Can’t kill dirt

Today I heard a story. 

The story centered on an interaction between an attending and a resident in an inner city hospital with a high intake of repeat patients coming in with knife and gunshot wounds. 

The resident was baffled by the ability of many patients to survive and recover in spite of these violent traumas. So, s/he goes to the attending and asks “How the heck do these patients survive?”

The attending’s answer? 

“You can’t kill dirt.”


Yea…that answer has soooo much wrong with it. 

It shows enormous disrespect (even contempt) for patients and dehumanizes the people coming in for these violence-related wounds. 

Yes, seeing these repeat patients would be immensely stressful and intensely frustrating, and yes it would be easy to mask this stress in callousness. But the concept that a person’s socioeconomic status or other characteristics makes a person harder to kill, and comparable to impervious filth seems appallingly dangerous. 

Upon hearing this story, a visiting researcher in the group had the guts to comment that the story really wasn’t that hilarious and that the quote from the anonymous attending was appalling. This comment seemed to fall on deaf ears*.

I just don’t know what to make of this story and my fellow listeners’ reactions to it…is this sort of thing just harmless stress relief, or necessary distancing from the daily trauma**? Or do interactions like these truly harm patients, the standard of care, and society in general?

*this story was told in a social context, so not the most conducive atmosphere for critical analysis, but still…

**Mary Roach’s book “Stiff” has a really fascinating discussion of the shift away from humor and emotional distancing and towards respect and empathy in dealing with the emotional toll of human cadaver dissection in medical schools. From my limited experience similar coping strategies (both disrespectful and respectful) would likely be used in emotionally stressful interactions with patients.


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