Once there was a man so confident in his opinions he decided to become  a surgeon. He felt medical school was unnecessary and a waste of time, because he believed he had a great native intelligence and ‘feel’ for surgery already. In fact, as he saw it, he had a kind of instinctive genius on every subject that crossed his mind.

Using fake credentials, he managed to talk his way into a senior-level job at a teaching hospital. He was assigned nine medical students, who would accompany him on his rounds and in the operating room.

As the man proceeded to attempt various surgeries based on diagnoses provided by attending physicians, it became clear to his students that he was not a very good surgeon. But they kept quiet, or phrased their comments carefully so as not to insult someone who could decide their fates. “This is an appendectomy,” one might say during an operation, “perhaps we should remove the appendix instead of the gall bladder? I mean if you agree.”

Knowing these students had the edge on him in terms of knowledge and expertise, the phony surgeon would comply. But his considerable ego was bruised, and his ire increased, a little more with each comment. He developed an innate hostility toward those students who kept correcting him. He wondered about their priorities – about their loyalty. To him, it seemed some of them were just trying to make him look bad, or worse—to expose him.

One day he had had enough. During a fairly routine operation, the patient went into cardiac arrest. The phony surgeon continued on as if nothing was wrong, removing a healthy section of bowel rather than the cancerous part indicated by the x-rays. “I think we need to attend to this infarction, sir,” one brave student offered.

“Yes, well I’m in charge and I say we continue the operation. I’m almost done.”

Eventually the patient was stabilized and in the recovery room. But his cancer remained and he had serious heart damage. He suffered another heart attack and died.

The medical students knew this surgeon was incompetent, but what could they do? “Well,” said one to the others, “I’m not just going to stand by and let this fool continue to kill his patients.” The student reported the surgeon to the hospital director, and the medical board convened a hearing. 

At the board hearing, the clever impersonator defended himself vehemently, expressing indignation at the gall of some inexperienced nobody of a student second-guessing his professional judgment. “It’s a complete hoax,” he said. “No one told me about the heart attack, and in fact I’m not so sure there was one. Lots of alarms were beeping, who could know what it was, and how could I do anything different anyway? I was concentrating on the surgery. In fact it was a perfect operation, it was beautiful, you can ask anyone who was there. And anyway, people are telling me the patient had a history of bad behaviors — smoking, drinking, no exercise, drugs maybe — who knows? I really I inherited a mess there. And that student who reported me—she’s always had it in for me for some reason. She’s not even from this country, maybe she hates people from this country, I don’t know. She lies all the time and has a very low IQ from what I’ve heard. Believe me, she’s a nasty person, a real dog. I don’t know, maybe I’m wrong, but many people are saying it.” 

After some debate, the phony surgeon was narrowly cleared of all charges. While a sizable minority wanted further investigation, the majority and the chairman made it clear they weren’t going to continue to jeopardize the career of a valued teaching surgeon based on the accusations of a single student, whose own allegiances and motivations were now questionable. And after all, there’s the reputation of the hospital and medical school as a whole to consider. 

The medical student who reported the phony surgeon was reprimanded for insubordination. She eventually dropped out of the program under pressure from the junior teaching staff and some of her fellow students, who privately referred to her as “the rat.” Finally, after a new investigation involving the local FBI, she was deported based on some problem they found with her initial visa application.

The hospital was glad to have things back to normal. A disturbing trend of negative patient outcomes had recently been identified, and the counterfeit surgeon had hinted to the board chairman that he knew of a few students who seemed to him to be, in his words, “real losers.” The board and the staff needed to focus on that inquiry.

You could hear many of the staff, during informal hallway conversations, remarking on the ex-student, wondering why she was so full of hate, why she wanted to disrupt everything and distract the hospital as a whole from its important work just because of her personal feelings toward her mentor. Sure, he was brash and arrogant, and he rubbed many the wrong way. But he wasn’t hired to be liked, he was hired to get important work done. Why couldn’t she just let him alone to do his job? Why had she become so obsessed with bringing him down?