The Give and Take of Surgery

By Simone Betchen

I recently applied to an executive MBA program and was asked the essay question based on Adam Grant’s groundbreaking TedTalk “Are You a Giver or a Taker?”.  He describes three primary personality types in the workplace: givers, takers, and matchers. I was asked “based on your understanding of yourself and our program, how do you intend to give and take as a student…?” Takers in general as constantly tipping the scales in their own favor.  They are out for themselves and see the world as an eat what you kill kind of place.  Matchers have a great sense of fairness in a tit for tat system. Givers look to see what others need from them and often look out for the common good.  Grant explains that in businesses, it’s the givers that end up on both ends of the spectrum as the most and least productive of employees. I sat down to think about how this applies to medicine and more specifically surgery.  While as doctors and surgeons we all are extreme givers, aren’t we all takers too in the name of patient advocacy and care? How does one describe a surgeon’s life as a giver, taker, or matcher?

I realized as I have moved through my medical training and my career as a neurosurgeon, that I have succeeded by toggling through all three types of interactions, giver, take, and matcher, on a macroscopic scale. In the beginning as a resident you are given an enormous list of tasks to complete.  Getting patients ready for surgery, doing emergency room consults, drawing blood, ordering medication, and going to the operating room to help are only a few of the roles I learned to shift among on a daily, and often hourly basis, in a way that has the potential to make the difference of life or death.  It meant navigating my way through the hospital dealing with patients, families, nurses, other doctors, and front desk staff. At every interaction, I have had to read the situation and decide how to best approach it. Sometimes as the taker I would allow another resident or specialist to take over. Sometimes as the giver I would do everything myself to get the patient safely to the operating room.  Sometimes as the matcher I would call in a previous favor done. It taught me to be agile in my interactions and able to switch around my role given what the situation needs. Now as an attending, these lessons learned continue to be utilized every day.

With all my patients, I have to gauge the interaction and make them feel comfortable in their decisions.   Some patients clearly enjoy humor and others appreciate a more serious tone. Given my years of experience at different roles in the workplace, I have learned how to read the situation and adapt my role to what is necessary at the time to accomplish the best for the patients.  In many ways, I see the role with the patient as a giver. We devote ourselves to doing what is best for each patient. On the flip side, we are often takers from the support staff around us. I often feel in the operating room like the ultimate taker, constantly asking others to do things specifically for me to carry out a successful operation.  Being the taker has its consequences. Relationships with OR staff are often strained when one is always the taker. So I try to be mindful of giving something to those around me in the operating room. Adam Grant in his talk speaks of the 5-minute favor. Giving quick medical advice, listening to a problem, or hearing a story about their kids or latest trip often helps to nurture and balance the relationship with the staff around me.

I found this exercise offered me insight and a useful explanation behind many of the things I’ve learned to do over the years.  These are the same skills all of us have. For me, I learned them slowly over time. Maybe I would have learned them quicker had I the insight to look for these balances among co-workers.  To be successful as a female surgeon, each of us has had to find our own rapport with those around us. The patients, their families, colleagues, nurses, and staff all view us in a unique way.  Relationships amongst women surgeons with patients, staff, and co-workers can be hard to navigate. Maybe if we understood the different types around us and within ourselves, the path to a successful relationship would be more apparent. Everyday we take with some, match with some, and give to everyone.

Dr. Betchen is a board-certified neurosurgeon. She currently practices at Maimonides Medical Center in Brooklyn and is proud to have served the community there for a decade now. Dr. Betchen received her medical degree from Johns Hopkins Medical School. She did internship and neurosurgery residency at Mt. Sinai Hospital in New York City. After completing a neurosurgical oncology fellowship at Memorial Sloan-Kettering Cancer Center she made the big move south to Brooklyn where she now treats a wide variety of clinical problems in both the brain and spine including tumors, hydrocephalus, chiari malformation, herniated discs, and spinal stenosis. Her research interests are in clinical outcomes and quality of life with neurosurgical treatment. Outside of the hospital she is married with two children.

---

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.