Zero Tolerance?

I thought I had managed to control my temper reasonably well. I was wrong. I blew my top twice in a matter of two days. Perhaps it was because I had bottled it up for too long. The dispatch clerk had been acting up for quite some time. He would refuse to take our files for dispatch to other hospitals, telling us to ssend our own servant to do it. I had to ask him why he and his servant received salary from the hospital. That did the trick, and he took the files. I trust he sent them to the right places and did not send them for disposal in black bags used by the hospital for household waste. But he deteriorated suddenly. Or perhaps there was new guy. I couldn’t tell, because they had similar surnames, and similar if not worse behavior. He sent back a file in the hands of the servant who took the file to him. No remarks, no reasons. One month and a few days later I found the file on my desk without anything written in it after my last entry. I had to scold our RA (record assistant) not to keep such files in the cupboard but to take appropriate action. So she called him, and convinced him to send the file by dispatch. I hope the concerned people were not greatly unconvinced by the delay caused by that fellow. The next day he sent back another file similarly. The RA was apparently more afraid of me than of him. She called him, asked for an explanation, heard that the dispatch peon had returned it, not the clerk. He took that file finally. The very next day he returned the third file in a row. They call it a hat trick, I hear. It was past 4:00 P.M., past my departure time. My RA complained to me. We called the fellow, but he would not pick up the phone. I got bugged and I decided to settle the issue permanently. So I asked the peon to go with me to see the dispatch clerk and we went to see him. He gave me a new reason. He said there was no blank paper attached after my remarks for anyone to write anything on. My voice rose. That drew his head clerk to protect him. She made even more astonishing observations like I had not written any remarks on the file. I had to help her find my remarks made that same day - she seemed special with different needs perhaps. My voice had risen some more. That drew the administrative officer there, to pacify me perhaps. I asked them how they must be treating the general public if this was the way they treated senior officers of the institute. I wondered if they realized how much damage they were causing by delaying movement of papers to the next place of action. Finally I threatened to go to the Director himself the next time this happened. Then I left before my blood pressure shot up and caused a bleed somewhere in my CNS. Today the anesthetists tried my patience beyond limit. We have two of them in charge of anesthesia personnel in our theaters. I often see them in street clothes entering the theaters at least an hour after the juniors arrive. I don’t complain because the juniors induce cases. The older lot used to keep us waiting until their seniors arrived. These two insist on giving spinal anesthesia for our patients undergoing laparoscopy. The patients are uncomfortable, often in pain. When the situation becomes unbearable, they give additional general anesthesia. I suppose it must be personal comfort. One does not have to keep ventilating a patient under spinal anesthesia as under general anesthesia. I accepted that too, because I could not do anything much about it. If the patients developed any complications because of this practice, the anesthetists would hang. Many of the anesthetists, junior as well as senior, have poor concept of asepsis and antisepsis. Their masks hang below their noses. They wipe their wet hands and forearms on the sterile gowns they are going to wear after scrubbing. They wear surgical gloves touching their outer surfaces with skin surfaces. They order breakfasts in our theaters and throw half eaten stuff around so that the theater stinks and rats abound. They talk incessantly such that we cannot hear ourselves give instructions to assistants during surgery. They declare patients fit for anesthesia, and find something to declare them unfit when they (the patients) reach the operation table. They take their time reversing the last patient, or observing the patient on the OT table (if reversal of anesthesia is not an issue as with spinal anesthesia) beyond the induction time permitted for the last case of the day, so that they don’t have to do one more case and can be free at 1:00 P.M. instead of working up to 3:30 P.M. Today they refused to induce two patients on two tables at the same time. They would induce only one patient at a time. My associate professor heard this and walked away in disgust and frustration. I asked he reason for this, and discovered that they had only one co2 monitor, not two. We had another one in the next room, which they would not move to our theater, even if it was not needed where it was. I had a big OT list, and could not postpone any of it. Patients make a lot of arrangements at home, spouses’ workplaces, and also of their finances. That cannot be wasted because of silly reasons. I had to argue with them, and they kept arguing back. I lost my patience. My voice rose and kept rising, though I could have said everything with cold logic, which I was doing any way (I mean logically, not coolly). I finally got them to call their head of department, who advised them to get the equipment from the next OT and do the job. Even then they kept grumbling and passing remarks on how unfair my remarks were. I wonder if people take up jobs in institutes like ours to have freedom to work only as much as one pleases, drawing a good salary, and having security of a confirmed job, rather than to do good for the poor patients who have no other place to go to because they have little or no money. Have I reached the stage of zero tolerance?