. They trust the paradigm. I wish I could give this multiple choice question to them as a test, but wonder if they will know the right answer. A clinical psychologist would perhaps be able to tell me, but I don't know any.