H

is name was Marvin but I called him “Dr. Himmelman” when we were in session together, even though most of my patients introduce themselves by their first names. Yet in my mind, he was “Angry Doc.” He’d been referred to me by the head of his hospital after a string of incidents that were becoming untenable. He’d spent years yelling at nurses, students, administrative staff, other doctors, and even patients. But what finally set things in motion wasn’t his language or even his tone; it was that our mutual friend — who happened to be the hospital director — had found out that Angry Doc was taking meds for high blood pressure and told him, “You need to learn how to relax.” This escalated into a shouting match, which lead to a referral to my office with the threat of a suspension from hospital-related activities should Angry Doc refuse to comply. Angry Doc, without much choice in the matter, chose the less embarrassing of the two.

“They tell me I need to relax,” he said after we exchanged some stilted pleasantries. “But I’m telling you, these morons don’t understand how medicine is supposed to work. One doctor gives orders and the rest of the team carries them out. That’s how patients get healed. That’s how I do my job.”

“Maybe there’s something else?” I prodded.

“Listen, Dr. Freedman, I’m not here to schmooze or to make friends. I already have friends and I don’t have time for schmoozing. I run the busiest emergency room in the city. I don’t need what they call ‘anger-management’ and I definitely don’t need a psychiatrist.”

“So you’re not an Angry Doc?”

“Absolutely not!” he shouted.

I’d met angry docs before, and was in medical school in New England when I heard one of the most outrageous Angry Doc stories. While both the surgeon and anesthesiologist were respected individuals in their field, the surgeon waited half an hour for the anesthesiologist to show up. By the time the anesthesiologist came into the operating room, the surgeon had already lost his patience and made a snide remark about punctuality. Not one to go down without a fight, the anesthesiologist then made an inappropriate comment about one of the surgeon’s family members and before you knew it, there were surgical instruments flying across the room and the two of them were wrestling on the floor. According to hospital legend, the terrified patient jumped off the operating table and scampered out to safety where he alerted security.

I’d met short-tempered cardiologists and furious obstetricians during my training, but this particular Angry Doc — despite his short fuse and improvable bedside manner — was actually a pretty nice fellow, as opposed to Angry ICU Doc who had been through three divorces, and Angry Spinal Surgeon who’d been arrested for assault after some unlucky soul rear-ended his Ferrari. This Angry Doc gave a lot of tzedakah to Jewish organizations and served on the board of the local Bais Yaakov. As his boss assured me, “He’s really a good guy, he’s just a terror in the hospital and it’s taking a toll on his body. He’s only 49. You’ve got to help him before he has a stroke from all the stress.”

But you can only help someone who acknowledges that he has a problem, yet Angry Doc felt he was doing “an exceptional job” according to his own assessment. “Our department has one of the lowest rates of medical errors in the entire hospital, and our documentation is flawless,” he told me. “I’ve created one of the single greatest emergency departments in the country.”

But it sounded like he had also created a dictatorship and had lost a number of good staff in the process. One of his best junior doctors left, and if you’d ask the young physician himself, he’d tell you that it was because his department chair was a terror — but Angry Doc saw it differently: “He was soft. He couldn’t handle the stress of the situation.”

“It certainly is a stressful situation running an ER,” I said. “I can only imagine how difficult it must be and how many things you’re juggling each and every moment.”

“You have no idea,” he said. “If I’m not on top of everything, then the entire department crumbles and lives are on the line.”

“That’s why you’re so intense at work?” I asked.

“You bet your entire student loans that’s why I’m intense. I’m intense because the situation is intense.”

“But it sounds like they think you’re angry.”

“Sure I get angry sometimes,” he began to yell. “I need to control the situation or it falls to pieces!”

I nodded my head. “You know, my rav, Rabbi Naftoly Bier of the Boston Kollel, always cautioned us med school guys never to become Angry Docs.”

“I’m not an Angry Doc!” His face turned red. “I’m just in a situation that always needs someone to take control before people start dying left and right in the ER!”

I sat quietly as he calmed down.

“I’m sorry, Dr. Freedman. I’m really not an angry guy, though.”

“I know, Dr. Himmelman,” I said in my most soothing voice. “Now let’s take a few deep breaths,” which we did together before I continued. “I know that you’re a good guy. I know you have good kids and are a tremendous baal tzedakah. But Rabbi Bier always told us, ‘The trap of anger is that a person gets angry because he wants to be in control, but as soon as he gets angry he loses all control.’ Dr. Himmelman, your staff is scared of you and your best junior doctor quit. And I bet you’d be even more effective if you could run things without screaming and yelling all the time. It can’t hurt to try, because the other way clearly isn’t working.”

“And what makes you say that, Dr. Freedman?”

“Because you’re sitting in my office. Plus, you’re taking antihypertensive medications, which means that decreasing your daily stress is imperative.”

“Hmm… I guess I can agree with that. So what do we do?”

“We start with learning relaxation and mindfulness exercises.”.

Angry Doc stood up to shake my hand and cracked a smile. He seemed relieved at the prospect of getting some help. “Okay, I’m in,” he said, “as long as you agree I’m not an Angry Doc.”

“Prove me wrong,” I said as I walked him out the door.

Originally featured in Mishpacha, Issue 717. Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy