I recently went to my high school reunion where a classmate said to me “you seem too nice to be a surgeon”. It was a reminder to me that the stereotype of the mean, angry surgeon as recently discussed in the AMA Journal of Medical Ethics is present outside of the medical field. I first learned about this stereotype as a medical student, and was surprised since my own experiences as a surgical patient were very different from what is perpetuated in popular culture and surgical lore.
My first memory of meeting with a surgeon was at age twelve when I was told that my spine had a curvature seen on a chest x-ray for pneumonia. I was referred to see an Orthopedic Surgeon at my local academic medical center. We went through a series of steps that day starting with specialized x-rays to further examine the abnormal curvature of my spine. Finally, I met with Dr. Stuart Weinstein and a plethora of orthopedic trainees and students. Noting my nervousness at being examined by a crowd, he sat down and explained that I would contribute to their education if I allowed them to participate in the visit. He emphasized that it was my choice.
Not only was he compassionate and patient, this doctor was talking directly to me and making the visit about me rather than my parents. I stopped feeling terrified and began to feel empowered. This was the beginning of a long journey of scoliosis treatment. Eventually I was given a back brace to wear 23 hours a day to try to stop my double curvature from progressing. I met with Dr. Weinstein every 6 months for the next several years to check the progress and my brace fit. Each time, he spoke directly to me with the same level of compassion encouraging me to continue activities like dance that would maintain a strong core. At some point, I learned that he was a renowned expert on my disease. Yet he approached me with the same humility even when I returned years later for a second opinion after another doctor recommended that I undergo surgery even printing research articles for me to read.
My other encounter with a surgeon was for an elective jaw surgery. I met with Dr. Edward Lorson several times over the years leading up to my surgery which included bracing to correct my teeth which had grown crooked to compensate for a prognathic mandible. He patiently explained to me a technique for surgery involving the placement of screws in my jaw via small neck incisions that would allow me to avoid having my jaw wired shut for six weeks. It was a difficult decision for a 17-year-old and he addressed my concerns about having visible scars on my neck. He took the extra time necessary to counsel me regarding the pros and cons leading me to the best option in a shared decision-making fashion. As a surgeon, I now understand that this takes more time and patience than a paternalistic approach to informed consent.
Being a patient is not easy even when treatment goes as planned. During my recovery from jaw surgery, I felt depressed and horrified at the swollen unrecognizable face staring back at me in the mirror. Dr. Lorson encouraged me to wash my tender face, get out of the house, and continue the protein-rich shakes to promote healing. It cannot have been easy to deal with me during that time, and I still appreciate his compassion and patience.
Experiencing surgery first as a patient helps me to understand how important it is to maintain compassion and patience even when we are under stress ourselves. I am fortunate that my experiences as a young patient were marked by compassion, patience, and respect for me as an individual. As humans, we all have moments where we act in haste or say things out of anger that we regret. If we stop believing that this is the dominant behavior of surgeons, then we can begin to show patients and each other the same compassion that alleviated my concerns so many years ago.
Lillian Erdahl, MD, FACS is an Assistant Professor of Surgery at the University of Iowa where she practices Breast and General Surgery. She is also Associate Program Director in General Surgery; head of the Iowa City VA Breast Clinic; Communications Director for @UIowa_Surgery; and involved in curriculum development for medical students, residents, and fellows. Her research interests include breast cancer prevention and treatment, faculty development, and surgical education. Her work for gender equity in medicine includes involvement in the Association of Women Surgeons as co-chair of the Twitter subcommittee and the @PROWDWomen group.
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