Bad Guys Corner

An Editorial from the Chief Resident’s Desk 

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Every residency program has a villain. In ours, it’s me. I know the reputation. I’ve heard the whispers in the call room and the half-jokes after rounds. “Malignant chief.” “Hard to work with.” “Impossible standards.” It’s become a kind of folklore in surgical training that every service has a Bad Guy, someone whose job seems to be making everyone else’s life miserable. But if you’re waiting for a confession or apology, you’re going to be disappointed. 

Here's how I see it: I'm a 13th century cobbler - the best in the biz. In the entire village, to be specific. You are my lowliest apprentice, here to deliver my every request without question or delay. If I need a piece of tanned leather, I expect you to anticipate that need before I voice it, and have that in my hand before my lips part. If you are exhausted from the 18 hour days 7 days a week, keep that to yourself. How do you think you get to become the #1 cobbler? Taking long lunch breaks, or golden weekends off?

Your job is not to evaluate the workshop environment or comment on the teaching style of the master. Your job is to watch, to fetch, and, if you are clever, to anticipate. If I reach for a strip of leather, it should already be in your hand. If I need a tool, it should be there before I have to ask. A good apprentice listens. A great one already knows what comes next. Half the time I feel like I’m running a shop full of apprentices who are surprised the work is hard.

You mention the hours a lot. The long days, the early mornings, the sense that the work stretches endlessly in front of you. The exhaustion. The feeling that you are constantly behind.

There’s also the matter of tone, which seems to concern you. Apparently I am too direct. I interrupt when something is wrong. I correct you sharply instead of waiting politely for the end of your presentation. But when you are learning a craft, corrections are rarely whispered.

If you ruin a piece of leather, it cannot be un-ruined. If the stitching is crooked, the shoe fails. The customer returns angry, and the reputation of the shop suffers. Precision matters. Details matter. Knowing exactly what you’re doing—before you do it—matters.

You interpret this as hostility. I interpret it as training.

What fascinates me is how every generation of apprentices believes they are the first to discover suffering. The hours are worse than ever, the expectations unfair, the masters crueler than the ones who came before. And yet, somehow, the craft continues.

The truth is that the work has always been hard. The difference now is that we spend a lot more time discussing how hard it feels.

None of this means I want you to fail. Quite the opposite. The entire point of this arrangement is transformation. Right now you are clumsy with the tools. You hesitate. You ask questions whose answers you will eventually know instinctively. If you stay long enough, that changes. Your hands move faster. Your instincts sharpen. One day you notice you’re anticipating the next step without thinking about it. Eventually you stop being the apprentice who needs to be told everything.

And then something interesting happens: you become the one running the shop. When that day comes, you will look across the room and see a new apprentice standing exactly where you once stood—tired, overwhelmed, convinced the master cobbler is the villain in the story.

And you will hear yourself saying the same thing I say now.

Hand me the leather. Not that one. The other one.

Honestly. Didn’t they teach you anything at that school of yours?

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