Blog # 133 Andrew Siegel, MD
Dr. Ray Lee was an obstetrician-gynecologist at the Mayo Clinic who died in 2012. At the Mayo Clinic he was awarded “Teacher of the Year” as well as “Distinguished Clinician.” He was instrumental in developing the subspecialty of female pelvic medicine and reconstructive pelvic surgery (my sub-specialty in Urology and that which I received board certification in in 2013, the first time the board exam was offered).
He spoke using many aphorisms that will be shared here (this information is abstracted from an article that appeared in International Journal of Uro-gynecology, written by John Gebhart: Int Urogynecol J (2013) 24:1263-1264). He taught compassion, pride, humility, and integrity–character traits important for surgeons, but equally important in all aspects of life. His words are in boldface and my explanations are in parentheses in order to help explain some of the lines that are most relevant to the context of the operating room and may not be understood by non-surgeons.
- Never operate on a stranger. (Really get to know your patient before applying the knife; have enough contact and contact time so that all parties are very comfortable with each other.)
- Communication will be critical to your practice. Be an excellent listener.
- You have a tremendous responsibility and a privilege in the care of the sick. Kindness has not gone out of style. It is better to have your name etched in the heart of your patient than having it engraved in granite outside of the building.
- Anyone can operate with good exposure and it’s a shame not everyone tries it. (Exposure is creating the greatest amount of visibility of the operative field through the use of retractors.)
- Avoid following complications with complications. (If a complication does occur, fix it definitively.)
- Your true measure as a surgeon will be determined by your performance during the most adverse circumstances. These experiences will develop your character and better prepare you for the next challenge.
- Pay strict attention to details, keep the operative field dry (free of bleeding), re-check the operative site… ensure that the anastomosis (the suturing of one hollow organ to another, typically bowel to bowel) shows perfect approximation… free of tension and perfect hemostasis (free of bleeding).
- There is nothing hemostatic about a well-placed drain. (A surgical drain is used to avoid fluids accumulating within the operative site…it should not be used as a substitute for thoroughly stopping bleeding before closing the incision).
- Do your work in such a way that you would be willing to sign your name to it…the operation was performed by me.
- I’m convinced surgeons are made and not born. Be an active learner for the rest of your life. Commit yourself to staying up-to-date in this fast-changing arena.
- Many times it will be more difficult not to operate than it will be to operate. It is important to learn the things not to do.
- Errors and failures will make an indelible mark on your heart, and they should. Like a broken bone, it is better to experience this when you are young; albeit painful, it will heal faster. Be sure to learn something from each of your errors. You will never become so accomplished that there will not be room for improvement.
- With success, never forget who you are, for we all have numerous reasons to be humble. Never let arrogance creep into your practice. Success can be more dangerous than occasional failure. Recognize areas of weakness so they can be identified, and goals can be set to correct them.
- Applaud your colleagues in public; criticize them behind closed doors, one-on-one. When giving advice, be aware that it may be least appreciated by those who need it the most.
Andrew Siegel, M.D.
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Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food: www.promiscuouseating.com
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Author of: Male Pelvic Fitness: Optimizing Sexual and Urinary Health; in press and available in e-book and paperback formats in January 2014.
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