3 phases in a surgeon’s life · Lifestyle Founders Group™

3 phases in a surgeon’s life

Surgery can be a mixed experience, for those on the table the only outcome beneficial is to be better than before. The same should be for the surgeon. In this current time we severely overestimate surgery benefits. But what else should a surgeon do? Yes, if you do not operate you can hardly call yourself a surgeon, but by being open minded, people can dramatically improve their health status without unnecessary surgery. As someone who has seen the inside of the operating room I can tell many stories, but let’s tell this one through the 3 phases in a surgeon's life.

First phase: how to operate. When you start you want to scrub in every time you can. A 6-hour Whipple surgery? Sure. A 5-hour laparoscopic prostatectomy? I’m in. A 4-hour revision surgery in femoral fracture nou-union? Yes, please. Even the small procedures are interesting: nail removal, wound suturing, skin tag removal. You want to do, assist, see as many as possible, because one time you will be the one to do these grandiose procedures, being in the spotlight, carrying the weight of responsibility for the patient's outcome. Many struggle even in this phase. Why? They are not as dexterous, they are lazy, they are not interested. Then why choose surgery? There are many reasons why someone lands in this field either by parental pressure, or they have a plan just to survive residency and then do their own thing. On the other hand many attendings simply don’t care, they just want a pair of hands to assist and someone to fill in the paperwork, so they don’t have to deal with administration.

Second phase: when to operate

If you stay in the first phase, then your superiors make the decision for you. The others enjoy this phase, finally they have some confidence in their ability to persuade the patients into surgery. They can rationalize why surgery will have a better outcome than any other treatment or it can act as a supplementary treatment. They spend long hours in the operating room, they enjoy doing surgery, sometimes at the expense of all other aspects of their life: health, family, relationships, financial decisions. They create their own echo chamber, when they connect with similar minded surgeons. Implementing new techniques, doing research, finding mentees, it all very existing. Until the complications pile up. That’s mostly the first warning call, if you ignore your crumbling relationships, your constant debt payments, alienated kids… Don’t get me wrong surgery carries risks, even if you are the best surgeon in the world, you can not avoid this. It is always how you deal with them. You can ignore them, saying your workflow is perfect, you can refer them to other surgeons, they will eventually hate you or you change something. Which is a trait not many surgeons have. They like their workflow, because it took years, long nights and little free-time to materialize the current situation. Being in the spotlight, doing surgery they want, not many can get to such a stage. And something should change. While a transient surge of complications can be resolved, the next wave can be more detrimental. You either start to see your downfall or you ascend to the next phase.

Third phase: when not to operate.

In trauma surgery there is a term called personality of fracture. While strict objective measures like fracture lines and sites dictate an operative approach. Seeing the patient, getting an impression of them could mean a definitive conservative approach. Or you just suggest some conservative measures before operative treatment is considered. After the conservative approach the need for surgery completely vanishes. This stage is not accessible for all surgeons. Either too shy to find the right patients for surgery or too vain to take an U-turn and find another approach. In this stage you don’t care how many surgeries you have done the last week or the last month. You simply care that the patient's wellbeing is the priority. Teaching your mentee’s to be thoughtful. Shiny object syndrome has left your thoughts. Recognizing which new treatments have potential and sticking to old treatments that provided value over time. You also take time with patients to illuminate the benefits of conservative treatment. This stage does not mean you have given up on surgery, but you recognize that stat padding procedures, piling up on surgery cases is not sustainable in the long run.

The last phase is usually reserved for seasoned surgeons, who left many nights and days in the operating room. Maybe I ran through the stages too soon. But I am grateful that I achieved this phase earlier than later. I got clarity on how to approach surgery, medicine and life as a whole. Helping those who want help, not helping everyone for the sake of helping. And also not being at the tailend of treatment for many conditions and tackling them before redundant procedures are made.

1 comment

3 phases in a surgeon’s life