How it Started
Anyone can walk into an ER with a minor ear infection, laceration, fever, or broken bone, but at a tertiary care hospital, the choices also include children with rare medical conditions who are cared for by the specialists at UCSF. As the story slowly unfolded, I slowly realized that David, the senior pediatric resident, didn’t have a clue how to handle the situation. When we learned that he was a patient of one of the pediatric endocrinologists in the department the light went off. BINGO: he had a rare pituitary condition which resulted in hypoglycemia, low blood sugar, and seizures.
There are 4 Choices
The ideal situation is being on call with a competent senior resident who would also be as engaging like David. When there were no patients, the competence criteria wasn’t very relevant, but when the patient arrived, I realized David was in the wrong box. I would have gladly traded our delightful conversation for someone in the competence plus box when the child was having a seizure in front of us.
Start Where You Are
Twenty years later I was sitting at a small biotech company in Silicon Valley and had to hire a statistician as we grew our team to do clinical trials for therapeutic monoclonal antibodies for different diseases. I had interviewed a soft spoken applicant with an impressive resume, but who exuded a high level of social awkwardness. Of course, he would do an excellent job, but I kept going back to the application of the consultant who I had been working with for the past year. Maybe his resume was less extensive, but I looked forward to our meetings and never questioned his expertise. That’s when the 2 by 2 table flashed back in mind. Given the choice between two candidates, both competent, the lunch factor was catching up to the competence factor. I hired the consultant. Our tenure at the company is now history for both of us, but I never looked back on my decision and still consider him a friend.