I was on call with Nice when Toxic came to sign out to us on the patient he just operated on. He shared his plans and some labs to follow up on.

I asked if the labs had already been ordered or if I needed to order them. Things went off the rails quickly. This was routine for him to go off for random reasons. And it didn’t help that he and I never got along for some reason.

He started berating me and called me all kinds of names. I looked over at Nice. Nothing. Just looking at his shoes. As a chief resident who ran out of Fs to give, I turned around and walked away. He kept yelling as I walked away.

Later on in the evening, I was in the operating room with Nice. We didn’t talk about what happened earlier with Toxic. “I like how you handled that situation with Toxic,” he said. I didn’t respond. I didn’t know what to say to him.

This was a common and widely known behavior which many had witnessed themselves. Yet, nothing ever got said and nothing ever got done. Not even by the nice surgeons.

So when we see charts like this one showing Black and Latinx trainees being driven out of surgery and surgical sub specialties, it’s not only because of those who contribute to the toxic culture of surgery. It’s also because of the nice bystanders who say and do nothing.

As a surgeon, how are you standing up to toxic surgeons? How are you supporting trainees who are vulnerable? #BlackMedTwitter #MedTwitter #MedStudentTwitter #surgery #SoMe4Surgery

Or are you Toxic 👀?

@QaaliHussein1 I’ve had a similar experience, where consultants came back into the room to congratulate me and tell me what a great patient advocate I am. I told them all you just watched while he yelled at me, in front of a patient and their family and 20 people when you ALL agree with me???

@katelambertpicu I have been in too many similar situations to count

@QaaliHussein1 And you are chief resident, so at least you get to walk away. Imagine an surgery intern in your shoes, who just started in July, in the same scenario.

@ZinmarHtun2 I was that chief resident. I was also that intern who experienced this and much worse.

@QaaliHussein1 In this story, I witnessed 2 toxic attendings: One overtly toxic and the other covertly toxic. When you permit toxicity by silence and failure to interrupt, you are complicit and thus toxic.

@innodim

@QaaliHussein1 I went to administration once over the extreme toxic behavior of a surgeon. Instead of talking to said surgeon their solution was to never place me with him again. Um... how does that help the actual problem?

@SirenSophie It doesn’t. It sustains the status quo.

@QaaliHussein1 Way.too.common.

@QaaliHussein1 💔💔💔💔

@QaaliHussein1 It’s not even just surgery. Even in medicine toxic attendings are tolerated and even encouraged. The “nice” attendings will never say a word. Then one finishes they then pretend to be nice because they no longer have power over us. It’s pathetic.

@QaaliHussein1 I’ve realized that most days, niceness is a ploy/mask to cover indifference, cowardice, and apathy. I can’t stand ‘nice’ people for this reason and think of them as more toxic than actual toxic people. Because they lull us into this false sense of safety and security.