Punishment

It happened quite some time ago. I cannot forget it because it is tearful and funny at the same time. "If you admit you have committed a grave willful error in that patient's management, what punishment do you think you should have?" I asked my residents. I do not believe in treating them like children. I prefer an adult to adult relationship, as in transactional analysis of Eric Burne. But if they continue to commit the same misconduct despite repeated instructions to the contrary, and when asked for an explanation come up with only 'sorry, sir', I cannot take any other stand but that of a strict parent. Probably punishment is the only method, if at all, of correcting such people. "I think I must tell the Dean to take disciplinary action on you." "Please don't tell the Dean. We will take any punishment you give, sir" they said. There were two of them both girls, and quite scared girls at that. I was not going to tell the Dean. It was my job as head of the unit to correct treatment errors of residents so that patients still got the best treatment and and to prevent residents committing mistakes so that they became better doctors. But there was no point in telling them so. "Any punishment?" I asked incredulously. "Any punishment!" they confirmed. "OK. Write down the entire text-book of Williams' Obstetrics ten times" I said quietly. They were too upset to look stunned. They kept quiet. "If not that, let us stop your operative work for the remaining duration of your current posting. How long do you have?" "Three and a half months, sir." "OK. So no operative work for that period" I said. "Please sir, I want to learn how to operate. Not this punishment, sir" said the first year resident. "Then write Williams' Obstetrics ten times" I suggested. "OK sir" she said tentatively. "Do you think you have enough time left to write that much?" I asked mildly. The second year resident was scheduled to go on exam leave in one and a half month's time. She had no time. She kept quiet. "Have you seen Williams' Obstetrics?" I asked the first year resident. Perhaps she thought it was a tiny booklet, like our labor ward protocol book. "Yes sir. It is that thick" she spread her fingers as much as possible to show how thick it was. "The how will you write it ten times?" "I will try" she said. So she would probably write two pages and then declare she had failed. "Can you not think of any other punishment?" I asked. "We will go to the patient and apologize" they offered. They were truly idiots if they believed it would work. Either the patient and her relatives would bash them up or take them to a consumer court. "Go away" I said. "Sir, please" they begged. "Please go away" I corrected myself. "Sir, please" they said again.They must have missed what I said. "Now what do you want?" I asked. "Please give us punishment" they said. "Write down what you did" I said and gave them two sheets of paper. "Sir, please" they said. "You don't want to write Williams' ten times. You don't want to write even one sheet of paper. That is not fair." I got up and left because they would not go away, and to watch two girls cry was a punishment for me. A half hour later they found me and handed me two sheets of paper with their apologies. I still have them. I am toying with the idea of framing them and giving them to the two girls perhaps as their graduation gifts, to be hung where they can see them periodically and behave.